Academic journal article British Journal of Occupational Therapy

Supporting Workers with Musculoskeletal Conditions: A Survey of United Kingdom Occupational Therapists' Communications with Clients and Their Employers

Academic journal article British Journal of Occupational Therapy

Supporting Workers with Musculoskeletal Conditions: A Survey of United Kingdom Occupational Therapists' Communications with Clients and Their Employers

Article excerpt

Introduction

Musculoskeletal conditions are one of the five main causes of short- and long-term sickness absence in the United Kingdom (UK) (Chartered Institute for Personnel and Development [CIPD] 2012). The main conditions include osteoarthritis, inflammatory arthritis, back and neck pain, and fibromyalgia. Symptoms are often recurrent, and for some people are persistent and can lead to disability. In 2011-12, an estimated 439,000 employees in Great Britain experienced a musculoskeletal condition caused or made worse by their current or past work (Health and Safety Executive 2012) and 7.5 million working days were lost due to sickness absence as a result. There is also growing evidence that people with chronic conditions may remain at work whilst symptomatic rather than take sick leave, which may result in reduced productivity, known as 'presenteeism' (Munir et al 2008). People with musculoskeletal conditions are referred to a range of hospital and community services, including orthopaedic, pain, rheumatology, and vocational rehabilitation services (British Society of Rehabilitation Medicine 2004), and occupational therapists work regularly with this patient/client group (Booker et al 2008). (The researchers referred to patient/client in the questionnaires but hereafter, for consistency, this research article uses 'client' to encompass both.) Occupational therapists may treat clients who are struggling at work, limiting their hours and duties, or taking sick leave, all of whom would benefit from work-related advice and support. Although there is a growing evidence base for occupational therapy in vocational rehabilitation for this client group, it remains limited and further evaluation is required (Hammond 2008).

Reduction in the rate of sickness absence and the prevention of work disability is high on the UK Government agenda (Black 2008). This has led to the development of several reviews and initiatives aimed at helping those with health conditions to remain in or to regain employment (Black 2008, Department for Work and Pensions [DWP] 2008, 2013), and at increasing the role that healthcare professionals, including occupational therapists, have in this process. Firstly, the government is to fund Independent Assessment and Advisory Services (DWP 2013), which will 'draw on the expertise of, for example, appropriately skilled occupational therapists' (Black and Frost 2011, p29) and, secondly, the Allied Health Professions Advisory Fitness for Work Report (Chartered Society of Physiotherapy [CSP], Society of Chiropodists and Podiatrists [SCP], College of Occupational Therapists [COT] 2011) has been introduced. This can provide standalone evidence for the employer on the employee's fitness for work, and for sick pay purposes, although it cannot be used in claims for state benefits.

Although occupational therapists seem ideally placed to advise and treat clients with regard to work, there is uncertainty regarding their confidence and competence in addressing clients' work issues (COT 2009). No evidence has been published to date that identifies whether, and how, UK occupational therapists provide work-related advice and support to clients with musculoskeletal conditions, and if this extends to clients' workplaces. The aim of this study was, therefore, to investigate current practice provided by occupational therapists to both clients with musculoskeletal conditions and their employers.

Method

Questionnaire

A postal questionnaire survey design was chosen to address the study's aim, drawing on relevant published literature and the expertise of the research steering group. Questions concerned the treatment of employed clients with musculoskeletal conditions in community or outpatient settings, and included:

* conditions treated and treatment setting

* provision of work-related advice and/or support

* proportion of client-related time involved

* use of standardized assessments

* work-related interventions

* contact made with employers and methods used

* factors associated with communicating with employers

* the Allied Health Professions Advisory Fitness for Work Report (AHP-AFWR). …

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