The physiotherapist's role in the management of stress-related work absence in vocational rehabilitation

Welcome to Queen Margaret University's Current and Emerging Roles in Physiotherapy Practice project. This space was created by and for the students at Queen Margaret University in Edinburgh, UK. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editor - Your name will be added here if you created the original content for this page.

Top Contributors - Alix Maxwell, Lucy Camlin, Roxanne Sasha Ross, Laura Robertson, Kim Jackson, Hannah Radford, 127.0.0.1, Claire Knott, Amanda Ager, Admin and Jane Hislop  

Introduction

Explain purpose of wiki, (final year students, background and context, justify relevance)

- introduce learning tasks and lighbulb 'key points' that will occur throughout the wiki

- suggest that people can commen/give feedback?! State how we would actively like people  

Learning Outcomes

Aims

The aims of this wiki are:

1)To present a learning resource for Scottish final year physiotherapy students and newly qualified graduates which aims to develop their evidence-informed knowledge and understanding of vocational rehabilitation.

2)To present a learning resource for Scottish final year physiotherapy students and newly qualified graduates which aims to develop evidence-informed knowledge and understanding of vocational rehabilitation for stress-related work absence and promote in-depth exploration of the physiotherapist’s role in this area.

Learning Outcomes

Through completion of this wiki you will be able to:

1)Synthesise the main principles of vocational rehabilitation and critically analyse its role in achieving an optimum vocational outcome.

2)Explain the impact of stress and stress-related work absence on the individual.

3)Critically evaluate the role of the physiotherapist in the management of stress-related sickness absence/work loss in stress and how this relates to vocational rehabilitation settings.

4)Critically reflect on the challenges facing the physiotherapist in vocational rehabilitation.

Stress

Definition

There are numerous definitions of stress but no generally established scientific definition, (Waddell & Burton 2006). However, the Health and Safety Executive (2012) define stress as the negative response an individual exhibits when excessive pressure or demands are placed on them. 

Prevalence

Facts and fig.

Mental health conditions are increasingly prevalent
Stress is increasingly reported

Although not a medical condition in itself, stress that is left unmanaged has been associated with mental and physical health problems such as anxiety, depression, cardiovascular disease and musculoskeletal pain, (CIPD 2011).

Impact

Although there is a collective opinion that mental health problems are caused by work the relationship between the two is complex. While there is strong evidence that work is good for both mental and physical health, there is also evidence that mental well-being can be adversely affected by work.

Work-related stress may occur when individuals are faced with work demands or pressures they cannot cope with or have very little control over. The Health and Safety Executive defines stress as the negative response an individual exhibits when excessive pressure or demands are placed on them. Job stress is one of the top 10 work-related health problems and has increasingly been associated with the occurrence of mental health problems, cardiovascular disease and musculoskeletal disorder, (Waddell and Burton 2006; Habibi, Dehghan and Hassanzadeh 2014).

It is believed that the pathogenesis of physical disease is influenced by stress. Stress results in the production of adverse affective states which have a direct impact on the biological processes and behavioural patterns that predispose an individual to the risk of disease.

Stress can elicit the same responses that the body would produce if it were under physical danger. The body goes into ‘flight or fight’ mode triggering stress hormones adrenaline, noradrenaline and cortisol which in turn cause accelerated breathing, increased heartrate and dilation of blood vessels leading to increased blood pressure. In small amounts these responses are not harmful however when exposed to them for prolonged periods degenerative changes can occur within the body. Prolonged exposure to increased heart rate, blood pressure and stress hormones consequently lead to hypertension, arrhythmias, myocardinal infarctions, or stroke, (Torpy et al 2007). Furthermore, adrenaline can cause muscles to automatically contract and tense up in a biological response to stress as a means to protect the body from further harm. Prolonged exposure to muscle tension and muscle overuse causes the muscles to fatigue, tighten or degenerate consequently increasing the risks of developing musculoskeletal disorders, (Lundberg 2002).

Stress can cause psychological changes that result in numerous adverse effects on an individual such as reduced competency, diminished initiative, reduced thought flexibility, loss of accountability and reduced concern for both work colleagues and the organization as a whole. Additionally stress alters an individual’s physical state. The changes that occur in muscular structures can cause pain and discomfort resulting in an individual finding it difficult to sit at an office desk the whole day or concentrate on work tasks due to lack of comfortability. If stress is not managed immediately the physical and psychological effects of it that consequently lead to mental and physical changes can stop an individual from working at optimum capacity, (Ongori and Agolla 2008).

The conservation of an individual’s physical and mental health depends on their ability to adequately satisfy the demands they are confronted with. The greater an individual’s ability and control are over the exposed demands the more effective the response produced will be. Conversely, when an individual is exposed to demands found to predominate their current knowledge and abilities they exhibit reduced capacity to work and perform their job adequately causing them to produce responses that are not effective, (Negeliskii and Lautert 2011).

A major contributor to an organizations profit and its existence is the amount of productivity delivered by employees. It is well established that excessive stress is detrimental to both an individual’s mental and physical well-being as well as productivity. With knowledge of this it can be recognised that stress is therefore a serious concern for organizations. Mental and physical changes can significantly influence an individual’s ability to work effectively which as a consequence can lead to increased absentee rates, increased turnover, sickness absence and work-related accidents. All of which negatively impact on an organization by decreasing its probability of success in competitive markets through reductions in overall productivity and service quality as well as increased expenditure on recruitment and selection costs as a result of turnover effects, (Ongori and Agolla 2008; Ekundayo 2014). Additionally, these factors cost the national economy an astounding amount of money annually through sickness absence which results in sick pay, staff turnover and lost productivity. Furthermore, social welfare systems endure the costs of medical care and potential compensations in salary, (Park 2007; Hauke et al 2011).

Vocational Rehabilitation

What is it

Who is involved; MDT, (PT is part of this...)

Physiotherapists Role in Vocational Rehabilitation

Which settings are they involved in

What conditions/problems do they help deal with What interventions do they use to help these problems

Look specifically into stress management

Link into PT and stress: managment and return to work

Challenges to Vocational Rehabilitation

- barriors

- communication

- teamwork

early intervention

gap between reserch and practice- we can all add to

managment oposition

lack of resources, policy support, networks like other organisations

work hand in hand with employers and pts

Internal barriors

Managers beliefs

Barriors to returning to work in stress

Specific to PT_________________________________________________________

- barriors to PT in stress; pts communication style changing when stressed

Physiotherapist Role in Managing stress through VR

- Consolodate all evidence

 

Conclusion

- - Linking diagram; consolodating eveything

References

References will automatically be added here, see adding references tutorial.