Biomedical subjects

Brigitte Vachon

Publications and source records attributed to Brigitte Vachon.

3 recordsLinked to original sources

PubMed2003

Constructing the program impact theory for an evidence-based work rehabilitation program for workers with low back pain.

PURPOSE: Several low back pain work rehabilitation programs have been developed and evaluated for their outcomes. Unfortunately, the program impact theory for these programs is not described, and consequently, the exact mechanisms of action by which these programs intend to increase the probability of return to work remain unknown. This lack of knowledge jeopardizes the implementation of effective programs by health professionals and managers. The objective of this paper is to present the results of an exploratory study aimed at building the program impact theory for the PREVICAP work rehabilitation program. METHODS: The program impact theory was develop by conducting: unpublished documents and scientific literature analyses, individual and group discussions with multiple stakeholders and observation of program reality by reviewing the files of workers who completed the program. RESULTS: The PREVICAP program's impact theory was elaborated based on an ecological approach to work rehabilitation. Program goals and objectives were defined for the three dimensions of the model: the worker, the work environment and the interaction between the worker and his work environment. Two program action mechanisms were defined and describe how the program was intended to achieve its expected outcomes. CONCLUSIONS: This study made explicit the PREVICAP program impact theory and can help rehabilitation practitioners to address work disability according to an ecological model.

Canada↗

PubMed2002

Discriminative and predictive validity assessment of the quebec task force classification.

STUDY DESIGN: A prospective cohort study of workers with low back pain who had been absent from work for more than 4 weeks was conducted. OBJECTIVE: To assess the discriminative and predictive validity of the Quebec Task Force Classification for workers during the subacute phase of disability from back pain. SUMMARY OF BACKGROUND DATA: The Quebec Task Force Classification was designed for clinical decision making, prognosis establishment, quality of care evaluation, and scientific research in low back pain. METHODS: For this study, 104 workers absent from work because of back pain were classified according to the first four categories of the Quebec Task Force Classification 4 weeks after their first day of work absence. They then were randomized into four treatment groups: standard care (control), clinical-rehabilitation intervention, occupational intervention, and the Sherbrooke model (a combination of the clinical-rehabilitation and occupational interventions). Functional status, pain level, and work status were assessed at baseline and after 1 year. Duration of full compensation and back-related costs were calculated over a mean follow-up period of 6.5 years. The discriminative validity of the Quebec Task Force Classification was evaluated using Kendall tau correlation coefficients. Predictive validity was evaluated using logistic regression analyses. Age, gender, comorbidities, body mass index, and treatment group were considered as potential confounders. RESULTS: Significant but low correlation coefficients were found between Quebec Task Force Classification categories and functional status scores at baseline. Subjects classified as having distal radiating pain (categories 3 and 4) at baseline were more likely to have a lower functional status, higher pain level, and no return to regular work at the 1-year follow-up evaluation. They also were more likely to accumulate more days of full compensation and to cost more after a mean follow-up period of 6.5 years. CONCLUSION: The Quebec Task Force Classification demonstrated good predictive ability by discriminating between subjects with and those without distal radiating pain.

Adult↗

PubMedDate not supplied

From evidence to community practice in work rehabilitation: the Quebec experience.

BACKGROUND: The causes of prolonged disability due to back pain are multiply determined, involving medical, social, and environmental factors. Possible solutions to the problem of prolonged back pain disability have emerged from recent research but few efforts have been made to transfer evidence-based programs to large community settings. OBJECTIVE: This article describes three phases of the process of transfer of evidence from rehabilitation research to community practice in the province of Quebec. METHODS AND RESULTS: Phase A: Based on literature review and expert knowledge, the Sherbrooke model was developed and assessed through a population-based, randomized clinical trial. Results at 1-year follow-up showed quicker return to regular work and improvement of quality of life; the 6-year follow-up showed the cost-effectiveness of the method. Phase B: Based on the Sherbrooke model experience and recent evidence, a new program addressing the disability paradigm was developed and implemented in the province of Quebec (Canada). Results at 1- and 3-year follow-ups showed that only 24% of workers were not working owing to their musculoskeletal disorder. The program is presently being tested through a population-based, randomized clinical trial in a population of construction workers. Phase C: To implement the program at a provincial level, a network for management, research and education in work rehabilitation was developed. An external assessment is presently planned to evaluate return to work and economic outcomes and quality of implementation of the program in various settings.

Adult↗