Biomedical subjects

Renée-Louise Franche

Publications and source records attributed to Renée-Louise Franche.

12 recordsLinked to original sources

PubMed2006

Depression and activity limitations: examining gender differences in the general population.

BACKGROUND: This study examines the relationship between major depression, subclinical depressive symptomatology and activity limitation in a representative sample of Canadian men and women, with a particular emphasis on examining gender differences. METHODS: Over a 4-year period, the three waves of data were collected from a representative sample of Canadian adults aged 18-60 beginning in 1994. A brief diagnostic interview for major depression, current limitations in home, work, and other activities (e.g., leisure), presence of each of 13 chronic medical conditions, and other sociodemographic information were gathered. Regression analyses adjusted for potential confounding of time-dependent and time-invariant covariates. These analyses were performed separately for men and women. RESULTS: Major depression had a significant adverse impact on all types of activities for the entire community sample, and this impact was generally robust when controlling for potential confounders. Gender differences were observed for leisure activities with depressed men showing a higher likelihood of limitation in these activities than depressed women. CONCLUSIONS: The findings provide further evidence that major depression leads to impairments in a range of daily activities. Gender differences in the impact of depression on leisure activities may be important to consider in depression treatment.

Adolescent↗

PubMed2006

Duration of work disability: a comparison of self-report and administrative data.

BACKGROUND: Studies have used insurer-reported compensable days absent as an outcome measure when studying work-related injury or illness. Compared to self-reported days absent, insurer data are less expensive to collect. Previous work has identified that insurer-claims data consistently underestimate the duration of days absent when compared to self-report. The objective of this study was to examine the agreement between the number of self-reported days absent from work following a compensable work-related injury and the number of insurer-reported compensation days paid, and to examine factors associated with the magnitude of the discrepancy between the number of self-reported days absent and the number of insurer-reported compensated days paid. METHODS: One hundred sixty six respondents who experienced a work-related injury were interviewed approximately 200 days post-injury to assess the number of days absent from work. The number of days compensated by the insurer was compared to self-report using descriptive statistics and linear regression. RESULTS: Respondents who had yet to experience a return-to-work (RTW) had the largest median discrepancy followed by respondents with an unsustained RTW and finally sustained RTW. Respondents with upper extremity injuries, lower education, and lower RTW self-efficacy showed greater discrepancy between self-reported and compensated days absent. Among respondents who self-reported fewer days absent than insurer-compensated days absent an inverse relationship between firm size and discrepancy was noted. CONCLUSIONS: Researchers should be aware of the discrepancies between self-reported and compensated days absent. Future studies planning to incorporate days absent as an outcome variable should carefully consider what measure would be more appropriate and potentially collect both self-report and administrative data to assess the discrepancy.

Absenteeism↗

PubMed2006

The impact of work-related musculoskeletal disorders on workers' caregiving activities.

BACKGROUND: The purpose of the study was to describe and quantify the impact of work-related musculoskeletal disorders on workers' caregiving activities. METHODS: A cross-sectional study was conducted in which a telephone survey was administered to 187 lost-time workers' compensation claimants from Ontario, of whom 49.2% were women. Forty-eight percent of the injured workers were providing unpaid care prior to the injury. RESULTS: Injured workers providing caregiving reported an average reduction in time spent in caregiving activities of 5.5 hr/week, 8 months post-injury. A Sex X Return-to-work status ANCOVA was conducted with difference in caregiving hours as the dependent variable, and with the following covariates: Mean number of caregiving hours, comorbidities, site of injury, and education. Independent of weekly hours of caregiving, decreases in caregiving hours were significantly higher if the worker was a woman or had not returned to work. CONCLUSIONS: Work-related musculoskeletal disorders have a significant impact on workers' time spent in unpaid caregiving activities, an example of the social consequences of occupational injuries. Occupational and caregiving roles are limited by work-related disorders in a parallel fashion.

Activities of Daily Living↗

PubMed2006

Early healthcare provider communication with patients and their workplace following a lost-time claim for an occupational musculoskeletal injury.

PROBLEM: One of the key players in the return-to-work (RTW) and work accommodation process is the healthcare provider (HCP). This study examines the association between RTW approximately one month post injury and early, proactive HCP communication with the patient and workplace. METHODS: In this cross-sectional study 187 Ontario workers completed a telephone survey 17-43 days post injury. All had accepted or pending lost-time claims for back, neck or upper extremity occupational musculoskeletal injuries. Logistic regression was used to analyze the effects of three self-reported items "your HCP told you the date you could RTW," "your HCP advised you on how to prevent re-injury or recurrence," "your HCP made contact with your workplace" on self-reported RTW. Fourteen potential confounders were also tested in the model including sex, age, income, education, occupational classification, worksite size, co-morbidity, psycho-physical work demands, pain, job satisfaction, depression, and time from injury to interview. RESULTS: The HCP giving a patient a RTW date (adjusted OR=3.33, 95% CI=1.62-6.87) and giving a patient guidance on how to prevent recurrence and re-injury (adjusted OR=2.71, 95% CI=1.24-5.95) were positively associated with an early RTW. Contact by the HCP with the workplace was associated with RTW, however, this association became weaker upon adjusting for confounding variables (crude OR=2.11, 95% C1=1.09-4.09; adjusted OR=1.72, 95% CI=0.83-3.58). INTERPRETATION: Our study lends support to the HCP playing an active role early in the RTW process, one that includes direct contact with the workplace and proactive communication with the patient.

Adolescent↗

PubMed2006

Examining the relationship between work-family spillover and sleep quality.

The present study examined the relationship between work-family spillover, job characteristics, and sleep quality in a sample of health care workers (N = 168) recruited from 3 Canadian hospitals. A multiple regression analysis revealed that positive family-to-work spillover is associated with better sleep quality, after controlling for age, physical health, depressive symptomatology, work situation, and number of children. These findings are discussed within a theoretical framework drawing on the concepts of effort and recovery.

Adult↗

PubMed2006

Health-promoting behaviors through pregnancy, maternity leave, and return to work: effects of role spillover and other correlates.

Women's health-promoting behavior changes and their correlates across the transition to motherhood and return to work are insufficiently understood. The purpose of this study was to describe and compare women's health-promoting behaviors, particularly physical activity (PA), across these transitions. A prospective, observational design was employed to assess 243 female healthcare workers from 3 sites with regard to health-promoting behaviors, and their demographic (e.g., age, parity) and psychosocial (i.e., work-family role spillover) correlates. Forty-two participants were recruited while pregnant and re-assessed during maternity leave and upon return to work, and compared to 201 non-pregnant participants. No significant changes in health-promoting behaviors were observed from pregnancy through the postpartum. Pregnant participants reported better nutrition than comparison participants (p=.001), and were more likely to check their pulse when exercising (p=.004). During pregnancy, health-promoting behaviors were related to parental status, with first-time mothers engaging in more positive behaviors. Correlates of PA during maternity leave and return to work included family income and exercise history. Positive family-to-work spillover was significantly greater among pregnant women than among comparison participants (p<.001), and positive work-to-family spillover was related to greater PA upon return to work (p<.01). This study reveals little variability in health-promoting behaviors from the prenatal to the postpartum period. Both demographic and psychosocial factors have effects on health-promoting behaviors, and we must look to these correlates to promote increased PA.

Adult↗

PubMed2006

Systematic review of the qualitative literature on return to work after injury.

OBJECTIVES: This paper reports on a systematic review of the international qualitative research literature on return to work. This review was undertaken in order to better understand the dimensions, processes, and practices of return to work. Because return to work often includes early return before full recovery while a person is undergoing rehabilitation treatment, physical recovery is embedded in complicated ways with workplace processes and practices and social organization. These process-oriented dimensions of return to work are well described in the qualitative literature. METHODS: This systematic review of the literature covered peer-reviewed papers that focused on musculoskeletal and pain-related injuries and were published in English or French between 1990 and 2003. Findings from papers meeting relevance and quality criteria were synthesized using the meta-ethnographic approach. RESULTS: This review found that return to work extends beyond concerns about managing physical function to the complexities related to beliefs, roles, and perceptions of many players. Good will and trust are overarching conditions that are central to successful return-to-work arrangements. In addition, there are often social and communication barriers to return to work, and intermediary players have the potential to play a key role in facilitating this process. CONCLUSIONS: This paper identifies key mechanisms of workplace practice, process, and environment that can affect the success of return to work. The findings illustrate the contribution that qualitative literature can make to important aspects of implementation in relation to return to work.

Accidents, Occupational↗

PubMed2005

Training the next generation of researchers in work disability prevention: the Canadian Work Disability Prevention CIHR Strategic Training Program.

INTRODUCTION: There is a need to create, disseminate, and implement new knowledge in the work disability prevention (WDP) field. Training programs attracting high-quality applicants and taking into account the complexity of this emerging field are urgently needed. METHODS: An advanced training program, funded by the Canadian Institutes of Health Research (CIHR), was developed by 24 mentors affiliated with nine different universities. The main objective of this program is to develop transdisciplinary knowledge, skills, and attitudes regarding WDP. This program has been developed for PhD students or post-doctoral fellows already registered full-time in a Canadian or recognized foreign university whose main interest is WDP, regardless of the health problem. RESULTS: Since its implementation, the program received two successive cohorts of 10 students. They were registered in 13 universities in five countries and trained in nine different disciplines. CONCLUSIONS AND SIGNIFICANCES: Appropriate WDP research may save major societal costs attributable to prolonged work disability. The proposed training program will contribute to developing tomorrow's research workforce.

Attitude of Health Personnel↗

PubMed2005

Workplace-based return-to-work interventions: optimizing the role of stakeholders in implementation and research.

INTRODUCTION: The challenges of engaging and involving stakeholders in return-to-work (RTW) intervention and research have not been well documented. METHODS: This article contrasts the diverse paradigms of workers, employers, insurers, labor representatives, and healthcare providers when implementing and studying workplace-based RTW interventions. RESULTS: Analysis of RTW stakeholder interests suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals. We review how specific aspects of RTW interventions can be instrumental in resolving conflicts arising from differing paradigms: calibration of stakeholders' involvement, the role of supervisors and of insurance case managers, and procedural aspects of RTW interventions. The role of the researcher in engaging stakeholders, and ethical aspects associated with that process are discussed. CONCLUSIONS: Recommendations for future research include developing methods for engaging stakeholders, determining the optimal level and timing of stakeholder involvement, expanding RTW research to more diverse work settings, and developing RTW interventions reflecting all stakeholders' interests.

Community Participation↗

PubMed2005

Workplace-based return-to-work interventions: a systematic review of the quantitative literature.

INTRODUCTION: A systematic review was conducted to review the effectiveness of workplace-based return-to-work (RTW) interventions. METHOD: Seven databases were searched, in English and French, between January 1990 and December 2003 for peer-reviewed studies of RTW interventions provided at the workplace to workers with work disability associated with musculoskeletal or other pain-related conditions. Methodological quality appraisal and data extraction were conducted by pairs of reviewers. RESULTS: Of a total of 4124 papers identified by the search, 10 studies were of sufficient quality to be included in the review. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace; and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator. For these five intervention components, there was moderate evidence that they reduce costs associated with work disability duration. Evidence for sustainability of these effects was insufficient or limited. Evidence regarding the impact of supernumerary replacements was insufficient. Evidence levels regarding the impact of the intervention components on quality-of-life was insufficient or mixed. CONCLUSIONS: Our systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs, however the evidence regarding their impact on quality-of-life outcomes was much weaker.

Cost-Benefit Analysis↗

PubMed2004

Sex differences in predictors of illness intrusiveness 1 year after a cardiac event.

OBJECTIVE: This prospective study examined sex differences in illness intrusiveness and in baseline predictors of illness intrusiveness in cardiac patients' 1-year postcardiac event. METHODS: Patients diagnosed with a myocardial infarction (MI) or unstable angina (UA) completed a baseline questionnaire during their hospitalization (139 men and 104 women). Eighty-one men and 67 women completed the follow-up questionnaire 1-year postcardiac event. The questionnaire included measures of illness intrusiveness in three life domains, depressive symptomatology, social support, medical information, risk factors for heart disease, and sociodemographic information. RESULTS: A MANCOVA with the three Illness Intrusiveness subscales as dependent variables, sex as the between-group factor, and partnership status as a covariate found a sex effect for the Intimacy subscale, but not for the Instrumental and the Relationships/Personal Development subscales. Men reported more intrusiveness in the Intimacy domain of their life as compared to women. After controlling for sociodemographic factors and risk factors for heart disease, hierarchical regressions indicated sex differences in baseline predictors of 1-year follow-up illness intrusiveness in the three life domains. For men, being satisfied with support from partner at baseline was associated with less intrusiveness in the Instrumental Life domain 1 year after the cardiac event. For women, surprisingly, more satisfaction with support from their partner at baseline was associated with more intrusiveness in their intimate lives 1 year after their cardiac event. In addition, emotional symptoms of depression at baseline were predictive of increased illness intrusiveness in Relationship/Personal Development and Intimacy domains for men and in Instrumental and Intimacy domains for women. CONCLUSION: Support from partner may have a differential impact for men and women after a cardiac event. Depressive symptomatology during initial hospitalization, particularly emotional symptoms, is a prominent indicator of illness intrusiveness for both sexes 1 year after the cardiac event.

Angina, Unstable↗

PubMed2002

Readiness for return to work following injury or illness: conceptualizing the interpersonal impact of health care, workplace, and insurance factors.

Return to work after injury or illness is a behavior influenced by physical, psychological, and social factors. Disability research lacks a conceptual framework for combining these factors in the study of the return-to-work process. Two extant theoretical models within the social context are considered as they apply to the behavior of returning to work: 1) the Readiness for Change Model originating from the field of health promotion and addressing the issue of motivation for behavior change, and 2) the Phase Model of Disability developed for the epidemiological study of occupational disability addressing the developmental and temporal aspects of disability. A new Readiness for Return-to-Work Model is proposed focusing on the interpersonal context of the work-disabled employee. Employee interactions with the workplace, the health care, and insurance systems are considered as they impact the three defining dimensions of change--decisional balance, self-efficacy and change processes. The evidence for their impact on return-to-work is examined within the framework of the Phase Model of Disability, which puts forth the phase-specificity of symptoms, risks, and interventions for disability. The Readiness for Return-to-Work Model has the potential to account for individual variation in optimal stage-specific timing of interventions based on an individual's readiness for return-to-work. The model therefore complements the Phase Model of Disability by allowing for an individual-level staging of the disability and recovery process within the broader group-level-derived framework of occupational disability phases. This link between the two models needs to be empirically tested in future research.

Accidents, Occupational↗