Prevalence and factors associated with inadequate work ability among community health workers in Montes Claros, Minas Gerais state, Brazil: a cross-sectional study, 2018.

OBJECTIVE: To estimate the prevalence and analyze factors associated with inadequate work ability among community health workers (CHWs). METHODS: This was a cross-sectional study conducted with CHWs, from July to October 2018, in Montes Claros, state of Minas Gerais, Brazil; work ability, sociodemographic, occupational, and clinical factors were investigated; prevalence ratios (PRs) with 95% confidence intervals (95%CI) were calculated using Poisson regression. RESULTS: Of the 675 CHWs, 25.8% (95%CI 22.7;29.2) showed inadequate work ability; length of service greater than five years (PR = 1.64; 95%CI 1.24;2.18), poor health status (PR = 2.10; 95%CI 1.56;2.83), depressive symptoms (PR = 1.98; 95%CI 1.54;2.55) and voice disorders (PR = 1.85; 95%CI 1.26;2.73) were associated with the event. CONCLUSION: There was a high prevalence of inadequate work ability, associated with occupational and clinical factors. MAIN RESULTS: There was a high prevalence of inadequate work ability among community health workers (CHWs), associated with occupational and clinical factors. IMPLICATIONS FOR SERVICES: This study can contribute to the planning of preventive actions and the promotion of the work ability of CHWs, with repercussions on the quality of service provided by these professionals. PERSPECTIVES: Longitudinal studies are strongly recommended in order to establish cause-and-effect relationships between the variables investigated.

The Work Ability Index (WAI) in the Healthcare Sector: A Cross-Sectional/Retrospective Assessment of the Questionnaire.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, assessing its characteristics is worthwhile. The WAI was distributed online among the employees of a healthcare company; the results were compared with data contained in the employees' personal health records and with absence registers. A total of 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in their day shift counterparts due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to over-report illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

Revision of the brief international classification of functioning, disability and health core set for multiple sclerosis: a study of the comprehensive icf core set for multiple sclerosis with participants referred for work ability assessment.

OBJECTIVE: To evaluate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for multiple sclerosis with regard to the Brief ICF Core Set for multiple sclerosis. DESIGN: Descriptive cross-sectional single-centre study. SUBJECTS: A total of 151 participants (99 females/52 males, mean age 49 years) referred for work ability assessment. METHODS: Data were collected from clinical recordings and by telephone interview. RESULTS: Among 33 Body Functions, 14 were impaired in over 60% of the participants, and 6 in over 75%. These 6 most impaired functions were related to exercise tolerance (b455), urination (b620), muscle power (b730), motor reflex (b750), control of voluntary movement (b760) and gait pattern (b770). Among 54 Activities and Participation categories, 8 were impaired in over 60% of the participants, and 3 were impaired in over 75%. The latter activities were related to walking (d450), moving around (d455) and moving around using equipment (d465). Among the 36 Environmental categories, most were facilitators, except for temperature (e2250) and employment (e590). The latter category was both a facilitator and a barrier. CONCLUSION: These results suggest additional categories that should be included into the Brief ICF Core Set, to improve its representation of the complex disability of multiple sclerosis.

Examination of the structural components of the Abilitator-A self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position.

OBJECTIVES: According to the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel, structural validity describes how well Patient-Reported Outcome Measures' (PROM) scores reflect the dimensions of the measured construct. The main purpose of this study was to examine the structural components of the Abilitator, a co-developed self-report questionnaire on work ability and functioning for the population in a weak labour market position. METHODS: We examined to what extent the Abilitator has reflective and formative elements in its five summary scales: "C. Inclusion", "D. Mind", "E. Everyday life", "F. Skills", and "G. Body". The Abilitator data sample (n = 4555, men 51%, mean age 37 years) was collected in 2017-2022 by the Finnish Institute of Occupational Health in cooperation with the European Social Fund Priority 5 projects in which the participants have multiple challenges to gain employment. For the structural components and validity analysis we implemented both Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). RESULTS: Based on the COSMIN criteria for structural validity, the Abilitator reached approximate model fit with CFA when we analysed the different concepts of the questionnaire separately rather than in one unified model. An exception was "E. Everyday life" which was a formative summary scale, and it did not reach approximate fit. EFA showed that the items in the Abilitator's summary scales loaded on ten factors. CONCLUSIONS: The Abilitator had both reflective and formative elements in its structure. It reached structural validity in those separate concepts that were based on a reflective model. This study revealed interesting connections between different aspects of the Abilitator and produced valuable information for further modification of the questionnaire.

Adolescent Cardiorespiratory Fitness and Future Work Ability.

Importance: Although research indicates that low fitness in youth is associated with a higher risk of chronic disability in men, the association of fitness in adolescence with work ability in working men and women remains unknown. Objective: To examine the associations of adolescent health-related physical fitness with future work ability. Design, Setting, and Participants: This 45-year observational cohort study, conducted in Finland, examined the direct and indirect longitudinal associations of objectively measured health-related fitness in adolescence (in 1976) with self-reported work ability and sickness absence in early middle age (in 2001) and the Work Ability Index in late middle age (in 2021). A countrywide stratified random baseline sample included fitness measurements for cardiorespiratory fitness (CRF) (running 1.5 km for girls and 2 km for boys), musculoskeletal fitness (MF; standing broad jump and sit-ups for both sexes, pull-ups for boys, and flexed-arm hang for girls), and height and weight, from which body mass index (BMI) was calculated. Structural equation modeling-based path analysis, adjusted for age and sex at baseline and for educational level, work-related physical strain, and leisure-time physical activity in late middle age, was conducted. Data analysis was performed from January to July 2023. Main Outcomes and Measures: Self-reported work ability was measured with structured questions in early middle age and with the validated Work Ability Index in late middle age. Results: The final sample from longitudinal analyses (1207 individuals; 579 [48%] male individuals) consisted of participants with fitness measurement from age 12 to 19 years, and work ability assessment from age 37 to 44 years and/or age 57 to 64 years. Higher adolescent CRF was associated with higher work ability (839 participants; ß = 0.12; 95% CI, 0.01 to 0.22; P = .03) and lower sickness absence (834 participants; ß = -0.07; 95% CI, -0.12 to -0.02; P = .004) in early middle age and, indirectly, mediated by work ability in early middle age, with a higher work ability at the end of working age (603 participants; ß = 0.04; 95% CI, 0.001 to 0.08; P = .04). The results remained consistent in both sexes and after adjustment for the confounders. Neither MF nor BMI was associated with work ability (MF, 1192 participants; ß = -0.07; 95% CI, -0.17 to 0.03; BMI, 1207 participants, ß = 0.09; 95% CI, -0.004 to 0.19) or sickness absence (MF, 1185 participants, ß = 0.02; 95% CI, -0.03 to 0.06; BMI, 1202 participants, ß = -0.03; 95% CI, -0.09 to 0.03) in early middle age or with late middle age work ability, mediated by work ability in early middle age (MF, 603 participants, ß = -0.02; 95% CI, -0.06 to 0.01; BMI, 603 participants, ß = 0.03; 95% CI, -0.004 to 0.07). Conclusions and Relevance: These findings suggest that low CRF in youth is associated with poor work ability at the middle and end of working life, which highlights the informative and prognostic value of CRF assessment early in youth. Enhancing CRF in the first decades of life might contribute to better work capacity and productivity in the labor force, which would have implications for health, quality of life, society, and the economy.

Association between physical fitness and perceived work ability among Finnish population: a cross-sectional study.

OBJECTIVE: This cross-sectional study aims to examine association between different components of physical fitness and perceived work ability among working age population. METHODS: The population-based study sample included 2050 participants aged 18-74 from the Finnish national Health 2011 study. Physical fitness was assessed by the single leg stand test, the modified push-up test, the vertical jump test and the six-minute walk test, and perceived work ability was assessed via interview. Logistic regression was used for examining the associations between physical fitness and work ability. RESULTS: After adjusting for potential confounders (age, sex, marital status, educational level, work characteristics, total physical activity, daily smoking, BMI and number of diseases), odds ratios indicated that good work ability was more likely among those who had better balance in single leg stand test (OR = 1.54; 95% CI 1.07-2.24), and who belonged in the high fitness thirds in six-minute walking test (OR = 2.08; 95% CI 1.24-3.49) and in vertical jump test (OR = 2.51; 95% CI 1.23-5.12) compared to lowest third. Moreover, moderate (OR = 1.76; 95% CI 1.02-3.05) to high fitness (OR = 2.87; 95% CI 1.40-5.92) in modified push-up test increased the likelihood of good work ability compared to lowest third. CONCLUSION: These study results indicate that good musculoskeletal as well as cardiorespiratory fitness are associated with better perceived work ability. Promoting physical fitness in individual and societal level may be potential targets for maintaining good work ability in working age population.

Climacteric status at age 46 is associated with poorer work ability, lower 2-year participation in working life, and a higher 7-year disability retirement rate: a Northern Finland Birth Cohort 1966 study.

OBJECTIVE: To study the association between an advanced climacteric status at 46 years of age and current perceived work ability, the consequent 2-year accumulation of disability and unemployment days, and the 7-year incidence of disability pensions. METHODS: Study participants (n = 2,661) were recruited from the Northern Finland Birth Cohort 1966 study's 46-year follow-up in 2012. The participants' perceived work ability was investigated using the Work Ability Score (0-7 = poor vs 8-10 = good), along with potential covariates. Data concerning their consequent disability days, unemployment days, and disability pensions were collected from national registers. The association between their climacteric status at age 46 years, work ability, and working life participation was assessed using regression models. RESULTS: The climacteric women were more often smokers and more often had a lower level of education. The odds ratio for poor perceived work ability was 1.41 (95% CI, 1.06-1.87), and the incidence rate ratios for disability and unemployment days during the 2-year follow-up were 1.09 (95% CI, 1.07-1.11) and 1.16 (95% CI, 1.14-1.18), respectively, for the climacteric women compared with the preclimacteric women in models adjusted for smoking and education. The 7-year hazard ratio for disability pensions was 1.72 (95% CI, 1.02-2.91) for the climacteric women. CONCLUSIONS: An earlier menopausal transition is associated with poorer perceived work ability, and it predicts lower recorded work participation and a higher disability pension rate in subsequent years.

Occupational health literacy and work ability: a moderation analysis including interpersonal and organizational factors in healthy organizations.

Introduction: Healthy organizations approach to occupational safety and health should holistically include individual, interpersonal, and organizational levels. There is an empirical research gap in considering different levels in organizations for health promotion in the context of maximizing work ability. This study aims to investigate the association of (1) occupational health literacy (on an individual level), (2) health-oriented leadership (interpersonal level), (3) participation possibilities in health, and (4) values of health in companies (both organizational levels) on work ability. Additionally, we examined the potentially moderating role of health-oriented leadership, participation possibilities in health, and values of health between occupational health literacy and work ability. Methods: Cross-sectional data were obtained from 828 employers and employees in small and medium-sized enterprises. Self-report measures included occupational health literacy, health-oriented leadership, work ability, participation possibilities in health at work, and values of health in the company. Occupational health literacy comprises two factors: a knowledge-/skill-based approach to occupational health and a willingness/responsibility for occupational health. Participation possibilities in health are measured regarding participatory opportunities and co-creation of health at work. Values of health in the company capture the importance of health in the workplace and the scope for improving employees' health. Data were analyzed using latent regression and latent moderation analyses controlling for age, gender, and educational level. Results: Occupational health literacy (knowledge-/skill-based), health-oriented leadership, participation possibilities in health, and values of health in companies showed positive associations with work ability. Health-oriented leadership on an interpersonal level was found to moderate the positive relationship between (knowledge-/skill-based) occupational health literacy and work ability. Participation possibilities in health on an organizational level acted as a moderator on the relationship between both occupational health literacy factors and work ability. Discussion: Individual, interpersonal, and organizational factors play important roles in maintaining work ability in healthy organizations. This study highlights the importance of promoting occupational health literacy among employees and leaders, creating a healthy workplace through health-oriented leadership, and providing participatory opportunities for co-creation in health promotion at work. Future research should further explore these factors' roles in different industries and contexts and how they may be addressed effectively in tailored workplace interventions.

The cost of saying no: general practitioners' gatekeeping role in sickness absence certification.

BACKGROUND: General practitioners (GPs) have an important gatekeeping role in the Norwegian sickness insurance system. This role includes limiting access to paid sick leave when this is not justified according to sick leave criteria. 85% of GPs in Norway operate within a fee-for-service system that incentivises short consultations and high service provision. In this qualitative study, we explore how GPs practise the gatekeeping role in sickness absence certification. METHODS: Qualitative data was collected through six focus group interviews with 33 GPs, working in practices with a minimum of four practising GPs, in different geographical regions across Norway, including both urban and rural areas. Data was analysed using Braune and Clarke's thematic analysis approach. RESULTS: Our results indicate that GPs' sick-listing decisions are largely driven by patient demand and preferences for sick leave. GPs reported that they rarely overrule patient requests for sickness absence, including in cases where such requests conflict with the GPs' opinion of whether sick leave is justified or benefits the patient. The degree of effort made to limit unjustified or non-beneficial sick leave seems to depend on the GPs' available time and perceived risk of conflict with the patient. GPs generally expressed dissatisfaction with their role as certifiers of sickness absence. CONCLUSION: Our study suggests that GPs' decisions about sickness certification is largely driven by patient preferences. The GPs' gatekeeping function is limited to negotiations about grade and duration of absence spells.

Assessment of quality of life, job insecurity and work ability among nurses, working either under temporary or permanent terms.

OBJECTIVES: Aim of this study was to assess and compare health, quality of life, well-being, job satisfaction and job insecurity between nurses, in a tertiary hospital in Greece, working either under permanent or temporary contract. MATERIAL AND METHODS: In this cross-sectional study, consecutively recruited nurses answered a structured questionnaire, the WHO-5 Well-being Index (WHO-5), the Job Insecurity Index (JII), the Work Ability Index (WAI), and the Well-Being at Work Scale (WBWS). RESULTS: Included were 323 nurses (87.6% women, age M±SD 43.68±8.10 years). Tem- porary contract employees had worse quality of life (p = 0.009) and higher job insecurity: both in cognitive dimension (p = 0.013) and emotional dimension (p < 0.001). They also scored worse in the positive affect (p < 0.001), negative affect (p = 0.002) and fulfillment of expectations in work environment (p < 0.001) domains of the WBWS. Additionally, they reported less frequently occupational accidents and injuries (p = 0.001), muscu - loskeletal disorders of the spine or neck (p = 0.007), cardiovascular (p = 0.017), and gastrointestinal (p = 0.010) disorders, while they reported more frequently mental disorders (p < 0.001). Multivariate linear regression analysis showed that temporary work predicted high cognitive (p = 0.010) and emotional (p < 0.001) insecurity, low positive emotions and mood index (p = 0.007), low achievement-fulfillment index (p = 0.047) and high index of negative emotions (p = 0.006), regardless of gender and age. CONCLUSIONS: Temporary employment among nurses is associated with a lower sense of job security and well-being, and a higher prevalence of mental disorders, independently of age or gender without a significantly negative effect on their ability to work. Managers, as well as occupational physicians, should recognize the extent of nurses' job insecurity and assess their ability to work, to provide them with the necessary support and to stimulate the sense of occupational security and work capacity, so that they can thrive in their workplace and therefore be more productive and provide high quality healthcare. Int J Occup Med Environ Health. 2024;37(1):98-109.

Rehabilitation with intensive attention training early after acquired brain injury promotes better long-term status on health-related quality of life, daily activities, work ability and return to work.

OBJECTIVE: To describe long-term effects on activity, participation, and quality of life (i) at different post-injury starting time points of attention training and (ii) of two different types of rehabilitation with attention training in patients after stroke or traumatic brain injury; and to describe their functioning level. DESIGN: 2 years after rehabilitation intervention, comparisons were made in one cohort receiving attention training subacute (< 4 months) or post-acute (4-12 months) and in one cohort with two different training methods, a process-based and an activity-based method respectively. PATIENTS: 100 patients were recruited from our earlier RCT study. They had mild to moderate stroke or traumatic brain injury with relatively limited symptomatology, and all had moderate to severe attention impairment. METHODS: A questionnaire-based interview: EuroQol 5 dimensions, Occupational Gaps Questionnaire, Work Ability Index, self-assessed work status, self-reported employment conditions, sick leave, and experienced cognitive limitations in work performance. RESULTS: An advantage for patients receiving subacute attention training regarding daily activities, work ability and returning to work. CONCLUSION: The results indicate that subacute rehabilitation with attention training (< 4 months) is preferable compared to post-acute intervention (4-12 months). There were only minor differences between the training methods.

Work Ability, Anxiety, and Depression among Long-Term Breast Cancer Survivors of Northern Kerala, India; A Historical Cohort Study.

BACKGROUND: Increasing number of breast cancer cases, and improved survival due to advancements in early detection, and treatment resulted in an increase in women living beyond a cancer diagnosis. Survivors have to face long-term physical effects as well as psychosocial issues post-treatment. This study aims to study survivourship in terms of work ability, anxiety and depression. METHODS: Retrospective cohort study on female breast cancer survivors from Hospital Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC). Data from 2016 (n=534) were collected from the medical records, and a follow-up survey (n=209) was conducted in 2022 to study their survivorship issues. RESULTS: In 2022, the mean age of the cohort (n=209) was 55.45 ± 9.36. The mean work ability score was 40.7±5.73 (95% CI 39.92 to 41.48).  In the multivariate binary logistic regression model, those who were married (OR 7.15, 95%CI 2.61 to 19.55), disease-free (OR 15.27, 95% CI 2.36 to 98.7), employed (OR 9.09, 95%CI 1.12 to 73.5), having no fatigue (OR 2.6, 95% CI 1.05 to 6.48), no pain (OR 3.11, 95% CI 1.16 to 8.35), and no depression (OR 6.58, 95% CI 1.82-23.8) were found to have optimal work ability. Anxiety (OR 4.93, 95% CI 1.76 to 13.76), and sub-optimal work ability (OR 4.22, 95% CI 1.39 to 12.77) were predictors of depression among survivors. Disease status and fatigue were associated with all three dimensions of survivorship in our study. CONCLUSION: Understanding survivorship will help improve health outcomes in this population. In our study, work ability, anxiety, depression, and their associated factors were found to be interrelated. Interventions in these areas can go a long way in improving breast cancer survivorship.

Sustaining work ability amongst female professional workers with long COVID.

BACKGROUND: Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than WA in men. Exploration of lived experiences could elucidate the WA support required. AIMS: To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks. METHODS: Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return to work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation. RESULTS: All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as facilitated by a professional role, rapid health care access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organizational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers' workforce diversity and competence would be protected and that workers would need to reciprocate flexibility. CONCLUSIONS: These qualitatively derived findings of workers' lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working-age adults with complex long-term health conditions.

Factors associated with work ability among employees of an Italian university hospital.

BACKGROUND: A growing body of evidence clearly documents the benefits of integrated systems approaches to protecting and promoting the safety, health and well-being of workers. The purpose of this study is to provide a holistic view of the work ability of employees of an Italian University Hospital measuring their resources in relation to job demands. In particular, it examines socio-demographics, family and organizational antecedents of health professionals' work ability. METHODS: A survey was conducted to assess the work ability of healthcare professionals, including physicians, nurses and administrative staff, working at the University Hospital of Modena (Italy). The data collection allows us to get a sample of 443 workers, who correspond to 11% of the target population. The data were analyzed using preliminary statistics on the main characteristics of the sample in terms of work ability, socio-demographic variables, family and organizational characteristics. In addition, logit models of the likelihood of having high work ability were estimated using SPSS version 25. RESULTS: Work ability decreases with increasing age, comorbidity, high body mass index, having at least one child under 5 and/or a dependent adult, having a poor work-life balance, and doing more than 20 h of housework. Specific job resources can significantly promote work ability, including relationship-oriented leadership, autonomy in decision making and individuals' skill match. The nursing profession is associated with a low work ability. Finally, a significant gender gap has been documented. Women find it more difficult to reconcile life and work, especially when they have children of preschool age and work in professions with greater responsibilities, as in the case of women doctors, who experience lower work capacity. CONCLUSIONS: Our results suggest that it is necessary to consider other factors, in addition to age, that are equally relevant in influencing work ability. Consequently, organisational interventions could be implemented to improve the work ability of all workers. In addition, we propose targeted interventions for groups at risk of reduced work capacity, in particular older workers (45 years and over), nurses, women with children of preschool age and in the position of physician.

Effects of panic-specific cognitive behavioural and psychodynamic psychotherapies on work ability in a doubly randomised clinical trial.

Objective: The effects of panic-specific psychotherapy on occupational functioning remain under-researched. This study tests whether two brief psychotherapies for Panic Disorder with or without Agoraphobia (PD/A) may generate improvement in work ability. Methods: Adults (N = 221) with a primary diagnosis of PD/A were randomised to wait-list, panic-focused psychodynamic psychotherapy (PFPP), panic control treatment (PCT), or to the choice between the two treatments. Participants completed the Work Ability Inventory (WAI) at baseline, post-treatment, and during 24-month follow-ups. Change in WAI scores were assessed using segmented multilevel linear growth models, and mediation was explored through path analysis. Results: WAI scores changed from the moderate to good range between baseline and post-treatment (SMD = 0.45; 95% CI [0.33, 0.57]) and continued to increase throughout the follow-up (SMD = 0.16; 95% CI [0.03, 0.28]) with no differences between treatments or allocation forms. In PFPP (but not in PCT) pre- to post-treatment change in WAI was mediated by reduction in panic symptoms and WAI predicted employment status and absences. Conclusions: Two brief panic specific psychotherapies, one cognitive behavioural and one psychodynamic, produced short and long-term increases in work ability.

Work Ability and Its Correlates With Workers Aging Among Blue-Collar Workers in a Manufacturing Company: A Cross-sectional Study.

OBJECTIVE: This article assesses work ability in a sample of blue-collar workers who often perform physically demanding tasks. METHOD: The data collected resulted in 354 validly completed questionnaires from 426 participants (response rate: approximately 90%). RESULTS: In this sample, the average score on WAI of workers is 37.42 (SD = 6.62), indicating good work ability. Regression analyses revealed that work ability was significantly associated skill discretion (ß = 0.365, P = 0.001), home-work conflict (ß = -0.199, P = 0.001), and work-home conflict (ß = -0.320, P = 0.001). CONCLUSIONS: Of the psychosocial factors examined in this study, skill discretion was the most important factor associated with work ability. Therefore, it is necessary to develop measures that support this component.

Physiotherapists' engagement in work ability and return to work issues of patients with musculoskeletal disorders. A cross-sectional survey in Norway.

BACKGROUND: Work and health are a national priority in Norway, and leading health authorities call for treatment approaches that incorporate these perspectives. We have little knowledge of how physiotherapists in private practice integrate the work perspective during the treatment of patients with musculoskeletal disorders. Thus, the purpose of this study was to gain more insight into the way physiotherapists in Norway integrate the aspect of work. METHODS: In 2021, all 2650 privately practising members of the Norwegian Physiotherapist Association received a web-based survey that was answered by 514 physiotherapists. The survey included questions about treatment approaches, competencies, and collaboration with other health professionals in the context of promoting work participation. RESULTS: 91% of the physiotherapists reported that they play an important role in assessing work ability. 75% were confident in assessing the patients' work ability, while 25% stated that they have little or some competence. 49% of the physiotherapists often contacted the general practitioner (GP) to discuss patients' ability to work, and 19% were often contacted by the GP. Only 14% stated that they were invited to participate in dialogue meetings with the Norwegian Labour and Welfare Administration. 28% of the physiotherapists reported that insufficient knowledge about social security issues was an obstacle in promoting the patient's work participation. The physiotherapists believed that increased use of standardised assessment tools, better knowledge of social security issues, and closer collaboration with other professionals may strengthen their role in promoting work participation. DISCUSSION AND CONCLUSION: Although physiotherapists promote work participation when treating patients on sick leave, limited communication with the stakeholders, and inadequate knowledge of social security issues pose an obstacle. To strengthen the physiotherapist's role in the return-to-work facilitation, work and health should become a separate subject in basic and advanced education programmes for physiotherapists.

Social and health care top managers' perceptions and aims of strategic work ability management in the midst of change.

BACKGROUND: Existing research has mostly focused on themes related to returning to or staying at work and studied organizations' operational rather than strategic level actions to support work ability. Top managers' understanding of work ability management (WAM) may influence how work ability support processes are implemented in organizations. OBJECTIVE: To find out how top managers define WAM, what the aims of WAM were and whether the aims were on a strategic level. METHODS: Altogether 28 semi-structured interviews among Finnish social and health care top managers were conducted during the years 2019-2021 and analyzed inductively using qualitative thematic analysis. RESULTS: Top managers' definition of WAM was mainly multidimensional. Two main aims were identified, i.e., to support work ability 1) at the individual and 2) at the organizational level. The aims of the former were to anticipate the decrease of health and functional capacity, to support workers already decrease in these, to develop competence, and to manage the effects of changes on work ability. The aims at the organizational level were to improve labor availability and personnel retention, to ensure the flow of work, and to increase trust and create shared values. Top managers described the aims as being at a strategic level, but this was not yet realized in their organizations because the actions were reactive rather than proactive. CONCLUSION: Top managers' multidimensional perception of WAM, emphasizing proactive actions, and strategic level aims are crucial and require the commitment of the top managers for strategic WAM, especially during constant changes.

Urinary incontinence associates with poor work ability in middle-aged women: A Northern Finland Birth cohort 1966 study.

INTRODUCTION: Urinary incontinence is a common ailment in women and is likely to affect their work ability. We investigated the associations between the different subtypes of urinary incontinence and several dimensions of perceived work ability in middle-aged general population. MATERIAL AND METHODS: Cross-sectional survey at age 46 among participants of the Northern Finland Birth Cohort 1966 study (n = 3706, response rate 72%). Urinary incontinence symptoms and several items of Work Ability Index were collected by postal questionnaire. Work ability was dichotomized as good or poor work ability in general, in relation to physical job demands, to diseases and own 2-year prospect of work ability. The associations between urinary incontinence and work ability measures were assessed using logistic regression models, with further adjustments for biological, behavioral and work-related factors as well as general health. RESULTS: The odds ratio (OR), from lowest to highest, for poor work ability were 1.4-fold among women with stress urinary incontinence (OR 1.37, 95% confidence interval [CI] 1.09-1.72), 2.5-fold with mixed urinary incontinence (OR 2.51, 95% CI 1.68-3.74) and 3.3-fold with urgency urinary incontinence (OR 3.34, 95% CI 1.95-5.70). We note that our results reflect work ability in a Nordic society. CONCLUSIONS: Especially urgency and mixed types of urinary incontinence are associated with poor work ability among middle-aged women.

Work Ability and Work Nonparticipation: A Prospective Study of 2426 Participants in Germany.

OBJECTIVE: The aim of the study is to examine the association between work ability and work nonparticipation, including long-term sickness absence (LTSA), unemployment (UE), and disability pension/early retirement (ER). METHODS: We conducted a questionnaire-based 5-year follow-up study on a representative sample of the German working population (n = 2426). We used a two-part model to examine the association of continuous Work Ability Index (WAI) scores with the probability of events of work nonparticipation and the duration thereof. RESULTS: Higher WAI scores were protective against total work nonparticipation (an index combining the three indicators), LTSA, ER and UE, the latter among males only. Higher WAI scores were protective also against duration of total work nonparticipation and LTSA, but not against duration of UE and ER among males and duration of UE among females. CONCLUSIONS: Higher WAI scores have a protective role against work nonparticipation.