38 research outputs found
Impediments to Disability Accommodation
The results of a qualitative field investigation exploring how tripartite relationships affect disability accommodations are reported. Arbitration cases, in-depth interviews and other documentation are analyzed using grounded theory techniques. Four key categories emerge as contributors to difficult accommodations. The first category suggests that managerial reluctance and bias may stem from added workload or from questions about disability credibility. It further demonstrates how trust issues spill over to affect future accommodations. The second category, employee involvement, indicates that excluding the disabled employee from accommodation planning occurs frequently and has a negative affect on communication patterns, again damaging trust. The third category, ineffective investigation, highlights the difficulty managers have balancing confidentiality requirements: over-investigating illness legitimacy and under-investigating accommodation options. The final category, union-management climate, looks at union roles in accommodation and suggests that while unions often play a unique and positive role, substantial union-management animosity taints return-to-work efforts.L’accommodement en milieu de travail dans les cas d’incapacitĂ© peut semer la confusion et apparaĂ®tre compliquĂ©. Il y a rarement des solutions toutes faites car chaque situation prĂ©sente un ensemble unique de circonstances. Quand un salariĂ© est frappĂ© d’une incapacitĂ©, on exige de l’employeur et du syndicat qu’ils fassent tous les efforts raisonnables pour arriver Ă un accommodement. Parfois chacun en sort content, le salariĂ© retourne Ă son travail et progresse d’un emploi adaptĂ© Ă sa condition vers un retour Ă ses pleines responsabilitĂ©s ou bien on lui trouve un travail adaptĂ© Ă son incapacitĂ© avec assez de facilitĂ©. Dans d’autres situations, cependant, le processus d’accommodement est semĂ© d’embĂ»ches et peut donner lieu Ă un litige.Alors, on doit se demander qu’est-ce qui fait la diffĂ©rence entre ces deux scĂ©narios ? Y a-t-il quelque chose que les employeurs ou les syndicats font qui puisse diminuer les chances de succès de l’accommodement raisonnable en milieu de travail ?Nous avons examinĂ© soixante-douze dĂ©cisions arbitrales (qui reprĂ©sentent plus de 1500 pages de texte) et effectuĂ© vingt-trois entrevues en profondeur. Nous avons ensuite analysĂ© toutes ces informations Ă l’aide de techniques de codage appuyĂ©es sur des mĂ©thodes d’analyses thĂ©oriques pour tenter d’identifier les facteurs qui, dans une relation tripartite, peuvent affecter nĂ©gativement le retour au travail. Quatre catĂ©gories de facteurs contribuant Ă rendre l’accommodement plus difficile se sont dĂ©gagĂ©es de l’analyse de donnĂ©es : 1) l’attitude de l’employeur, 2) l’implication du salariĂ©, 3) une enquĂŞte inefficace, 4) le climat des relations du travail.Dans la première catĂ©gorie, celle de l’attitude de l’employeur, la recherche montre que les employĂ©s ayant besoin d’un accommodement perçoivent frĂ©quemment des prĂ©jugĂ©s ou des actions prises Ă leur Ă©gard Ă contrecoeur. Les donnĂ©es nous suggèrent que dans plusieurs occasions ces perceptions peuvent ĂŞtre exactes. La latitude de l’employeur dans le choix des mesures d’accommodement peut aussi permettre l’exercice de traitements privilĂ©giĂ©s. Ainsi, dans certains cas, des travailleurs peuvent rĂ©colter les avantages d’un accommodement exceptionnel, alors que d’autres peuvent ĂŞtre forcĂ©s d’accepter des offres rigides et dĂ©favorables imposĂ©es par des supĂ©rieurs moins sympathiques.Les donnĂ©es tirĂ©es des cas indiquent que des prĂ©jugĂ©s peuvent aussi survenir du fardeau additionnel que placent sur les employeurs les exigences de l’accommodement compte tenu du peu de rĂ©compense pour leurs efforts. D’autres prĂ©jugĂ©s peuvent aussi apparaĂ®tre si les employeurs mettent en doute la crĂ©dibilitĂ© des salariĂ©s au sujet de la lĂ©gitimitĂ© de leur incapacitĂ© ou des restrictions prescrites. Ceci se traduit parfois dans des accommodements qui visent Ă punir les salariĂ©s handicapĂ©s. La rĂ©sistance des employeurs, quelle soit perçue ou authentique, est importante parce que : a) elle accentue le conflit et la mauvaise communication; b) elle diminue la qualitĂ© de l’accommodement offert; c) elle diminue l’engagement du salariĂ© impliquĂ© Ă l’endroit de l’organisation et du processus de retour au travail. De plus, il existe une certaine preuve Ă l’effet que l’expression d’enthousiasme de la part de l’employeur Ă l’endroit des mesures d’accommodement et du retour de l’employĂ© a Ă©tĂ© observĂ©e et imitĂ©e par des collègues de travail, ce qui peut en avoir amplifiĂ© les effets.Le deuxième thème qui s’est dĂ©gagĂ© de l’analyse a Ă©tĂ© l’exclusion de la personne atteinte de l’incapacitĂ© dans la planification de l’accommodement en vue de son retour au travail. Cette exclusion n’est pas nĂ©cessairement voulue. Cependant, la preuve laisse croire que, si elle n’est pas explicitement intĂ©grĂ©e aux responsabilitĂ©s et aux rĂ´les des employeurs, il est fort probable qu’on n’y porte pas attention. L’étude de cas dĂ©montre que le fait d’exclure ainsi les employĂ©s concernĂ©s peut rĂ©sulter en une incomprĂ©hension Ă l’égard des aptitudes de ces salariĂ©s, de leur volontĂ© de travailler ou bien Ă l’égard du dĂ©sir de l’employeur de les voir rĂ©intĂ©grer le travail. Ă€ moins que l’employeur invite le salariĂ© Ă assister aux discussions sur la planification du retour au travail, ce dernier ne sera probablement pas renseignĂ© sur les options envisagĂ©es, les considĂ©rations inhĂ©rentes Ă la production ou encore les limites dans l’établissement des horaires de travail, qui peuvent exercer une influence sur l’offre finale d’accommodement. Cela peut par inadvertance soulever des questions, mĂŞme dans l’esprit des employĂ©s qui jouissent d’excellentes mesures d’accommodement eu Ă©gard Ă l’effort ou Ă la qualitĂ© de l’accommodement.Le troisième thème qui est ressorti des donnĂ©es est la confusion tant chez les employeurs que chez les salariĂ©s au sujet de l’équilibre Ă conserver entre une enquĂŞte suffisante sur l’incapacitĂ© et le harcèlement des employĂ©s. Dans 64 % des cas oĂą les griefs ont Ă©tĂ© maintenus, les arbitres ont statuĂ© que l’échec des employeurs face Ă une investigation correcte permettait de conclure que l’obligation d’accommodement n’avait pas Ă©tĂ© rencontrĂ©e. Les employeurs ne rĂ©ussissaient pas Ă colliger suffisamment d’information eu Ă©gard Ă l’ampleur de la maladie de l’employĂ©, Ă sa capacitĂ© fonctionnelle ou aux ajustements possibles Ă ses tâches qui faciliteraient l’accommodement. Dans d’autres circonstances, les employeurs ont outrepassĂ© les liens de confidentialitĂ© ou bien ils ont harcelĂ© les employĂ©s lorsqu’ils ne croyaient pas Ă l’authenticitĂ© de leur incapacitĂ© ou de leurs limitations.La dernière catĂ©gorie, celle qui concerne le climat des relations patronales-syndicales, montre que les syndicats ont un rĂ´le unique et positif Ă jouer pour faciliter le retour au travail des employĂ©s. Les rĂ´les qui nous ont Ă©tĂ© dĂ©crits en entrevue et qui ont contribuĂ© Ă des accommodements rĂ©ussis incluaient : a) l’assistance aux employĂ©s frappĂ©s d’une incapacitĂ© auprès des organismes publics d’indemnisation des travailleurs ou auprès des assureurs privĂ©s; b) l’offre d’un support psychologique et d’aide dans le labyrinthe des processus administratifs de retour au travail; c) le maintien d’un lien avec les salariĂ©s absents de leur travail pendant leur convalescence et, enfin, d) l’insistance auprès des employeurs pour qu’ils regardent de plus près lorsqu’une solution convenable n’apparaĂ®t pas immĂ©diatement Ă©vidente.Par contre, de mauvaises relations patronales-syndicales jouent parfois un rĂ´le très destructeur en brouillant les communications et en interfĂ©rant au moment de l’identification des options d’accommodation. Dans ces entreprises, les syndicats sont perçus par les employeurs comme des institutions politiques dĂ©montrant peu de considĂ©ration pour le bien-ĂŞtre de leurs membres. Les dirigeants syndicaux ont Ă©tĂ© accusĂ©s d’obstruction Ă des tentatives d’accommodement en refusant des croisements de groupes de salariĂ©s ou en avisant les employĂ©s de ne pas divulguer de l’information mĂ©dicale. Une mĂ©fiance Ă l’endroit des motifs du syndicat Ă©tait constamment manifestĂ©e par les dirigeants qui soutenaient qu’un raisonnement propre au monde des affaires pouvait ĂŞtre retenu comme une manière d’expliquer l’approche plutĂ´t prudente mise de l’avant par le syndicat face au processus de retour au travail. Les attitudes nĂ©gatives ont mĂŞme Ă©tĂ© observĂ©es par des travailleurs du secteur de la santĂ©, qui considĂ©raient l’environnement de travail empoisonnĂ©, ralentissant le processus d’accommodement et interfĂ©rant avec la confiance entre le personnel mĂ©dical et les employĂ©s handicapĂ©s.En conclusion, nous soulignons les apports uniques de cette recherche et nous recommandons des avenues potentiellement fructueuses pour d’autres travaux sur le sujet.Se presenta aquĂ los resultados de un estudio cualitativo de terreno que explora cĂłmo las relaciones tripartitas afectan la acomodaciĂłn de discapacitados. Utilizando las tĂ©cnicas de la teorĂa enraizada, se analizaron casos de arbitraje, entrevistas en profundidad y otros documentos. Cuatro categorĂas claves emergen como elementos que dificultan las acomodaciones. La primera categorĂa sugiere que la falta de interĂ©s y suspicacia de parte de los directivos pueden provenir de la carga de trabajo agregada o de cuestiones relativas a la credibilidad de la invalidez. Se demuestra, más adelante, cĂłmo estas cuestiones de confianza desbordan afectando las acomodaciones futuras. La segunda categorĂa, la implicaciĂłn de los empleados, indica que el empleado discapacitado es frecuentemente excluido de la planificaciĂłn de la acomodaciĂłn y que esto tiene un efecto negativo en el modelo de comunicaciĂłn, dañando una vez más la confianza. La tercera categorĂa, la investigaciĂłn ineficaz, resalta la dificultad que los directivos experimentan para equilibrar los requerimientos de confidencialidad: investigaciĂłn excesiva sobre la legitimidad de la enfermedad e investigaciĂłn insuficiente de las opciones de acomodaciĂłn. La Ăşltima categorĂa, el clima de las relaciones patronal-sindicales, señala el rol de los sindicatos en la acomodaciĂłn y sugiere que mientras los sindicatos juegan con frecuencia un rolo Ăşnico y positivo, la animosidad sustancial de las relaciones patronal-sindicales empañan los esfuerzos de retorno al trabajo
Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14?16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change. Electronic supplementary material The online version of this article (doi:10.1007/s10926-016-9664-z) contains supplementary material, which is available to authorized users
The Job Accommodation Scale (JAS): Psychometric Evaluation of a New Measure of Employer Support for Temporary Job Modifications
The final publication is available at Springer via http://dx.doi.org/10.1007/s10926-014-9508-7An employer offer of temporary job modification is a key strategy for facilitating return-to-work for musculoskeletal conditions, but there are no validated scales to assess the level of support for temporary job modifications across a range of job types and organizations. Objective To pilot test a new 21-item self-report measure [the Job Accommodation Scale (JAS)] to assess its applicability, internal consistency, factor structure, and relation to physical job demands. Methods Supervisors (N = 804, 72.8 % male, mean age = 46) were recruited from 19 employment settings in the USA and Canada and completed a 30-min online survey regarding job modification practices. As part of the survey, supervisors nominated and described a job position they supervised and completed the JAS for a hypothetical worker (in that position) with an episode of low back pain. Job characteristics were derived from the occupational informational network job classification database. Results The full response range (1–4) was utilized on all 21 items, with no ceiling or floor effects. Avoiding awkward postures was the most feasible accommodation and moving the employee to a different site or location was the least feasible. An exploratory factor analysis suggested five underlying factors (Modify physical workload; Modify work environment; Modify work schedule; Find alternate work; and Arrange for assistance), and there was an acceptable goodness-of-fit for the five parceled sub-factor scores as a single latent construct in a measurement model (structural equation model). Job accommodations were less feasible for more physical jobs and for heavier industries. Conclusions The pilot administration of the JAS with respect to a hypothetical worker with low back pain showed initial support for its applicability, reliability, and validity when administered to supervisors. Future studies should assess its validity for use in actual disability cases, for a range of health conditions, and to assess different stakeholder opinions about the feasibility of job accommodation strategies.This research was supported by CIHR Grant MOP-102571, Supervisors’ perspectives on accommodating back injured workers: a mixed-methods study (PI: V Kristman) and by intramural research funding (Project LMRIS 09-01) of the Liberty Mutual Research Institute for Safety (PI: W Shaw).http://dx.doi.org/10.1007/s10926-014-9508-
Physical activity and exercise interventions in the workplace impacting work outcomes: a stakeholder-centered best evidence synthesis of systematic reviews
Open access article. Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) appliesBackground: The prevention of work disability is beneficial to employees and employers,, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability. Objective: To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes. Methods: Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process. Results: Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts. Conclusion: The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1–2 modal components) appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions, methods and measures and blinded evaluation would improve research quality and strengthen stakeholder-centered guidance.Ye
Job demand and control interventions: a stakeholder-centered best-evidence synthesis of systematic reviews on workplace disability
Open access article. Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) appliesBackground: Physical and psychological job demands in combination with the degree of control a worker has over task completion, play an important role in reducing stress. Occupational stress is an important, modifiable factor affecting work disability. However, the effectiveness of reducing job demands or increasing job control remains unclear, particularly for outcomes of interest to employers, such as absenteeism or productivity. Objective: This systematic review reports on job demand and control interventions that impact absenteeism, productivity and financial outcomes. Methods: A stakeholder-centered best-evidence synthesis was conducted with researcher and stakeholder collaboration throughout. Databases and grey literature were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO, TRIP, health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. Articles were assessed independently by two researchers for inclusion criteria and methodological quality. Differences were resolved through consensus. Results: The search resulted in 3363 unique titles. After review of abstracts, 115 articles were retained for full-text review. 11 articles finally met the inclusion criteria and are summarized in this synthesis. The best level of evidence we found indicates that multimodal job demand reductions for either at-work or off-work workers will reduce disability-related absenteeism. Conclusion: In general, the impacts of interventions that aim to reduce job demands or increase job control can be positive for the organization in terms of reducing absenteeism, increasing productivity and cost-effectiveness. However, more high quality research is needed to further assess the relationships and quantify effect sizes for the interventions and outcomes reviewed in this study.Ye
Social support and supervisory quality interventions in the workplace: a stakeholder-centered best-evidence synthesis of systematic reviews on work outcomes
Open access article. Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) appliesBackground: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/ abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.Ye
Mental health interventions in the workplace and work outcomes: a best-evidence synthesis of systematic reviews
Open access article. Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) appliesBackground: Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. Objective: To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. Results: The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. Conclusion: There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.Ye
The twilight of the Liberal Social Contract? On the Reception of Rawlsian Political Liberalism
This chapter discusses the Rawlsian project of public reason, or public justification-based 'political' liberalism, and its reception. After a brief philosophical rather than philological reconstruction of the project, the chapter revolves around a distinction between idealist and realist responses to it. Focusing on political liberalism’s critical reception illuminates an overarching question: was Rawls’s revival of a contractualist approach to liberal legitimacy a fruitful move for liberalism and/or the social contract tradition? The last section contains a largely negative answer to that question. Nonetheless the chapter's conclusion shows that the research programme of political liberalism provided and continues to provide illuminating insights into the limitations of liberal contractualism, especially under conditions of persistent and radical diversity. The programme is, however, less receptive to challenges to do with the relative decline of the power of modern states
Philosophy of action
The philosophical study of human action begins with Plato and Aristotle. Their influence in late antiquity and the Middle Ages yielded sophisticated theories of action and motivation, notably in the works of Augustine and Aquinas.1 But the ideas that were dominant in 1945 have their roots in the early modern period, when advances in physics and mathematics reshaped philosophy