Work Assessment Components PDF

[Components of the Work Assessment ] *See above notes on: Referral* What comprises the **clinical examination** of a work assessment? ----------------------------------------------------------------- - Blood pressure, heart rate → endurance & engagement - Height, weight (BMI) - Clinical e...

[Components of the Work Assessment ] *See above notes on: Referral* What comprises the **clinical examination** of a work assessment? ----------------------------------------------------------------- - Blood pressure, heart rate → endurance & engagement - Height, weight (BMI) - Clinical examination suited to diagnosis and impairment. - Vision screen - Muscle strength → usually a functional assessment not MMT - Grip strength (dynamometer) - Range of motion → functional assessment - Oedema - Appearance of affected limb, e.g., scarring, skin grafting - Cognitive screen, e.g., MOCA, MMSE What comprises the **Questionnaires** component of work assessment? ------------------------------------------------------------------- - Relevant to the diagnosis, impairment, and job - Correct literacy level and language of client - Usually person (patient) rated - Gives indication of how person rates their own impairment, and also idea of literacy - Pain scales - Provide details of type, intensity, frequency of pain experienced by client - Functional scales to describe and quantify dysfunction - Lower Extremity Functional Scale - Oswestry Low Back Pain Questionnaire - Disabilities of Arm, Shoulder and Hand (DASH) - Psychosocial assessment tools - E.g., GAD7, PHQ9 - Useful to assess anxiety, PTSD and other mental health that influences work performance - Generalised disability scales - E.g., WHODAS 2.0 - Useful to assess how the individual experiences disability and their motivation What comprises the **Skilled observations** components of work assessment? -------------------------------------------------------------------------- - \*See B OT I Lectures - Advantages - Can observe person in real work situation - Easily applied to context - e.g., school of skills, training centres - Can be used for collateral information - Disadvantages - Usefulness can vary depending on skill level of clinician - More experienced and more skilled can gain more information - May be unable to observe person in real work context What are **Work Samples** as a component of work assessment? ------------------------------------------------------------ - Definition → small sample of what the total work involves. - Simulated work activity that resembles the actual work situation as it occurs in industry. - Allow the person to function as a worker, manipulate specific tools and display worker characteristics. - Example: VALPAR Work Samples - Advantages - Large variety of VALPAR work samples → applicable to [many] work contexts - Provides opportunity to observe simulated work and work-related behaviors in a controlled, standardized setting. - Approximates real jobs - Facilitates development of vocational plan for an individual - Gives clear instructions for verbal administration and demonstration - Standardized assessment - Provides immediate feedback to person on their performance - Can be used for work rehabilitation - Criterion-referenced (not norm-referenced) → applicable for SA population - Minimal reading and writing requirements - Disadvantages - Very expensive to purchase -- American tool - Not a complete FCE protocol on its own - Must be combined with other components of work assessment - Some aspects may need to be converted for South Africa - e.g., electricity, weight - Standardized instructions are in English - Standardization is lost with translation - Work samples may not be culturally relevant for SA population - Need to be critical about appropriateness for client & environment What are some other standardized assessments / performance-based tests? ----------------------------------------------------------------------- - Various tests of occupational enablers you may have learnt in other areas of OT - Smith Hand Function Evaluation - Purdue Pegboard - Advantages: - Usually easily available equipment in an OT practice - Can assess practical task execution quickly and easily - Useful in low resource environments - Disadvantages - May not be representative of performance in the workplace - May not represent actual tasks, tools or methods used. What are **Simulated work tasks** as a component of work assessment? -------------------------------------------------------------------- - Definition → method for evaluating a person's ability or facilitating work rehabilitation, by simulating the regulations, work task or workplace (workstation) and culture of a workplace as accurately as possible. - Creates an atmosphere of work by - Using materials, equipment and tools usually found in the workplace - Establishing realistic work attitudes - Setting expectations → productivity and performance standards - Observing person performing structured tasks which resemble tasks found in the workplace - Setting the same rules and regulations as in the actual workplace - Performance in simulated work task is compared with qualitative & quantitative standards in industry. - Advantages - Person can experience working with tools, materials and equipment found in the workplace in a "safe" environment - Person can evaluate own performance realistically in a supportive situation - Eliminates the pressure of producing a product or service for payment - Allows for person to adjust to their limitations and find new ways of coping, try assistive devices - Direct feedback - Disadvantages - It is an approximation -- may not be representative of the actual work situation - May not have the required tools or equipment for simulation - May be other variables in the workplace that cannot be simulated → social behavioural aspects of workplace What are **Actual work tasks** as a component of work assessment? ----------------------------------------------------------------- - Gold standard → assess worker in actual work environment doing actual tasks - Advantages - Can obtain accurate information about actual job demands - Can obtain accurate information about the workers performance in actual job - Facilitates contact with employer/supervisor/manager - Disadvantages - Time consuming -- travel to site etc. - Can be difficult to arrange or impractical - Consider PPE, safety, and confidentiality requirements on site What are **Work visits / worksite evaluations** as a component of work assessment? ---------------------------------------------------------------------------------- - Definition → On the job assessment to determine whether person can return to work or needs reasonable accommodations to facilitate return to work. - Entire work assessment can be conducted at the worksite, or a work visit can be conducted after the work assessment at the clinic/practice site - Enhances the validity of the work assessment - What needs to be considered in preparation for the work visit? - Obtain job description or job demands analysis from employer, HR practitioner, or worker - Schedule a time with the worker and supervisor/manager/employer - Find out about PPE and confidentiality requirements (photos/videos) - Clipboard, tape measure, camera, pen, scale, safety shoes/helmet - What do you do at the worksite? - Observe an employee in their actual job you are assessing & practice yourself - Confirm whether job demands analysis is correct - note additions or changes - use activity analysis - Find out what the essential functions are - Ask about quality and quantity standards - Assess the work environment - e.g., parking, distance to break room & toilets, stairs, ergonomics - Contact employer - additional info, discuss possibilities for reasonable accommodation What is **Task analysis / job demand analysis** as a component of work assessment? ---------------------------------------------------------------------------------- What is a **Protocol based assessment / FCE** as a component of work assessment? -------------------------------------------------------------------------------- - Standardised protocol for FCE - Step by step guide of what order to conduct tests in - E.g., Workwell, Joule, Ergoscience - Advantages - Has established psychometric properties - Well researched - Easily defensible in legal battles - Disadvantages - Certification and training is expensive - Often developed outside of South Africa -- check cultural appropriateness - Prescribes assessments to be done and test procedure → client centredness - Can limit or downplay clinical reasoning of the practitioner [The Work Abilities Framework] What is the Work Abilities Framework? ------------------------------------- - Framework used to guide work assessment - Particularly useful to use with people who don't have predominantly physical impairments - i.e., intellectual impairments or psychiatric illnesses - When using this framework, reference the university slides - Coetzee, Z. Work Assessment Lecture Slides, Stellenbosch University Occupational Therapy second year, 2019. What are the components of the framework? ----------------------------------------- - General information - Name of client - Age of client - Reason for referral - Presenting symptoms - Date/s of assessment - Job title - position you are assessing the person for - Level of productivity - Obtained by asking person - Compare to pre-morbid levels (percentage/descriptive) - Can also be obtained from supervisor / manager / employer - Specify standard (school of skills / open labor market standard) - Work Habits - **Personal presentation** → for all of these record the sources, methods, dates results and comments made/used during the assessment - Attendance and punctuality - How regularly do they attend work / school? - Are they punctual? - When they are absent, why are they absent? - Appearance - Collateral information - Observe using skilled observation - Clothing & personal hygiene & appropriateness - Self-discipline - Are they able to follow instructions? - Are they able to discipline themselves to complete the task? - Are they able to keep to the task at hand? - Obtained through observation / collateral information - Social presentation - How do they interact with others in workplace? - Respect for others in how they interact / communicate - Cooperation in group tasks - Work competency - **Ability to follow instructions** → differentiate familiar & unfamiliar tasks - Demonstration - Do they require this? - How many times before they are able to follow? - Verbal - Are they able to follow? - 1/2/3 step instructions? - Written - Particular language? - What level? - Combinations → pictures & verbal & demonstration - **Stages of task performance** → explain the task and then observe: - Planning a task - What are the steps? - In which order should these be done? - Executing a task - Do they use the appropriate tools & materials in an appropriate manner? - What is the quality & speed of execution? - Completing a task - Can they focus / self-discipline? - How much supervision is required? - Evaluating a task - Can they determine whether they have made any errors? - E.g., ACLS very good assessment; identify & correct mistake - Care of and use of materials, equipment, and machinery - Look at job demand analysis which specifies tools/equipment/etc. - Are they able to use them in appropriate manner? - Can they name them? - Do they know what the purpose is? - Are they able to care for the tools --- clean & maintain? - Work endurance - Often where the big problem lies - Physical - Assessment methods - METS scale - Dictionary of occupational titles: job demands analysis - Heart rate & physical signs of fatigue - 6 min walk test - Results & comments - Psychological - Is the person able to concentrate for the duration they are needing to? - Can they pay attention? - Can they concentrate and block out non-essential stimuli? - E.g., Thurstone questionnaire → add noise & test psychological endurance - Productivity - Employers perspective - Expected level - Determine this → varies according to labour market and nature of employment/environment etc. - Quality - Are they expected to maintain conversation / neatness standards / friendliness? - Quantity - How many items of quality standard did the client produce VS how many were of poor quality? - Work motivation - Intrinsic or Extrinsic factors - If they were motivated in the past, how were they motivated? - E.g., Earning income / engaging with other people - Adjustments / adaptations required - Looking at the results of all the previous assessment - Compare to standards that have been performed - Do they need to improve & where? - How can adjustments be made in the workplace to assist improvement? *See PDF for actual form* [Prevocational Assessment ] What is the role of OT in prevocational assessment? --------------------------------------------------- - Identify readiness to work in individuals - e.g., at special schools, schools of skills, adolescents with intellectual disability, people with mental illness - 2 aspects considered - Identifying with the individual person with disability or illness whether they are ready to enter employment → for first time / re-enter after period of disability - Identify factors of a particular job → aspects that may render someone better suited to or likely to succeed in the job - Important to be aware of unfair discrimination - Can identify areas that need further attention/rehabilitation What are the components of the prevocational assessment? -------------------------------------------------------- - **Psychometric tests** (e.g., Interest checklists, Role checklist) - Often inappropriate for use with intellectual disability or mental illness → standardized tests often inappropriate / difficult to use - Require literacy skills and cognitive skills → language appropriateness - **Work samples** (e.g., VALPAR, WASP) - Situational assessment - Assesses performance in natural or altered environment - Work related activities and task analysis - E.g., Work simulation - Worksite evaluation - Supportive employment - Work-trial → assess them while doing the job at the actual work environment, but they are not yet employed - Skilled observation → B OT I - Functional assessment - Look at abilities and skills when performing functional task / activity - ACLS - Assessment of work abilities using a functional task - e.g., making a sandwich, making a bed What skills are assessed in prevocational assessment? ----------------------------------------------------- - Work behaviours - Concentration and Attention span - Attendance and punctuality - Respect for authority and peers - Initiative - Motivation - Personal and social presentation - Physical capacities - Motor coordination - Mobility → walking & functional mobility - Strength and manual handling - Work tolerance / endurance (physical & psychological) - Cognitive abilities → varies depending on disability - Following instructions - Reading - Calculation - Self-supervision - Recognising and correcting errors - What can influence the skills and assessment thereof? - Area you are working in - Population you are working with - Jobs you are working with [Legislation and policies relevant to work practice in SA] What is the United Nations Convention on the Rights of Persons with Disabilities, 2006? --------------------------------------------------------------------------------------- - International Human Rights treaty - Adopted in 2006 in UN Headquarters in New York - Signed and ratified by South Africa in 2007 - What is article 26, and why is it relevant? - Article 26 → Habilitation & rehabilitation - *Habilitation*: providing services to enhance the functioning of people who have never reached optimal function - *Rehabilitation:* where someone was at a certain level of functional independence before the incident, and rehabilitation is about getting them back to that previous functional independence - States: - Parties shall take effective & appropriate measures, including through peer support, to [enable persons with disabilities to attain and maintain maximum independence], full physical, mental, social, and [vocational ability], and full inclusion and participation in all aspects of life. - To that end, States Parties shall organize, strengthen, and extend comprehensive [habilitation and rehabilitation services] and programs, particularly in the areas of health, [employment], education, and social services, in such a way that these services and programs: - Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths; - Support participation and inclusion in the community and all aspects of society - Are voluntary - Are available to persons with disabilities as close as possible to their own communities, including in rural areas. - Parties shall promote the development of initial & continuing [training for professionals & staff] working in habilitation & rehabilitation services - Parties shall promote the availability, knowledge and use of [assistive devices and technologies], designed for persons with disabilities, as they relate to habilitation and rehabilitation. - What is Article 27 and why is it relevant? - Article 27 -- Work & Employment - States - Parties recognize [the right of persons with disabilities to work; on an equal basis with others]; this includes the right to the opportunity to gain a living by work freely chosen or accepted in a labour market and work environment that is open, inclusive and accessible to persons with disabilities. - Parties shall safeguard and promote the realization of the right to work, including for those who acquire a disability during the course of employment, by taking appropriate steps, including through legislation, to, inter alia: - [Prohibit discrimination on the basis of disability] with regard to all matters concerning all forms of employment, including conditions of recruitment, hiring and employment, continuance of employment, career advancement and safe and healthy working conditions; - Protect the [rights of persons with disabilities, on an equal basis with others, to just and favorable conditions of work], including equal opportunities and equal remuneration for work of equal value, safe and healthy working conditions, including protection from harassment, and the redress of grievances; - Ensure that persons with disabilities are able to exercise their labour and trade union rights on an equal basis with others; - Enable persons with disabilities to have effective access to general [technical and vocational guidance programs], placement services and vocational and continuing training; - Promote [employment opportunities and career advancement] for persons with disabilities in the labour market, as well as assistance in finding, obtaining, maintaining and returning to employment; - Promote opportunities for [self-employment, entrepreneurship], the development of cooperatives and starting one's own business; - Employ persons with disabilities in the public sector; - Promote the employment of persons with disabilities in the private sector through appropriate policies and measures, which may include affirmative action programs, incentives and other measures; - Ensure that [reasonable accommodation] is provided to persons with disabilities in the workplace; - Promote the acquisition by persons with disabilities of work experience in the open labour market; - Promote vocational and professional rehabilitation, job retention and return-to-work programs for persons with disabilities. - Parties shall ensure that persons with disabilities are not held in slavery or in servitude, and are protected, on an equal basis with others, from forced or compulsory labour. What does the South African Constitution & Bill of Rights put forth? -------------------------------------------------------------------- - Right to Equality - Everyone is equal before the law and has the right to equal protection and benefit of the law. - Equality includes the full and equal enjoyment of all rights and freedoms. To promote the achievement of equality, legislative and other measures designed to protect or advance persons, or categories of persons, disadvantaged by unfair discrimination may be taken. - [The state may not unfairly discriminate directly or indirectly against anyone on one or more grounds], including race, gender, sex, pregnancy, marital status, ethnic or social origin, color, sexual orientation, age, disability, religion, conscience, belief, culture, language and birth. - No person may unfairly discriminate directly or indirectly against anyone on one or more grounds in terms of subsection - National legislation must be enacted to prevent or prohibit unfair discrimination. - Discrimination on one or more of the grounds listed above is unfair unless it is established that the discrimination is fair. - Relevant in Bill of Rights → Article 23 (Labour Relations) & Article 27 (Healthcare) What is the White Paper on the Rights of Persons with Disabilities? ------------------------------------------------------------------- - Speaks directly to the UNCRPD -- South Africa's implementation of this - Updates the 1997 SA White Paper on an Integrated National Disability Strategy - What are Economic rights? - As in the case of social rights, economic rights can be accorded to all persons with disabilities applying the social model and mainstreaming approach. - On a practical level, it means that, amongst other tasks, [persons with disabilities must be involved] in conceptualizing, developing, implementing and monitoring economic development policies and programs. Also they must be considered when programs and projects are planned (as beneficiaries and implementers) and that all [barriers to access to the mainstream economy must be eliminated]. - Employers must take on the responsibility for providing for [reasonable workplace accommodation] & economic infrastructure must be built and/or renovated according to the concepts of [barrier-free access & universal design] - What is 6.1 Pillar 1 → Removing Barriers to Access & Participation? - 6.1.1 Focus Areas: Six dimensions have to be addressed in order to **remove barriers to access and participation**: - Changing attitudes and behavior; - Access to the built environment; - Access to transport; - Access to information and communication; - Universal design and access; and - Reasonable accommodation measures - ensures that persons with disabilities enjoy, on an equal basis with others, all human rights and fundamental freedoms. The PEPUDA includes 'denial of reasonable accommodation' as a form of unfair discrimination - Reasonable accommodation support tends to be individual and impairment specific, and includes measures to: - Make the physical environment accessible; - Provide persons with disabilities with access to information and communication; - Redress stress factors in the environment; - Accommodate specific sensory requirements such as those relating to light, noise and spatial stimuli; - Improve independence and mobility of persons with disabilities; - Guarantee participation and supported decision-making by persons with disabilities; and - Provide access and participation to quality education and work. - Reasonable accommodation measures are therefore inclusive of assistive devices, assistive technology, personal assistance, adaptations of the built environ, signage, captioning, text available in audio, loop systems, FM systems, alerting/alarm systems for evacuation procedures, dedicated sms lines to all emergency service call centers, adaptation of (for example) work arrangements and the implementation of flexibility within the workplace to accommodate persons with disabilities - The International Labour Organization (ILO) estimated in 2009 that South Africa loses about 7% of its annual GDP (Gross Domestic Product) due to exclusion of persons with disabilities from the workplace and the subsequent productivity loss. - Economic security and social protection for persons with disabilities requires a complex web of inter-related interventions. Persons with disabilities must have access to adequate financial resources to cover the additional cost of living associated with disability - 6.5.1 Focus Areas: Four dimensions aim to accelerate reducing the economic vulnerability of persons with disabilities and their families and fostering economic self-reliance: - Disability, poverty, development and human rights; - Access to decent work and work opportunities; - Persons with disabilities as owners of the economy; and - Reducing the cost of disability for persons with disabilities and their families - Employees with disabilities must have access to affordable vocational rehabilitation, skills development, job retention and return-to-work programs after onset of disability. - Persons with disabilities can and should be active players in building the economy, and must therefore be enabled to access opportunities aimed at [ownership] of the economy What is the SA National Development Plan 2030? ---------------------------------------------- - National Development Plan aims to [eliminate poverty and reduce inequality] by 2030. - Eliminate income poverty -- Reduce the proportion of households with a monthly income below R419 per person (in 2009 prices) from 39 percent to zero. - Increase employment from 13 million in 2010 to 24 million in 2030. - Ensure that skilled, technical, professional and managerial posts better reflect the country\'s racial, gender and disability makeup. - Establish effective, safe and affordable public transport. - Make high-speed broadband internet universally available at competitive prices What is the Employment Equity Act, 1995? ---------------------------------------- - Promotes equity in the workplace - Ensures equal opportunities and fair treatment for all workers - Prevents unfair discrimination - Aims to achieve workplace equity through Affirmative Action - Designated employers only (50 or more employees OR high annual turnover OR municipality OR state organizations) - EXCEPT SA defence force, National Intelligence Agency, SA Secret Services - Redress disadvantages faced by designated groups: black people, women and people with disabilities - BUT no guidelines for percentages of each designated group - Protects employees from unfair medical testing, e.g. HIV What is the Labour Relations Act, 1995? --------------------------------------- - Schedule 8 - Code of Good Practice: Dismissal - Incapacity: Ill health and injury - Incapacity on the grounds of ill health or injury may be temporary or permanent. - If an employee is temporarily unable to work in these circumstances, the employer should [investigate the extent of the incapacity] or the injury. - If the employee is likely to be absent for a time that is unreasonably long in the circumstances, the employer should [investigate all the possible alternatives short of dismissal]. - When alternatives are considered, relevant factors might include the nature of the job, the period of absence, the seriousness of the illness or injury and the possibility of securing a temporary replacement for the ill or injured employee. - In cases of permanent incapacity, the employer should ascertain the possibility [of securing alternative employment, or adapting the duties or work circumstances] of the employee to accommodate the employee's disability. What is the Occupational Health & Safety Act, 1993? --------------------------------------------------- - Aims to ensure the health and safety of all employees, as well as all people who could be affected by actions of employees - Provides guidelines for maintaining health and safety in the workplace - Not specific to people with disabilities What is the Compensation for Occupational Injuries & Diseases Act, 1993? ------------------------------------------------------------------------ - Shortened to COIDA - Provides compensation for death or disability resulting from occupational injuries or diseases - Covers temporary or permanent disablement - Requires the government to set up a Compensation Fund - Employers pay "assessment fees" for all employees - Employees can then claim from the fund if they sustain an injury or disease in the course of their work (must be related to work) - Compensation is a lengthy process -- forms by employee, employer, medical practitioner - Pays at private rates - Funds are paid to employees or health practitioners directly, not the employer - Examples of occupational injuries: loss of a limb or part of a limb, loss of hearing - Examples of occupational diseases: Asthma, Covid-19, TB, work related musculoskeletal disorders (e.g. carpal tunnel syndrome) What is the Skills Development Act, 1998? ----------------------------------------- - South African act that aims to develop and improve skills in the workforce - Integrates strategies with the National Qualifications Framework (NQF) - Provides for learner-ships that lead to recognized qualifications - Promotes self-employment (entrepreneurship) - Manages the Minister of Labour to work with SETAs (Sector Education and Training Authority) in promoting learner-ships in workplaces -- practical work experience - SETA -- Sector Education and Training Authority: "a body responsible for overseeing skills development and training within a certain industry." - Learner-ship -- "A learner-ship is a structured learning process for gaining theoretical knowledge and practical skills in the workplace leading to a qualification registered on the NQF. A learner-ship is outcomes-based and not time-based and allows for recognition of prior learning. Learner-ship duration varies but the average is about 18 months." What is the Covid-19 Workplace Preparedness Guide, 2020? -------------------------------------------------------- - Issued by SA Department of Labour in March 2020 - Classifies worker exposure risk - Very high exposure risk -- e.g. healthcare workers doing aerosol generating procedures - High exposure risk -- e.g. healthcare workers exposed to persons confirmed or suspected with COVID-19 - Medium exposure risk -- e.g. contact with the general public - Lower exposure risk -- minimal contact with people - Makes recommendations for workplace controls - First review current risk assessment procedures in light of COVID-19 - Engineering controls, e.g. air filters, desk screens - Administrative controls, e.g. staying home when sick, reducing amount of workers onsite, worker education and training - Safe work practices, e.g. hand-washing, no-touch bins, disposable towels - Personal Protective Equipment (PPE), selected based on worker hazard, procedures for removal and cleaning [Outcome measures in work practice ] What is the purpose of using outcome measures? ---------------------------------------------- - Gives a baseline measure of where the person is at before treatment. - Allows for assessment of improvement & comparison at the end of / during treatment - Provides evidence of effectiveness of treatment. - Provides language to communicate goals & outcomes of treatment to stakeholders. - Allows for joint goal setting at the start of treatment. - Provides a structure for treatment How do you choose an outcome measure for use? --------------------------------------------- - Focus on participation (ICF) / function / occupational performance rather than body functions and structures (ICF) / occupational enablers - Be more functional & occupationally related, rather than body functions & structure - ROM & concentration doesn't necessarily mean that the person will be more productive/ effective at work - Client-rated vs clinician-rated outcome measures - Client-rated: client rates their own performance (e.g. DASH) - Clinician-rated: practitioner rates their own performance (e.g. RULA) - Psychometric properties: Validity, Reliability, Clinical utility, Practicality - Clinical utility: easily available, free, practical, quick to use, does it need specific training/ equipment What are the most commonly used outcome measures in work practice? ------------------------------------------------------------------ - Absenteeism / presenteeism (not used so much by OT) - Absenteeism: off work --- due to health condition - Presenteeism: at work, but not productive - Productivity (able to produce products at rate required --- norm & what is their level of performance/quality) - WORQ -- Work rehabilitation questionnaire (based on ICF) - DASH (Disabilities of the Arm, Shoulder and hand questionnaire) and other similar questionnaires (e.g. Oswestry LBPQ) - RULA (Rapid upper limb assessment) - Pain -- Visual analogue scale (most commonly used --- visual analogue scale) - COPM (Canadian occupational performance measure) - FCE (Functional capacity evaluation) - Client abilities plotted on the Physical demand characteristics of work table (looks at the job & the requirements of the job --- if you plot the client's abilities on that, it can be used as an outcome measure) ### How do you assess **Absenteeism**? - How much sick leave does the person take for their medical condition? - (compare the number before treatment to after treatment) ### How do you assess **Presenteeism**? - How much of the time are they at work but with reduced performance? - (more difficult to measure, but more valuable) ### How do you assess **Productivity**? - Is the quality or quantity of their work affected? - (in most manufacturing environments you will have an idea of the quantity of products the client is required to produce) What is the Work Rehabilitation Questionnaire (WORQ)? ----------------------------------------------------- - Six-page questionnaire - Different versions What are the advantages and disadvantages of the WORQ? ------------------------------------------------------ - **Advantages:** - Based on the ICF - International tool -- well researched - Interviewer administered and self report version - Quick version - Freely available - **Disadvantages:** - Not validated for South Africa - May not be suitable for people with low levels of education What is the DASH: Work Module? ------------------------------ - Standardized and validated assessment - Available in English, Afrikaans and isiXhosa - Freely available and well researched - Specifically includes a work module that can be scored separately to determine work performance and outcomes - Simple and quick to administer - Only suitable for persons with upper limb conditions - You would not only do the work module section, you would do the entire DASH What is the RULA: Rapid Upper Limb Assessment? ---------------------------------------------- - Ergonomic assessment - Looks at various arm movements & positions - Movements & positions weighted depending on how risky they are - Provides a risk score for a particular activity at work - Can show improvement or reduction of risk after an ergonomic modification / intervention - Geared towards persons with upper limb conditions - 2 sections: - A: Arm and wrist analysis - B: Neck, trunk and leg analysis - Scoring: - 1-2 = acceptable posture - 3-4 = further investigation, change may be needed - 5-6 = further investigation, change soon - 7 = investigate and implement change What is the PAIN: Visual Analogue Scale? ---------------------------------------- - Simplest measure is a 10cm line where you ask the person to mark the level of the pain. Start represents 0 = no pain, and end represents 10 = worst pain. CM measure where client marks their pain is their pain level out of 10. - Adapted versions: faces, scores filled in. - **Advantages:** - Easy to understand - Can be used with clients with minimal education and low literacy - Quick to administer - Free - Commonly used in research and practice - **Disadvantages:** - Focus on occupational enabler - Impact on functioning not clear What is the Canadian Occupational Performance Measure? ------------------------------------------------------ - Found to be a useful outcome measure in vocational rehabilitation in Slovenia - **Advantages**: - Facilitates joint goal setting and collaboration with clients - Clarifies occupational performance issues at the outset of intervention - Focus on activity limitations and participation restrictions / occupational performance - Uses a client-centered approach - Found to be valid, reliable and clinically useful - Work rehab based on the COPM could facilitate higher improvements in work-related outcomes - Useful tool to describe OT outcomes in team discussions - **Disadvantages**: - Licensed -- must be purchased. What is the Functional Capacity Evaluation (FCE): outcome measure? ------------------------------------------------------------------ - Pre- and post- rehab FCE - **Advantages**: - Can be tailored to the specific job and job demands - Can take into account various outcomes within the FCE - **Disadvantages**: - Costly - Time consuming What is the Physical Demand Characteristics of Work table? ---------------------------------------------------------- - Measure and plot a person's physical abilities on the table -- can show improvement or deterioration. - **Advantages**: - Commonly used and easily understood by OTs - Based on research - Aligns with other WP tools, e.g. Dictionary of Occupational Titles, ONET - **Disadvantages**: - Cover certain aspects of job only (mobility and manual handling) - Focus on the physical