Pransky Glenn S, Fassier Jean-Baptise, Besen Elyssa, Blanck Peter, Ekberg Kerstin, Feuerstein Michael, Munir Fehmidah
Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
University of Massachusetts Medical School, Worcester, MA, USA.
J Occup Rehabil. 2016 Dec;26(4):465-479. doi: 10.1007/s10926-016-9670-1.
Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.
引言 许多残疾预防策略都聚焦于急性损伤和短期疾病发作，但对于雇主而言，管理老龄化劳动力中反复出现、慢性或波动症状的情况将面临越来越大的挑战。本文的目的是总结该领域现有的同行评审研究，将其与灰色文献中的雇主论述进行比较，并推荐未来的研究重点。方法 作者参与了为期一年的赞助合作项目，该项目最终促成了于2015年10月14日至16日在美国马萨诸塞州霍普金顿举行的为期3天的受邀会议“改进雇主预防残疾实践的研究”。该合作包括对科学和行业文献进行主题审查、通过小组讨论确定关键领域和挑战、起草初始文件，以及来自同行研究人员和具有雇主经验的专家特别小组的反馈。结果 选择癌症和精神疾病作为可能挑战传统职场重返工作实践的慢性或复发性疾病的例子。文献中确定的职场问题包括疲劳、情绪耗竭、上级和同事支持不足、污名化、歧视以及难以找到合适的便利措施。职场干预研究普遍缺乏，但对于改进职场自我管理策略、协作解决问题以及提供工作便利清单和其他工具存在初步支持，这些观点在针对雇主的文献中也有呼应。通过在工人职场问题发展的早期阶段进行跟踪研究，研究可能会得到改进。结论 未来关于工作残疾的研究应侧重于更早识别患有慢性疾病的高危工人、采用更具创新性和灵活性的与特定功能丧失相匹配的便利措施策略、将职场更有力地融入正在进行的康复工作，以及更好地理解职场中的污名化和其他社会因素。
