Presentation T P5

T P5 (Poster Presentation):
Decision-making during work rehabilitation interventions: is concertation needed upon return to work?

Presented by: Marie-Michelle Gouin

Authors

Gouin MM1,2, Truchon M1,2

  1. Université Laval, Québec
  2. Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

Abstract

Background

Long-term work disability after a musculoskeletal disorder is a rare but costly phenomenon (INSPQ, 2010). Workplace interventions (WI) would be effective to prevent it (Franche et al., 2005; Van Oostrom et al., 2013). Therapeutic Return to Work (TRW) is a particularly documented WI in Quebec where the stakeholders (eg. employer, worker and insurance board) must agree on WI strategies (eg. work task progression). To date and to our knowledge, no study has yet explored the types of decision-making (e.g. concertation, negotiation and imposition) in a WI. This study documents the dialogues in TRW leading us to (1) analyze the decision-making process; and (2) explore how the type of decision-making could influence sustainable return to work.

Methods

An exploratory multiple-case study (n=6) is carried out; each case corresponding to the dialogues between the stakeholders involved in the rehabilitation program. Data comes from non-participatory observations of meetings at three key moments (e.g. at the beginning of the program, at the beginning of TRW and after the end of the program), individual semi-structured interviews (with worker, occupational therapist and employer) and the consultation of documents. Inductive analysis is led for every case (intra-case), then in comparison (inter-case).

Results

TRW was set up for two cases; attendance at work was not possible for three of the cases; and a WI (not TRW) was set up for the last case. For all five cases involving a multidisciplinary follow-up, decision-making analysis between members suggests that there would be concertation. Nevertheless, analysis also suggests the possibility of negotiation and imposition between one or several member(s) of the interdisciplinary team and the other parties (e.g. worker and employer). Although more difficult, return to work would remain possible in cases of negotiated or imposed decision-making.

Conclusions

Concertation would not be the only possible type of decision making during a WI: negotiation and imposition would also be likely. A better understanding of the types of decisions in WI could contribute to raise the awareness of interdisciplinary members about their potential presence and influence on return to work. Given the restricted number of cases analysed, additional studies are required.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Social issues