Translating research into practice: Can we get there from here?

Abstract

In two articles appearing in this journal issue, the researchers challenge lay-public notions of persons with rheumatoid arthritis (RA) (1,2). Mancuso and colleagues demonstrate that there are few differences between patients with RA and healthy controls on a range of workplace issues and especially negative workplace experiences (1). In a well-designed longitudinal study, the authors demonstrate that persons with RA confront the same workplace conditions as healthy workers. Varekamp and colleagues use qualitative techniques to allow laypublic notions of working with arthritis to emerge from both employees with arthritis and the health professionals that treat these individuals (2). Surprisingly, there was much common ground between the 2 groups concerning what is needed for persons with arthritis to continue working. The challenge, manifested in the Varekamp et al study, is how to frame or conceptualize the problem both to enable research and to ensure that the knowledge generated from the research is translated into practice.Mancuso and colleagues use a stressful life events model to guide their work. This model, grounded in a rich intellectual research tradition, may not be the most relevant for labor market issues. The challenge has always been how to translate stress research into sound secondary prevention activities. Drawing on a strength of qualitative work, Varekamp and colleagues allow the theoretical issues to emerge from the participants. Their call for a multilevel, patient-centered approach to treatment and prevention is equally difficult to translate into practice in work settings due to the often competing agendas of the various individuals involved (managers, supervisors, insurers, health professionals, person with RA) and the broader organizational and societal context. Neither study helps achieve secondary prevention activities from the research.It is critical to consider the employer and the organizational context in which the person with RA works, from both a research perspective as well as a practice perspective. Organizational policies and practices (OPPs) have been shown to predict successful work role functioning in patients undergoing carpal tunnel release surgery (3). These policies and practices capture the broad culture of the organization, specifically safety climate, disability management policies and practices, and ergonomic policies and practices. Williams et al have shown how OPPs vary across organizations (4). Many of the themes and subthemes identified by Varekamp et al fit into the OPPs perspective (5). These themes and subthemes are not characteristics of the employee, but the organization the employee works in. Similarly, the health professionals also identified these same OPPs. Certainly, Varekamp and colleagues could reframe their findings, locating the employee within the organization and having health professionals work with the employer and the employee to manage RA more effectively. Why care about OPPs? The employer plays a key role in the management of work disabilit...