Associate Professor Carole James

© 2019 - IOS Press and the authors. All rights reserved. A conceptual framework is needed to understand injured workers' decision-making and inform evidencebased interventions to address behavior change regarding return-to-work (RTW). The Model of Human Occupation (MOHO) can help with understanding how an injured worker's characteristics can generate behavior change while Motivational Interviewing (MI) can help facilitate behavior change. OBJECTIVE: This theoretical paper provides an overview of how MOHO and MI can be applied and integrated in occupationalrehabilitation. The objectives of this paper are to: (1) evaluate MOHO as a framework for supporting occupational therapists (OTs) in occupational rehabilitation; (2) describe MI as a suitable approach for OTs in occupational rehabilitation; and (3) compare and integrate MOHO and MI. METHOD: Several important works and reviews were used to integrate MOHO and MI with occupational rehabilitation. IMPLICATIONS FOR PRACTICE: The identification of a model and approach to support OT practice in occupational rehabilitation can assist OTs to determine the most appropriate interventions and contribute to standards of best practice. CONCLUSIONS: IntegratingMOHOand MI provides a comprehensive framework for understanding impairment and RTW change processes with the potential to reduce work disability and improve RTW outcomes.

© 2017, Springer Science+Business Media New York. Purpose Workplace injury and illness rates are high within the nursing profession, and in conjunction with current nursing shortages, low retention rates, and the high cost of workplace injury, the need for effective return to work (RTW) for injured nurses is highlighted. This study aimed to identify current practices and processes used in the RTW of injured nurses, and determine if these are consistent with the seven principles for successful RTW as described by the Canadian Institute for Work & Health. Method As part of a larger cross-sectional study, survey data were collected from New South Wales nurses who had sustained a major workplace injury or illness. Survey questions were coded and matched to the seven principles for successful RTW. Results Of the 484 surveys eligible for analysis, most were from Registered Nurses (52%) in the Public Hospital Sector (48%). Responses indicated four main areas of concern: a commitment to health and safety by the workplace; early and considerate employer contact; provision of modified work; and individual knowledge of and involvement in the RTW process. Positive participant responses to co-worker and supervisor involvement were identified as areas consistent with best practice principles. Conclusions These findings suggest the practices and processes involved in the RTW of injured nurses are inconsistent with best practice principles for RTW, highlighting the need for interventions such as targeted employer education and training for improved industry RTW outcomes.

© 2018 La Trobe University. General practitioners (GPs) play a key role in the return-to-work process, and yet their experiences working with workplace Return-to-Work Coordinators (RTWCs) have rarely been studied. The aim of this paper is to provide insights from the GP perspective about their experiences with workplace RTWCs and their preparedness for the role. GPs from Australian states and territories where legislation mandates workplaces employ a RTWC were requested to complete a questionnaire on their experiences with workplace RTWCs. Fifty GPs completed a questionnaire on the preparedness of RTWCs in relation to their role, with 58% (n = 29) indicating RTWCs require more training. A total of 78% (n = 39) of respondents considered RTWCs were important in assisting injured workers return to work, with 98% (n = 49) ranking trustworthiness, respectfulness and ethicalness as the most important or an important trait for a RTWC to possess. Interestingly, 40% (n = 20) of respondents themselves reported having no training in the return-to-work process. GPs acknowledge the importance of the workplace RTWC in the return-to-work process, and the results highlight the need for RTWCs to possess specific traits and undergo appropriate training for the facilitation of a successful return to work for injured workers.

© 2018 - IOS Press and the authors. All rights reserved. BACKGROUND: Limited literature exists investigating biomechanical changes during a Functional Capacity Evaluation (FCE). OBJECTIVE: To determine change in joint angle measurement between minimum load to safe maximum load in the bench to shoulder lift of the WorkHab FCE. METHODS: Dartfish ProSuite was used to analyse bench to shoulder lift video from 28 subjects. Measurements of joint angle at lumbar spine, thoracic spine, elbow and shoulder at four points in the ascending and descending lift phases (0/3, 1/3, 2/3, 3/3) in the minimum load and safe maximum lift were collected. Paired t-tests were used to analyse differences in joint angles between lifts. RESULTS: Significant differences in joint angles were identified in the thoracic spine, elbow and shoulder at maximal weight. Increased extension occurred: Thoracic spine at 3/3 ascending [2.922, 95% CI 0.8, 3.8, p=0.004]. Increased flexion occurred: elbow ascending [1/3:6.405, 95% CI -11.8, 1.8, p=0.008],[3/3:15.575, 95% CI 4.2, 27.0, p=0.009]; elbow descending [0/3:18.446, 95% CI 9.5, 27.4, p=0.000]; shoulder ascending [3/3:16.785, 95% CI 11.8, 21.8, p<0.001]; shoulder descending [0/3:16.647, 95% CI 10.6, 22.7, p<0.001]. CONCLUSIONS: This study provides insight into the biomechanical changes during a bench to shoulder lift and support observations and clinical reasoning used in determining the safe maximal lift.

© 2018 - IOS Press and the authors. All rights reserved. BACKGROUND: Task rotation is used to decrease the risk of workplace injuries and improve work satisfaction. OBJECTIVE: To investigate the feasibility, benefits and challenges of implementing a task rotation schedule within an underground coalmine in NSW, Australia. METHODS: A mixed method case control pilot study with the development and implementation of a task rotation schedule for 6 months with two work crews. A questionnaire including The Nordic Musculoskeletal Questionnaire, The Need for Recovery after Work Scale, and The Australian WHOQOL- BREF Australian Edition was used to survey workers at baseline, 3 and 6 months. A focus group was completed with the intervention crew and management at the completion of the study. RESULTS: In total, twenty-seven participants completed the survey. Significant improvements in the psychological and environmental domains of the WHOQOL-BREF questionnaire were found in the intervention crew. Musculoskeletal pain was highest in the elbow, lower back and knee, and fatigue scores improved, across both groups. The intervention crew felt 'mentally fresher', 'didn't do the same task twice in a row', and 'had more task variety which made the shift go quickly'. CONCLUSION: Task rotation was positively regarded, with psychological benefits identified. Three rotations during a 9-hour shift were feasible and practical in this environment.

© 2017 Occupational Therapy Australia Background/aim: In Australia, all stroke survivors should not drive for four weeks and transient ischaemic attack (TIA) survivors should not drive for two weeks. This study investigates the provision of return-to-driving education in the acute hospital setting and the use of this education by a cohort of Australian patients who have experienced a mild stroke or TIA and who are discharged directly home from their acute hospital admission. Methods: A medical record audit was conducted of stroke patients discharged home from a regional hospital in Australia. All audited patients were sent a post-discharge anonymous survey of their post-stroke driving behaviours. Results: A total of 78 medical records were audited (32 women, 46 men; 15 TIA, 63 strokes). Mean age was 67.4¿years (SD¿=¿13.7, range 20¿89¿years). Only 27 (34.6%) patients had documented evidence that return-to-driving was discussed with them by a health professional, with only 10 (12.8%) having a restriction period documented. A total of 31 surveys were analysed (10 females, 21 males) and 20 participants had returned to driving. From 31 survivors of mild stroke/TIA, 21 recalled receiving advice on return-to-driving and seven resumed driving during the non-driving period of one month. Conclusions: Inconsistencies exist in the documentation of return-to-driving management after acute stroke or TIA and it is unknown whether patients who lack documentation in their medical records were provided with education or not.

© 2017 Taylor & Francis Group, LLC. Gaps exist in the knowledge of return-to-driving guidelines, and education is needed for Australian health professionals working in the field of stroke. In this paper, authors evaluate the implementation of an e-learning module. A pre- and post-module knowledge test and survey were used to assess the e-module's success in achieving its learning objectives. Initially, 204 learners completed the module, with 68% of learners scoring 100% in the post-module knowledge test. Only 12 learners completed the survey. The authors recommend that health professionals other than occupational therapists access this e-module, and a review on e-module structure is required to improve results of knowledge tests.

© 2016 Occupational Therapy Australia Background: While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference (PFsOR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings. Methodology: Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years. Findings: Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFsOR; (iii) resistance to PFsOR; and (iv) using PFsOR to enhance professional repertoires. Findings pointed to the need to ensure PFsOR include occupational considerations for occupation-based practice in mental health. Conclusion: A occupation-based perspective means balancing PFsOR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFsOR lest their most visible practical actions appear psychologically based rather than occupation based.

© 2017, BMJ. All rights reserved. Objectives: To investigate patterns of alcohol use within the coal mining industry, and associations with the personal, social, workplace and employment characteristics. Design: 8 mine sites across 3 eastern Australian states were surveyed, selected to encompass key geographic characteristics (accessibility and remoteness) and mine type (open cut and underground). Problematic alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT) to determine: (1) overall risky or hazardous drinking behaviour; and (2) frequency of single-occasion drinking (6 or more drinks on 1 occasion). Results: A total of 1457 employees completed the survey, of which 45.7% of male and 17.0% of female participants reported levels of alcohol use within the range considered as risky or hazardous, considerably higher than the national average. Hierarchical linear regression revealed a significant contribution of many individual level factors associated with AUDIT scores: younger age, male, current smoking status; illicit substance use; previous alcohol and other drug use (AOD) problems; and higher psychological distress. Workplace factors associated with alcohol use included working in mining primarily for the high remuneration, and the type of mining, with underground miners reporting higher alcohol use than open-cut miners. Conclusions: Our findings provide support for the need to address alcohol use in the coal mining industry over and above routine on-site testing for alcohol use.

© 2017 MA Healthcare Ltd. Background: There is limited literature specific to manual handling practices among informal carers, with most literature relating to nurses and paid carers. This study aimed to identify the current experiences and practices of informal carers in relation to manual handling and their perceived manual handling needs for this role. Methods: A quantitative cross-sectional study design utilising an online questionnaire was used to survey informal carers who were members of Carers NSW¿an organisation for carers in New South Wales, Australia. Seventy-five returned surveys were eligible for inclusion. The data was analysed with descriptive statistics using JMP software (version 10.0.0). Findings: Respondents were predominantly female (74.7%), over 45 years of age (81.1%) and were on a pension (35.8%). Respondents carried out a variety of caring tasks; however, they used limited equipment and received active/interactive training (workshop and training from health professionals) more than passive training (written materials in brochures, books, websites and posters). Conclusions: The study provides information on the manual handling experiences and practices of informal carers. The information can be used by health professionals to develop specific education programmes or appropriate manual handling literature to assist informal carers with this role.

© The Author(s) 2016. Introduction Individual placement and support is recognized as current best practice vocational rehabilitation for people living with a severe mental illness. This study aimed to provide insight into the consumer perspective of factors that impact the success of an individual placement and support programme in Australia. Method A qualitative study was conducted using semi-structured interviews with five participants. Participants were diagnosed with a severe mental illness and were engaged with an individual placement supported employment programme in one area health service in New South Wales, Australia. Data analysis was conducted using grounded theory methods. Results Analysis revealed the core category of pushing through, a three-step process that involved experiencing discomfort, learning to adapt, and getting into a groove. Pushing through described the participants' direct experience of individual placement and support, as well as their management of their health and ability to cope with everyday practicalities and relationships while engaged in the programme. Conclusions The participants in this study described their experiences of being involved in an individual placement and support programme as being characterized by a process of pushing through. The participants' actions and experiences at each stage of this process provide cues for more tailored support within individual placement and support to meet changing needs.

© 2016 MA Healthcare Ltd. Background/Aims: Manual handling is a significant component in the role of an informal carer. This research aimed to understand the manual handling needs and practices of informal primary carers. Methods: This qualitative study utilised semi-structured face-to-face interviews to gather data from one male and female carer living in the community with a spouse with Parkinson¿s disease. Using comparative thematic analysis, categories and themes emerged from the detailed descriptions of the lived experiences. Findings: Three main themes emerged from the data: 1. Carer experience: manual handling was a daily task, however care recipients sometimes assisted in a modified environment; and carers utilised previous experiences; 2. Equipment: a variety of prescribed and non-prescribed equipment was used, however limited training was provided; 3. Perceived needs: identified needs included education on manual handling techniques, physical exercises for carers, equipment information, financial assistance for equipment and increased formal support. Conclusions: A lack of assistance for Australian informal carers with manual handling in relation to information provision, training and awareness of equipment and supports was highlighted. There is a need for increased carer awareness of services and support group networks, as well as for health professionals to deliver relevant advice to carers as part of service provision to care recipients.

© 2016, Association for Educational Communications and Technology. This study examined and compared attitudes of both students and instructors, motivated by an interest in improving the development and delivery of online oral communication learning (OOCL). Few studies have compared student and instructor attitudes toward learning technologies, and no known studies have conducted item response theory (IRT) analyses on these factors. Two independent and anonymous surveys resulted in 255 participants (124 university students, and 131 instructors). Exploratory factor analyses produced final item sets and a two-factor model for student attitudes (Technology Self-efficacy [TSE], and Positive Attitudes [PA]), and a three-factor model for instructors (TSE, Behavioral Intentions, and PA). The OOCL attitude factors showed strong validity through both IRT and classical test theory analyses. Comparisons between students and instructors showed students generally had higher TSE and more positive attitudes towards OOCL. The attitudes most relevant to OOCL were intrinsic interest, behavioral intentions, and perceived usefulness of the technology. This study revealed that technological self-efficacy may be useful for differentiating students and instructors, but not for assessing OOCL attitudes. Further development in this field could focus on the improvement of instructors¿ attitudes and skills, as well as exploring the role of intrinsic interest.

© 2016 - IOS Press and the authors. All rights reserved. BACKGROUND: Following brief training, an Australian workplace Return to Work (RTW) Coordinator is expected to provide information to the injured worker, liaise with key stakeholders and maintain workplace policies and procedures in accordance with legislative requirements. OBJECTIVES: The aim of this study was to provide insights into the experiences and perceptions of the Australian Workplace RTW Coordinator in relation to current training practices and to identify any existing inadequacies within the available training. METHOD: Twenty-five workplace RTW Coordinators from five Australian states participated in six focus groups.Participants with a minimum of two years' experience as a workplace RTW Coordinator and involved with the development and implementation of workplace policies and procedures, were included in the study. Thematic analysis was performed to identity meaningful themes and patterns. RESULTS: The findings highlighted specific training requirements and additional support mechanisms recommended by current workplace RTW Coordinators. Four key themes clearly emerged: inadequate training; irrelevant content; the need for specialised trainers; and network support services. CONCLUSION: RTW Coordinators require effective training and support to ensure the appropriate and timely delivery of services to all stakeholders involved in the RTW process. The results of this study may inform future training practices for RTW Coordinators.

© 2014, Springer Science+Business Media New York. Introduction In the Australian context, a return to work (RTW) Coordinator assists an injured worker with workplace-based support and regulatory guidance for the duration of their injury. Coordinating the RTW process has been considered an effective approach for managing workplace injuries, however few studies have described the skills, traits or characteristics required to fulfil the role of workplace RTW Coordinator. This study aims to provide insight as to the skills and attributes needed for the role of the workplace RTW Coordinator from their experience and perception. Method Focus groups were conducted with workplace RTW Coordinators from six major Australian cities. Twenty five participants were recruited through a national RTW Coordinator website, and professional RTW interest groups using a snowballing technique. Participating workplace RTW Coordinators were required to have a minimum 2¿years¿ experience and to have been involved with the development and implementation of workplace policies and procedures. Thematic analysis was performed to identify meaningful patterns and themes. Results The data analysed provided clear insight as to the specific role requirements necessary for working as an Australian workplace RTW Coordinator. Three key themes clearly emerged; communication skills, RTW Coordinator characteristics, and managing the RTW process. Conclusion The findings indicate that RTW Coordinators require a wide range of traits, skills, and attributes to successfully perform this role. Effective management by the RTW Coordinator of the complex RTW process is essential to facilitate a smooth transition for the injured worker, alongside maintaining a professional relationship with the employer and external stakeholders. The results of this study can be utilised to further improve the selection of future RTW Coordinators.

© 2014 Dietitians Association of Australia. Aim: The aim of this analysis is to establish if dietitians have the knowledge, skills and attitude to provide support to other health professional (HP) groups in the provision of weight management advice to overweight/obese patients. Methods: A secondary data analysis of a cross-sectional survey of HPs was undertaken to perform a gap analysis with regard to practices, knowledge, confidence and attitudes in the provision of weight management advice. Survey responses and additional measures (practice, knowledge, confidence and attitude scores) were compared between dietitians and other HPs. Descriptive statistics were undertaken, and differences between group ¿² tests were performed for nominal data and the Wilcoxon rank sum test for ordinal and non-parametric data. Results: About 100% of dietitians had received initial weight management training and 85% had participated in professional development training, compared with 18 and 19% of HPs, respectively, although 70% believed it was within their scope of practice to provide evidence-based advice. Dietitian respondents achieved a higher median score (maximum 10) in the following areas (practice = 6.5, knowledge = 8.0, confidence = 8.3) when compared with HP respondents (practice = 4.2, knowledge = 7.0, confidence = 5.4). The median attitude score for both groups was 6.0. Conclusions: HPs are receptive to providing evidence-based weight loss messages to overweight/obese clients in their current practice. However, weight management training is required to enhance HPs' knowledge and skills in order to increase confidence and improve practice skills. Dietitians can assist HPs to ensure that clear, consistent, evidence-based messages are delivered to overweight clients throughout the health-care system.

© 2015 Wiley Publishing Asia Pty Ltd. A cross-sectional survey was conducted in a regional area in Australia to measure nurses' perceptions, practices, and knowledge in regard to providing healthy lifestyle advice to people who are overweight or obese. Responses were compared between geographic regions. Participation was voluntary and anonymous. Of the 79 nurse participants, 68% considered that provision of healthy lifestyle advice was within their scope of practice. Only 28% reported frequently estimating body mass index in the practice setting. Nurses often recommended increasing activity levels (44%), but recommended reducing daily caloric intake less often (25%). Nurses' knowledge about weight management was variable and the proportion of correct answers to knowledge items ranged from 33-99%. Nurses have many opportunities to deliver healthy lifestyle advice in a range of practice settings. The variation in practices and knowledge of nurses indicates a need for improved healthy lifestyle education for undergraduate and practicing nurses.

© The Author(s) 2015. Introduction: This systematic review aimed to determine whether stroke survivors routinely received return-to-driving education in the acute hospital setting prior to discharge home; and if education was provided, were the restrictions in driving guidelines adhered to. Method: A systematic search was conducted of PubMed, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Web of Science, Scopus, Pedro and OTseeker databases for original research reporting findings on the adherence to return-to-driving legislation and clinical guidelines after stroke, and return-to-driving behaviours in stroke survivors up to 1 month post stroke. Results: Three studies met the inclusion criteria and reported on a combined total of 252 stroke survivors living in the United Kingdom. Forty-eight per cent of stroke survivors received education on the 1 month driving restriction. A total of 61.4% of participants waited 1 month prior to returning to driving. Conclusion: This review found that there is limited literature available on the management of return to driving following acute stroke but there is evidence that education may not be routinely provided in the acute hospital setting and that many stroke survivors could be returning to driving within the 1 month restriction.

© 2014 - IOS Press and the authors. All rights reserved. BACKGROUND: There is little health specific literature on returning nurses with injuries to work despite the high incidence of injuries and the workforce shortages of these professionals. OBJECTIVE: To identify enabling factors and barriers to return-to-work for nurses with injuries from the perspective of return-to-work coordinators. PARTICIPANTS: Workplace return-to-workcoordinators employed in a health or disability facility who had worked on a rehabilitation case with a nurse with injuries in the past 12 months in New South Wales (NSW), Australia. METHOD: Five focus groups were conducted with 25 return-to-work coordinators from 14 different organisations, representing different health sectors (aged, disability, public and private hospital and community health) in metropolitan and rural areas of NSW, Australia. RESULTS: This study reports findings specifically relating to the provision of suitable duties for nurses with injuries. Four key themes were identified: suitable duties; supernumerary positions; nurse specialisation and tailoring of return-to-work plans. CONCLUSIONS: This study identified that return-to-work coordinators were resourceful and innovative in their approach to the provision of suitable duties for nurses with injuries and highlighted the importance of including clinical duties in any return-to-work program and of tailoring the return-to-work to the nurses' work and personal circumstances.

Background/aim: Obesity affects more than half the Australian population and has become epidemic throughout the world. Little is known regarding occupational therapy interventions with clients who are overweight or obese. This study aimed to identify occupational therapy practice in relation to the provision of weight management. This was part of a larger study investigating health professional practice. Methods: A cross-sectional study design using a self-administered, purpose-designed survey was employed to identify the current practices of occupational therapists working in a regional area of New South Wales, Australia. Participants were recruited via email or mail as publically available. Results: Fifty-one occupational therapists anonymously completed the survey. Results revealed that 53% (n = 26) of respondents did not consider weight management to be within their scope of practice or their workplace role description. The most common intervention was the provision of physical activity advice (65.2%; n = 30). Dietary advice was provided by 20.8% (n = 10), while 77% (n = 32) referred onto dietitian services. During entry-level occupational therapy education, only 7.8% (n = 4) had received weight management advice education. Completion of postgraduate professional development training in this area was reported by 14% (n = 7) of respondents. Conclusion: This study provides insight into the current practices of Australian occupational therapists in relation to the provision of weight management advice. This research displays a need to acknowledge both a generic and a discipline-specific role for the provision of healthy lifestyle interventions. This may be achieved through better access to education during entry-level programmes and in the workplace. © 2013 Occupational Therapy Australia.