Training on involving cognitions and perceptions in the occupational health management and work disability assessment of workers: development and evaluation

Background In order to improve work participation of workers with a chronic disease, it is important for occupational health professionals (OHPs) to focus on those factors that can influence work participation. Cognitions and perceptions, such as recovery expectations and self-efficacy, are examples of these factors that can influence work participation. However, no training program is available for OHPs on how to involve cognitions and perceptions during their practice. Therefore, the aim of this study was to develop a training program for OHPs on how to involve cognitions and perceptions in the occupational health management and work disability assessment of workers with a chronic disease. In addition, to evaluate the OHPs’ satisfaction with the training and the feasibility of the training and learned skills. Methods The training program was developed using information from previously conducted studies regarding cognitions and perceptions in relation to work participation. Satisfaction with the training by OHPs was evaluated by means of a questionnaire. A smaller group of OHPs were interviewed three to six months after the training to evaluate the feasibility of the training and learned skills. Results The 4.5-h training program consisted of four parts concerning: 1) cognitions and perceptions associated with work participation, 2) how to obtain information on them, 3) the course of the conversation on these factors, and 4) intervening on these factors. Eight training sessions were conducted with 57 OHPs, of whom 54 evaluated the training. Participants were very satisfied (score 8.5 on a scale from 1 to 10). The eleven interviewed participants were more aware of cognitions and perceptions during consultations and perceived the training to be feasible. However, not all participants had applied the acquired skills in their practice, partially because of a lack of time. Conclusions OHPs are very satisfied with the training program and perceive it to be feasible. The training increases awareness of important cognitions and perceptions and may possibly help to increase work participation of workers with a chronic disease.

Pain Reduction in Adults with Limb Spasticity Following Treatment with IncobotulinumtoxinA: A Pooled Analysis

Some studies have shown that incobotulinumtoxinA reduces spasticity-associated pain, but further evidence is needed. This exploratory analysis pooled pain-relief data from six Phase 2 or 3 studies of incobotulinumtoxinA (four placebo-controlled studies) for treating upper limb spasticity in adults. Spasticity-associated pain was assessed at baseline and 4 weeks post incobotulinumtoxinA injection using the disability assessment scale (DAS) for pain. Only data for patients with pain at baseline were analysed. Overall, 544 (incobotulinumtoxinA, N = 415; placebo, N = 129) of 937 patients (58.1%) experienced pain at baseline. At Week 4, a significantly greater proportion of incobotulinumtoxinA- (52.1%) than placebo-treated patients (28.7%; Chi-square p < 0.0001) showed a response (≥1-point improvement in DAS pain score). In logistic regression analysis, incobotulinumtoxinA-treated patients were 2.6 times more likely to achieve this endpoint than placebo-treated patients. A significant difference between incobotulinumtoxinA and placebo was observed regardless of baseline pain severity. Additionally, 27.1% of incobotulinumtoxinA- versus 12.4% of placebo-treated patients reported complete pain relief at Week 4 (p = 0.0006). Pain relief increased with multiple injection cycles. To achieve patient-centred care, pain relief may be considered a treatment goal in adults with spasticity-associated pain regardless of pain severity. This study contributes to understanding the benefits of incobotulinumtoxinA in treating limb spasticity-associated pain.

Reliability and validity of a brief version of the Questionnaire of Olfactory Disorders (brief QOD) in patients with olfactory dysfunction

Background: The aim of this study was to determine the reliability and validity of the brief version of Questionnaire of Olfactory Disorders (brief QOD). Methods: A total of 372 patients participated in this study. Olfactory function was examined using the Sniffin’ Sticks test. The brief version of QOD, including 4 items concerning parosmia (QOD-P), 7 items concerning quality of life (QOD-QOL), and 3 visual analog scales to rate disease burden, awareness of the disorder and issues related to professional life (QOD-VAS), was used to assess subjective information on olfactory dysfunction. We evaluated the split-half reliability, internal consistency and validity of the brief QOD. Results: The split-half reliability was 0.60 (QOD-P), 0.87 (QOD-QOL), and 0.66 (QOD-VAS), respectively. The Cronbach’s α coefficient was 0.63 (QOD-P), 0.87 (QOD-QOL), and 0.71 (QOD-VAS), respectively. Olfactory function was found to be associated with QOD-P, QOD-QOL and QOD-VAS. Conclusions: The brief QOD is a suitable scale for the assessment of subjective severity of olfactory dysfunction for purposes such as treatment counseling, disability assessment, treatment control, and research in patients with olfactory disorder.

Diagnosis, rehabilitation and development of disability 2000-2019 in Iceland

INTRODUCTION: The disability assessment standard based on medically recognized illnesses or disabilities was introduced in Iceland 1999. The aim of this study is to examine the development of Social Insurance Administration (Tryggingastofnun ríkisins, TR) rulings regarding rehabilitation and disability pensions over a twenty-year period, since its introduction. MATERIAL AND METHODS: All registered diagnoses in the medical certificates of TR due to the approved rehabilitation or disability pension were examined in the period 2000-2019. The gender distribution and age distribution of these applicants and the number development during the period are described. At the same time, costs as a percentage of government expenditure are examined. RESULTS: The number of younger rehabilitation pensioners has increased rapidly in recent years, at the same time as the relative increase in disability pensioners has slowed slightly. Mental and musculoskeletal disorders are by far the most common types of illness leading to disability. Mental illnesses differ in terms of age distribution and increase over time. The proportion of individuals aged 18-66 with a 75% disability assessment has increased by a third during the period, from about 6% to 8%. The gender distribution of disability pensioners remains similar, with women accounting for 62% in total. Women are much more likely to receive disability pension due to musculoskeletal disorders than men and men are somewhat more likely to suffer from mental illness. The relative development of central government expenditure on total payments to rehabilitation and pensioners continues to grow as a proportion of central government expenditure. CONCLUSION: The number of rehabilitation pensioners has increased significantly since 2018, at the same time as the number of disability pensioners has decreased and there are indications that rehabilitation results in a lower number of new disability pensioners. Mental and musculoskeletal disorders are by far the most common types of illness leading to disability. A slightly lower proportion of disabled people have psychiatric diagnosis as a first diagnosis in the period 2000-2019 compared to those with a valid disability assessment in 2005, but the proportion of musculoskeletal disorders is slightly higher. Nevertheless, mental illnesses differ in age distribution and increase over time.

Força muscular e funcionalidade de pacientes hospitalizados admitidos por afecções respiratórias

Objetivo: Analisar a força muscular e a funcionalidade de pacientes hospitalizados admitidos por afecções respiratórias. Metodologia: Estudo transversal, realizado em pacientes diagnosticados e internados com doenças respiratórias. As avaliações foram realizadas por meio da Medical Research Council (MRC), Medida de independência funcional (MIF), World Health Disability Assessment Schedule (WHODAS), manovacuometria e dinamometria em pacientes internados no Hospital Universitário de Lagarto. Resultados: Participaram do respectivo estudo 97 pacientes, onde observou-se redução das forças musculares periféricas e respiratórias. Ao analisar a funcionalidade, notou-se moderada dificuldade funcional, sendo ambos instrumentos correlatos (r= -722; p<0,01). Ao analisar a relação entre média de MRC (MMSS) e FPP D e E, demostrou-se que houve correlação alta e positiva (p<0,01) entre as mesmas. Notou-se uma correlação alta e positiva (p< 0,01) entre MRC e MIF, e alta e negativa com o WHODAS (r= -598; p<0,01). Ao avaliar as médias da FPP e do MRC entre os grupos acima de 60 anos e abaixo de 60 anos, verificou-se que o fator idade contribui para a perda da força muscular e, consequentemente, da funcionalidade (p= 0.000). Conclusão: Os pacientes internados por afecções respiratórias agudas ou crônicas agudizadas apresentaram redução da força muscular periférica e respiratória. Esta realidade ressalta a importância de uma assistência fisioterapêutica precoce, pautada na funcionalidade e no ganho de força muscular desses pacientes.

Disability from chronic ear disease in Nepal assessed using the World Health Organization Disability Assessment Schedule 2.0 instrument

Objective Globally, South Asia has the highest proportion of disabling hearing loss. There is a paucity of data exploring the associated hearing loss and disability caused by chronic middle-ear disease in South Asia in the setting of surgical outreach. This study aimed to measure disability using the World Health Organization Disability Assessment Schedule 2.0 in patients undergoing ear surgery for chronic middle-ear disease in an ear hospital in Nepal. Method The World Health Organization Disability Assessment Schedule 2.0 was translated into Nepali and administered by interview to patients before ear surgery, and results were correlated with pre-operative audiograms. Results Out of a total of 106 patients with a mean age of 23 years, the mean World Health Organization Disability Assessment Schedule 2.0 score was 17.7, and the highest domain scores were for domain 6 ‘participation in society’ at a score of 34. There was a positive correlation of World Health Organization Disability Assessment Schedule 2 score with hearing level (r = 0.46). Conclusion Patients with ear disease in Nepal have had their disability measured using the World Health Organization Disability Assessment Schedule 2.0. Our study demonstrated a correlation between impaired hearing and disability in a surgical outreach context, which was an expected but not previously reported finding.

Validity and Reliability of WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) Type 12 Questions Indonesian Version on Back Pain

The study was to prove the validity and reliability of the WHODAS 2.0 Indonesian version questionnaire in patients with back pain. This study was an observational cross-sectional study conducted in 2018. The study included the filling of WHODAS 2.0 Indonesian version, Indonesian version of Oswestry Disability Index (ODI) questionnaire, Wong-Baker Scale, conducted at Department of Rehabilitative Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, against 82 respondents with back pain. Each respondent was given informed consent. The validity of the WHODAS 2.0 Indonesian version questionnaire was measured using Pearson's test on the correlation of WHODAS 2.0 Indonesian version questionnaire and Oswestry Disability Index questionnaire with r >0.3 (0.862). WHODAS 2.0 Indonesian version questionnaire and Wong-Baker Scale had r >0.3 (0.449–0.785). The reliability of the WHODAS 2.0 Indonesian version questionnaire was measured using Pearson's correlation test with r >0.3 (0.764–0.866). WHODAS 2.0 Indonesian version's internal reliability was tested using Cronbach-Alfa Test with alpha >0.6 (0.634–, 853). In conclusion, the WHODAS 2.0 - Indonesian version is a valid and reliable questionnaire for patients with back pain.