Work ability: Concept and assessment from a physiotherapeutic perspective. An interview study

Abstract

The aim of this study was to ascertain experiences and perceptions among physiotherapists (PTs) in Sweden regarding the concept of work ability as well as their perspectives of their professional role in work ability assessments. We conducted an in-depth interview study with four male and twelve female physiotherapists working in the field of occupational health care, orthopaedics, primary health care or rehabilitation. Qualitative content analysis was applied to the data. Work ability was perceived as the ability to perform work tasks as requested. Having the potential to adjust at work and to allocate resources, having an attachment to the workplace and time factors were vital. The physiotherapists were striving for a well-defined role within a multiprofessional team, where work ability assessments were performed in a real work environment. The PTs experienced contradictory roles in relation to the patient but believed they could contribute with valuable material for assessments; this professional help was not always requested. It was noted that there was a need for experience and further education to enable PTs to further engage in work ability assessments. It is important to improve collaboration and to further discuss the work ability concept from the viewpoints of different professionals.

Primary Healthcare Professionals’ Experiences of the Sick Leave Process: A Focus Group Study in Sweden

“…The informants in our study appeared less confident in their competence to assess work ability than in the two previous studies [24,25]. The work ability assessment is central for entitlement of sickness benefits in the Swedish social security system, but our findings indicate that the work ability assessment may not be that central in practice.…”

“…The physiotherapists reported assessing body impairments and activity limitations, and the occupational therapists reported assessing activities of daily life; however, neither they nor the counsellors felt that their competence was requested. There are few studies investigating the role of other healthcare professionals in sickness certifications [23,26], but two previous Swedish interview studies with physiotherapists [24] and occupational therapists [25] confirm our findings regarding available competence to assess work ability, which is not being requested.…”

“…In our study, the conflict in role responsibility between the patient advocacy and medical expert for the social security system was found to be valid for different professionals, who primarily considered them to represent the patient. This role conflict has been reported by physicians [9,11,8] and recently also by physiotherapists [24].…”

“…When there is a need for sick leave the physician together with the patient considers the advantages and the disadvantages of being on sick leave, determines the grade (full-time or part-time) and duration of sick leave, and what actions that need to be taken during the sick leave period in terms of investigations, treatments and rehabilitation interventions [3]. Previous research has shown that physicians belief that sickness certifications would benefit of involvement of other healthcare professions [18,10,8,23] and that physiotherapists [24,23] and occupational therapists [25] feel they have the competence to participate in work ability assessments. The few studies investigating the team members' roles indicate however an ambiguity in the team whether other healthcare professionals are supposed to work with work ability assessments [26].…”

Neurologists dealing with sickness certification: Experiences of problems and need of competence

“…The results regarding problems with assessing patients' work capacity are in line with results from other studies (Bränström et al., 2014; Kedzia et al., 2015; Ljungquist et al., 2015; Lofgren et al., 2007). Physician's knowledge regarding specific work demands of patients is often very limited (Stigmar, Ekdahl, & Grahn, 2012) and even when good, most expressed lacking an instrument to assess work capacity. Also, most did not have contacts with patients' employers (Table 2).…”