Comparison of two measures of work functioning in a population of claimants with physical and psychological injuries

Research has focused on advancing our understanding of strategies to improve return to work outcomes following a physical injury. There has been limited research on the different types of supports needed for workers returning to work following a psychological injury. Developing a better understanding of work limitations when people are back at work is a key step in the development of strategies in this area. Unfortunately, measurement tools have been established separately by injury type, limiting research opportunities to compare differences in work limitations. In this article, we compare two measures of work functioning in a population of claimants that have returned to work following a musculoskeletal or psychological injury: a modified version of the Work Limitations Questionnaire (WLQ) developed for workers with physical injuries and the Lam Employed Absence Productivity Scale (LEAPS) developed for workers with mental health claims. A telephone questionnaire was administered to 214 claimants who returned to work following a claim for a psychological injury or a musculoskeletal injury. While the modified WLQ detected differences in work limitations by injury type, there were no significant differences in levels of work functioning detected by the LEAPS. The comparison demonstrated the value of including questions about work limitations that go beyond mental and interpersonal demands for claimants with psychological injuries; however, there is also a need to limit questions about physical constraints. A modified version of the WLQ is recommended to further our understandings of the similarities and differences in the experiences of workers with psychological versus physical injuries.

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD) : a large, nationally representative survey in the Australian population

Background: Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD.

Methods. This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of "healthy" Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the 'days out of role' item.

Results: Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8- 17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning.

Conclusions: Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is required.

Non-standard work schedules and health outcomes in Australia : some evidence from the HILDA Panel

What does the around-the-clock economic activity mean for workers' health? Despite the fact that non-standard work accounts for an increasing share of the job opportunities, relatively little is known about the potential consequences for health and the existing evidence is ambiguous. In this paper I examine the associations between non-standard job schedules and workers' physical and mental health outcomes using longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA). Specifically, the four health indicators considered are self-rated health and the SF-36 health indices for general health, mental health and physical functioning. Overall results generally suggest a negative relationship between non-standard work schedules and better health for both males and females. Regarding the statistical significance and magnitudes of the associations, however, we observe apparent differences between males and females. Among females, most of the coefficients in all models are statistically insignificant, which implies very small magnitudes in terms of the correlation between non-standard working hours and health. These results apply uniformly to all health measures investigated. Among males, on the other hand, the negative relationship is more noticeable for self-rated health, general health and physical functioning than for mental health. The pooled OLS and random effects coefficients are usually larger in magnitude and more significant than the fixed effects parameters. Nonetheless, even the more significant coefficients do not imply large effects in absolute terms.

Depression as a predictor of work resumption following myocardial infarction (MI): a review of recent research evidence

Background Depression often coexists with myocardial infarction (MI) and has been found to impede recovery through reduced functioning in key areas of life such as work. In an era of improved survival rates and extended working lives, we review whether depression remains a predictor of poorer work outcomes following MI by systematically reviewing literature from the past 15 years.

Methods Articles were identified using medical, health, occupational and social science databases, including PubMed, OVID, Medline, Proquest, CINAHL plus, CCOHS, SCOPUS, Web of Knowledge, and the following pre-determined criteria were applied: (i) collection of depression measures (as distinct from 'psychological distress') and work status at baseline, (ii) examination and statistical analysis of predictors of work outcomes, (iii) inclusion of cohorts with patients exhibiting symptoms consistent with Acute Coronary Syndrome (ACS), (iv) follow-up of work-specific and depression specific outcomes at minimum 6 months, (v) published in English over the past 15 years. Results from included articles were then evaluated for quality and analysed by comparing effect size.

Results Of the 12 articles meeting criteria, depression significantly predicted reduced likelihood of return to work (RTW) in the majority of studies (n = 7). Further, there was a trend suggesting that increased depression severity was associated with poorer RTW outcomes 6 to 12 months after a cardiac event. Other common significant predictors of RTW were age and patient perceptions of their illness and work performance.

Conclusion Depression is a predictor of work resumption post-MI. As work is a major component of Quality of Life (QOL), this finding has clinical, social, public health and economic implications in the modern era. Targeted depression interventions could facilitate RTW post-MI.

Conceptualizing teamwork and group-work in architecture and related design disciplines

This paper reports on the early findings of an Australian Learning Teaching Council (ALTC/OLT) funded project – “Enhancing and Assessing Group and Team Learning in Architecture and Related Design Contexts.” This is a two-year project investigating good practice in Australian higher education for the teaching of teamwork in the design disciplines, with a focus on architecture. Drawing upon a review of the literature and discussions with teachers and practitioners, the paper considers how teamwork is conceived in the context of the design disciplines. The paper explores notions of team and group design activities in the literature, identifying the key elements and characteristics of effective teams and groups. While a great deal of research exists on effective teamwork in organizational, management and general education literature, this research found a clear gap in knowledge relating to teaching teamwork in architecture and related design contexts. Suggestions are made about the ways in which theories on effective teamwork in organisations might elucidate teaching and assessment of effectively functioning student design teams. The literature review prompted five key questions, outlined here, around the conceptualisation of teamwork in design education that were subsequently discussed with educators and practitioners, thus allowing the identification of issues, problems and solutions common to all fields of design.