Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Formation of Solutions for Rheumatic Condition-Related Work Barriers by Occupational and Physical Therapists (OTs/PTs).

Allaire2,  Saralynn H., Keysor1,  Julie J., Baker5,  Nancy A., Niu3,  Jingbo, LaValley4,  Michael P.

Boston Univ Sargent College, Boston, MA
Boston Univ School of Medicine, Boston, MA
Boston University, Boston, MA
BU School of Public Health, Boston, MA
University of Pittsburgh, Pittsburgh, PA

Purpose:

Identification of patients' rheumatic condition work barriers along with generation of solutions for barriers can reduce work disability. We have been exploring whether this type of intervention could be effectively provided by OTs/PTs. In a previous study 10 OTs/PTs had difficulty generating solutions for patients' work barriers. To address this finding we used literature and expert opinion to develop an informational booklet containing possible solutions for a wide variety of barriers. In this study, we examined solution generation quality in a large sample of OTs/PTs and tested the effect of providing the solution booklet on quality of solutions generated.

Methods:

Subjects were recruited from OT/PT professional associations. We developed and pre-tested 3 patient cases. Case information included a patient's 3 most bothersome barriers. and subjects were asked to provide >= 1 solution for these 3 barriers. OT and PT subjects were each randomized to either receive (experimental=EXPM) or not receive (control=CTRL) the solution booklet to use as a resource. Three reviewers, blinded on subjects' EXPM/CTRL and OT/PT status, rated the helpfulness of the solutions generated by each subject using a 5-point ordinal scale. Proportions of EXPM and CTRL subjects giving solutions rated as probably or very likely helpful were calculated. Wilcoxon rank tests were conducted to examine differences in the solution helpfulness scores between the two groups.

Results:

113 subjects provided data, 55 OTs (26 EXPM/ 29 CTRL) and 58 PTs (24 EXPM/ 34 CTRL). To date we have evaluated data from 2 cases. The quality of solutions generated by CTRL subjects was good for 2 physical activity type of work barriers, with >= 75% giving probably/very likely helpful solutions. The helpfulness scores of solutions from EXPM subjects for these 2 barriers were not significantly better. For a work/home life barrier the quality of CTRL subject solutions was poor, with only 22% providing helpful solutions. The EXPM subject solution score for this barrier was significantly better (p=.04), but quality was modest with 40% of solutions helpful. The quality of CTRL subject solutions for the remaining 3 barriers was modest with 45% giving helpful solutions for a cognitive barrier, 56% for a company policy barrier and 35% for a vocational direction barrier. However, the quality of solutions given by EXPM subjects for these barriers was good with 86%, 76% and 82% respectively giving helpful solutions (p<.001 for all).

Table. Helpfulness of Solutions Formed by Subjects Who Did and Did Not Receive Information about Possible Solutions

Work barrierSubjects Who Did Not Receive information (CTRL)* n = 63Subjects Who Did Receive information (EXPM)* n = 50p value for comparison of CTRL/EXPM solution quality scores†
Physical job activity barrier: prolonged standing
  Proportion giving helpful solutions‡75%†76% 
  Median (interquartile range) score§3.0 (2–4)‡3.5 (3–4)0.08
Physical job activity barrier: carrying suit cases
  Proportion giving helpful solutions87%90% 
  Median (interquartile range) score4.0 (3–4)3.5 (3–4)0.75
Work/home life barrier: attending children's recreational events
  Proportion giving helpful solutions22%40% 
  Median (interquartile range) score2.0 (1–2)2.0 (1–3)0.04
Cognitive work barrier: concentrating on work activities
  Proportion giving helpful solutions45%86% 
  Median (interquartile range) score2.0 (0–3)4.0 (3–4)<.0001
Company policy barrier: completing required overtime hours
  Proportion giving helpful solutions56%76% 
  Median (interquartile range) score3.0 (0–3)3.0 (3–4)0.0002
Vocational direction barrier: change job/career
  Proportion giving helpful solutions35%82% 
  Median (interquartile range) score2.0 (1–3)4.0 (3–4)<.0001
*CTRL = control group; EXPM = experimental group
†From 0–4 rating of quality (helpfulness) of proposed solutions; 0 = unlikely to be helpful, 4 = very likely to be helpful
‡Subjects giving responses rated as probably (3) or very likely (4) to be helpful
§Wilcoxon rank statistical analyses

Conclusions:

OTs/PTs not receiving supplemental information about potential solutions had only a modest ability to form helpful solutions for work barriers not related to physical job activities. However, providing information on ideas for solutions greatly enhanced the quality of solutions for other types of work barriers.

To cite this abstract, please use the following information:
Allaire, Saralynn H., Keysor, Julie J., Baker, Nancy A., Niu, Jingbo, LaValley, Michael P.; Formation of Solutions for Rheumatic Condition-Related Work Barriers by Occupational and Physical Therapists (OTs/PTs). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2143
DOI: 10.1002/art.29907

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