Courses A-D

Question 1

No matter what the type of disability incurred or if its severe – temporary or ongoing many people”

Answer 1

(1) Are away from work longer than is necessary
(2) Never RTW even though they could be productive if the working conditions were modified
(3) RTW and leave again because they cannot immediately keep up with the demands of their old job after a period of inactivity
(4) Leave work because of a disability that could have been prevented if the workplace culture, policies and procedures facilitated ergonomic improvements or job modification.

Question 2

The cost of absence for individuals

Answer 2

Lost income and lost careers

Question 3

The cost of absences for organizations

Answer 3

Experience high premiums, lost productivity and increased recruitment costs

Question 4

The cost of absences for society

Answer 4

Cost of social programs for people who – under the right conditions – could be productively employed and paying taxes.

Question 5

SWOT stands for…

Answer 5

Strengths, weaknesses, opportunities and threats

Question 6

What is a needs assessment?”

Answer 6

A process in which the understandings of a range of stakeholders are collected and synthesized as to what is currently happening, what could happen, and what is needed to bridge the gap.

Question 7

What should a needs assessment” review entail?”

Answer 7

Identify the current processes that are followed when an employee incurs a significant injury or illness as well as components that could be added to create an effective program.

Question 8

A needs assessment” shapes..”

Answer 8

the design of a new program and the implementation process including the development of policies and procedures relating RTW – or the improvement of an existing program.

Question 9

What is a Program Logic Model?”

Answer 9

identifies the outcomes that the program has been or will be established to meet and then works back from that point to outline in graphic form the assumptions and context underlying the goals, inputs (resources and investments), and the activities and people that are needed to realize the outcome.

Question 10

Developing a program logic model” can be very helpful when….”

Answer 10

it comes time to evaluate a program because it provides a focus on intended outcomes as well as the activities and resources that were designed to produce those outcomes.

Question 11

Gensy et al (2012)

Answer 11

Recovery tends to be faster and the likelihood of returning to work is increased if people come back to the workplace as soon as medically feasible, with modified activities in which there is no risk of re–injury as they heal.

Question 12

Definition of impairment”

Answer 12

any loss or abnormality of psychological, physiological, or anatomical structure or function.

Question 13

Definition of disability”

Answer 13

When a limitation restricts the ability to perform normal activities – one of which is work.

Question 14

Difference between impairment” and “disability” (provide an example)”

Answer 14

If an individuals’ hearing becomes less acute with age, that is an impairment. However, that person is not considered work disabled if a hearing aid enables her to answer customers’ questions – if that is a job activity.

Question 15

World Health Organization (WHO) views functioning and disability as….

Answer 15

A dynamic interaction between health conditions and contextual factors, both personal and environmental.

Question 16

Disability is seen as continuum…

Answer 16

In which limitations are thought of as more or less and not as existing or not existing.

Question 17

The Biomedical Model (Disability)

Answer 17

Disability results from a medical condition and involves a deviation from normal anatomical and physiological characteristics and function.

Question 18

Example of the Biomedical Model

Answer 18

Service providers would consider aspects of the vision such as visual acuity, focus and depth perception.

Question 19

Who is more likely to use the Biomedical Model?

Answer 19

Insurance companies – to determine whether or not someone is able to work or is entitled to have income replaced.

Question 20

Biopsychosocial Perspective (Disability)

Answer 20

Disability is explored from various points of view including the effects of illness and injury on the body and mind, the demands of the environment in which an individual operates, the economic and community resources available to that person, and the viewpoints and judgements of the people in the society in which the individual lives.

Question 21

The main characteristic of the biopsychosocial perspective:

Answer 21

The environment is considered to play a central role in either enabling or disabling a person with an impairment.

Question 22

What is the most commonly applied approach to Disability and RTW

Answer 22

The biopsychosocial perspective

Question 23

Social Construction Theory (Disability)

Answer 23

Regards impairment as an individual difference similar to gender, religion or ethic origin and posts that the negative implications of having an impairment is the way in which societal attitudes and values create disabling barriers to participation.

Question 24

Example of Social Construction Theory

Answer 24

A young person with very thick large glasses might be discouraged from participating in sport activities even though their glasses corrected their vision to a normal range.

Question 25

Vocational Rehabilitation Professional

Answer 25

Assist a person to gain skills to re–enter the workforce to a more suitable occupation.

Question 26

Definition of Disability Management

Answer 26

The process in the workplace designed to facilitate the employment of persons with a disability through a coordinated effort and taking into account individual needs, work environment, enterprise needs and legal responsibilities.

Question 27

Individual–focused disability management practices

Answer 27

Development and implementation of RTW plans

Question 28

Organization–focused disability management practices

Answer 28

Analysis of trends, cost benefit analysis, policies and procedures

Question 29

Society–focused disability management practices

Answer 29

Establishment of policies that protect workers, decrease accidents, and lower costs to taxpayers.

Question 30

While working in the field of disability management, an individual must…

Answer 30

be knowledgeable about related areas including injury prevention and health promotion, and compensation and benefits

Question 31

RTW activities involve ensuring that…

Answer 31

The appropriate assessments have occurred and that those who are completing the assessment – whether GP, physical or occupational therapists – have enough job information so that they can determine whether the employee can safely RTW and under what conditions.

Question 32

RTW activities involve identifying…

Answer 32

barriers to RTW and identifying services that could decrease the impact of such barriers.

Question 33

RTW activities involve developing…

Answer 33

a RTW plan in conjunction with the appropriate people

Question 34

RTW activities involve implementing….

Answer 34

The plan – ensuring that equipment, renovations, job modifications, or training are in place.

Question 35

RTW activities involve monitoring…

Answer 35

and adapting the plan as required.

Question 36

RTW activities involve evaluating….

Answer 36

The process.

Question 37

An effective DM program incorporates an…

Answer 37

Integrated approach to the protection of workers’ health, the promotion of workplace wellbeing and the provision of support and assistance of job retention and RTW.

Question 38

Primary, Secondary and Tertiary Prevention

Answer 38

Liaising with related programs of of occupational health and safety and wellness or health promotion to create a continuum of interventions aimed at creating a more health and productive workforce.

Question 39

What is one of the best ways to reduce / decrease disability costs?

Answer 39

Prevention of accident and injuries through occupational health and safety programs and to encourage activities that enhance health through wellness promotion programs.

Question 40

Post–screening

Answer 40

Some organizations will do these assessments to ensure that the individual who has been offered a job has the physical ability to carry out the job tasks outlined in the job description.

Question 41

Harder and Scott, 2005

Answer 41

The post–screening process lowers the level of injuries requiring significant physical activity

Question 42

Four types of compensation for disability

Answer 42

(1) Workers compensation or government insurance for occupational injuries/illnesses
(2) LTD and STD
(3) Automobile insurance
(4) Government programs such as sickness benefits, pension plan disability and social assistance.

Question 43

Compensation in Canada and USA

Answer 43

Workers who are injured as a result of work activities are entitled to workers’ compensation through insurance premiums paid by their employers

Question 44

Compensation in UK and Ireland

Answer 44

Occupational injuries are compensated with government payments and funded through taxes.

Question 45

A 20 year old worker has a…

Answer 45

3 in 10 change of incurring a disability before retirement age.

Question 46

Mental health & Labour trends

Answer 46

The presence of a mental health condition reduces labour force participation from 80% to 39% – and for those who continue working resulted in an average reduction in wages for men of 4.7 % and for women 3.1%

Question 47

New Zealand & Mental Health

Answer 47

More than 40% of the people on sickness benefits were entitled to it because of the psychological and psychiatric conditions, with the second most condition reason being musculoskeletal disorders, including sore backs and necks.

Question 48

Disabilities with a psychological component are becoming…

Answer 48

More costly to organizations, including depression and anxiety–related disabilities, chronic fatigue syndrome and fibromyalgia.

Question 49

Canadian Workplace & Stress

Answer 49

83% of Canadian employers ranked stress as a top tier risk factor for their workforce.

Question 50

As baby boomers….

Answer 50

age, there will likely be an increase in the length of disability–related absences since older people require a long period of time to heal.

Question 51

Correlation between worker compensation claims and individuals who are

Answer 51

45–49, although research indicates that the higher injuries and claims may be associated with older workers are less of a reflection of age and more of poor lifestyle habits and negative working conditions.

Question 52

Early Contact

Answer 52

Informing the person responsible for disability management that a worker has an injury or illness. Contacting workers shortly after the absence.

Question 53

Goal of Early Contact

Answer 53

To make sure that employees receive the treatment that they need, are aware of the benefits and entitlements, understand that their co–workers care about what happens to them, and are able to focus on RTW if their situation allows.

Question 54

Importance of Informal Contact

Answer 54

Helping the individual to retain a relationship with the workplace.

Question 55

Employers should be sensitive with informal contact as…

Answer 55

An employee may believe that the workplace rep is checking up on her and trying to persuade the RTW before she/he is ready and the call may cause anxiety.

Question 56

Early Intervention is important as…

Answer 56

a number of studies indicate that the longer someone is away from work, the less likely they are to return.

Question 57

Australian study of workers compensation indicated that…

Answer 57

50% of people who were absent from the workplace for as long as three months would RTW. That figure declined to 25% that lasted a year to 12% after two years and 4% after four years.

Question 58

Cost of replacing and training skilled workers

Answer 58

…can run into the thousands of dollars.

Question 59

Early intervention involves…

Answer 59

any activities that are designed to prepare the employee for returning (e.g, discussions that focus on how this could happen, assessments, ongoing rehab) or arrangements that bring the employee back to the workplace even if they cannot return to work immediately.

Question 60

The goal of Early Intervention

Answer 60

Employees with an impairment will continue to think of themselves as people who can carry out workplace activities and be productive and that they will retain their sense of being part of the workplace community.

Question 61

Examples of Early Intervention

Answer 61

Modifying the job / job activities, making ergonomic adjustments, allow shorter hours, adding assistive devices

Question 62

Avoid light duty ghettos”

Answer 62

Situations in which employees are assigned to work which may not be meaningful or contribute to the productivity of the organization and are then forgotten about.

Question 63

Both labour and management can…

Answer 63

Provide useful perspectives on work processes, corporate culture and barriers that decrease the likelihood of a RTW.

Question 64

Many labour–management agreements contain…

Answer 64

Language and provisions about disability management.

Question 65

Most people are better off financially….

Answer 65

Over time if they are working rather than receiving insurance payments. There is also a cost to society when people do not have wage income.

Question 66

Every dollar earned in BC…

Answer 66

80 cents was spent to defray arising from disability – whether directly through program expenditures or indirectly through non reimbursed personal expenditures and personal/family income loss.

Question 67

On an individual basis, the costs of not returning to work can be extremely high, which is why…

Answer 67

So many unions actively support RTW.

Question 68

Employees who do not return to work are considered by the insurer to be employable in another job….

Answer 68

and lose their coverage – if they cannot then persuade another employer to hire them and are forced on to social assistance – the economic losses for that same 35 year old worker would rise to 800k.

Question 69

Whether viewed from a societal, business or individual perspective…

Answer 69

It is desirable that people remain productive and retain their jobs and wage income. If insurance payments are not available or are time–limited, many people with disability are forced to depend on some kind of social assistance.

Question 70

Workers’ compensation legislation requires

Answer 70

Organizations that employ 20 or more people to accommodate a worker who has been employed for two years if the employee with the impairment can RTW within a two year period.

Question 71

Americans with Disabilities Act (1990)

Answer 71

Applies to employers with fifteen or more and requires them to provide an equal opportunity to benefit from the full range of employment–related opportunities available to others,” it “protects qualifies individuals with disabilities” against employment discrimination.”

Question 72

(US) Employees who believe that they have not received reasonable accommodation can make a complaint to the…

Answer 72

Federal Employment Opportunity Commission or designated state humans right.

Question 73

Rehabilitation Act (US)

Answer 73

Requires affirmation and non–discrimination among employers with government contracts or those who are receiving financial assistance from the federal government.

Question 74

The Equal Pay and Age Discrimination Age (US)

Answer 74

influences requirements for accommodating people with disabilities

Question 75

(UK) The Disability Discrimination Act

Answer 75

Prohibits employers from treating employees with disabilities in a less favourable way than they would treat employees without disabilities. Employers are required to make reasonable adjustments that will allow an employee with a disability to work or continue to working.

Question 76

Occupational Health & Safety Acts

Answer 76

govern the actions that organizations must take in response to actual and potential accidents.

Question 77

Freedom of Information & Privacy laws

Answer 77

Regulate what kind of health information may be received by a company without written permission from the employee.

Question 78

Disability management committees may be formed…

Answer 78

by formal establishment, multi–level, labour–management that will continue on once the program is implemented or simply a representative group whose role is to get the program started.

Question 79

The needs or situational assessment will provide information on…the current situation

Answer 79

the processes being followed and the outcomes being obtained

Question 80

The needs or situational assessment will provide information on…the desired situation

Answer 80

how the organization would like the disability issues and RTW to be handled and the results they would like to obtain through a disability management program

Question 81

The needs or situational assessment will provide information on…goals and objectives

Answer 81

Met over a period of time – such as targets for decreasing the length of absences of returning workers who have experienced injuries, illnesses or chronic conditions

Question 82

The needs or situational assessment will provide information on…the budget

Answer 82

Funds and other support required.

Question 83

The implementation plan of the needs assessment will identify

Answer 83

(1) the tasks to be carried out by employees who are hired or assigned to DM responsibilities
(2) the ongoing role of the joint committee
(3) desirable policies and procedures
(4) program standards and qualifications of staff.

Question 84

In a unionized organization, general principles relating to the disability management process may be outlined in…

Answer 84

A letter of intent

Question 85

Letter of Intent

Answer 85

Provides a brief program framework and may include statements, the role of joint committees, program eligibility, RTW processes, any limitations.

Question 86

SWOT

Answer 86

Stands for strengths, weaknesses, opportunities, and threats.

Question 87

SWOT analysis can be…

Answer 87

External or internal.

Question 88

The SWOT process allows…

Answer 88

People who are involved with a disability management program to consider the environment in which the program is or will be operating.

Question 89

The SWOT analysis can be

Answer 89

Generally informal; it may involve a small group brainstorming activity that sets the stage for a needs assessment and development of a program logic model.

Question 90

The advantage of someone internal performing the needs assessment

Answer 90

They are familiar with the workplace and organizational culture and they know where the information needed can be obtained.

Question 91

The advantage of someone external performing the needs assessment

Answer 91

They may be seen as objective and without preconceptions; they may not be diverted by the time pressures of other responsibilities within the company.

Question 92

Much of the information for the needs analysis or program review can be obtained through:

Answer 92

Interviewing a rep of stakeholders, collecting data and statistics, reviewing documents (policy and procedures), visiting or researching other organizations or sources when additional ideas are needed about what could be put in place.

Question 93

People to interview as stakeholders for the needs analysis

Answer 93

Human resources personnel, safety managers, occupational nurse, benefits administer, union officers, supervisors, potential users of the program.

Question 94

People to interview as external reps for the needs analysis

Answer 94

Organizations providing insurance
Medical and rehab providers
Disability management staff

Question 95

RTW Coordinators are..

Answer 95

Trained professionals who believe at an intellectual and emotional level that everyone has a contribution and who are committed to helping the people they work with make that contribution in the workplace if at all possible.

Question 96

RTW Coordinators act as a…

Answer 96

Central point for the returning work, service providers, management, supervisor, health & safety representatives, shop steward, work representatives and others who will be involved in the process.

Question 97

The RTW Coordinators are NOT…

Answer 97

directly involved in claims management, this is mainly an administrative process and aimed at settling a claim

Question 98

RTW Coordinators must have…

Answer 98

Excellent communication skills, they must be able to explain constraints by legislation, insurance contracts or collective agreements, while acting as an advocate for the employee.

Question 99

RTW Programs have policies that outline a hierarchy of RTW options…

Answer 99

beginning with the least complex – RTW to the same job OR retraining for a new career.

Question 100

RTW coordination involves ensuring that

Answer 100

The right services and supports are provided at the appropriate time by qualified people.

Question 101

The RTW process can be conceptualized as involving two major activities

Answer 101

Accommodation
Service Coordination

Question 102

Accommodation

Answer 102

Includes steps taken to adapt the work environment so that it fits the physical, intellectual and psychosocial capabilities of the returning worker.

Question 103

Service Coordination

Answer 103

A form of case management that can be described as identifying and making available services that will assist the worker in RTW – and many of these services may be aimed at stabilizing personal as well as work life.

Question 104

What are the steps in the RTW process

Answer 104

(1) support with treatment and rehab
(2) assistance with information and how to obtain compensation and benefits if required
(3) pre–return assessment that indicates what tasks an employee can/cannot do
(4) developing the RTW plan
(5) implementation of the plan
(6) monitoring and adapting the plan
(7) evaluation

Question 105

RTW Coordination and Awareness of Services

Answer 105

The RTW coordinator should be aware of the range of services available in the community and be able to provide information to the worker without harming the doctor–patient relationship.

Question 106

Second Medical Opinion

Answer 106

In some cases, company policy requires an employee to obtain one in certain circumstances.

Question 107

The main types of interventions – in addition to prompt and appropriate medical care –– that can assist with building work capacity is…

Answer 107

Occupational Therapy
Physiotherapy
Work Hardening
Counselling
Stress Management Skills Training
Pain Management

Question 108

RTWC & Assistance with Benefits

Answer 108

The RTWC should be available to provide information or facilitate the process. Claims can be rejected for reasons ranging from forms not being filled out correctly. They should also know about LTD/STD, and government benefits.

Question 109

RTWC and Insurers (When a Claim is Denied)

Answer 109

The RTWC may need to engage with a claims manager on behalf of the worker but must try to avoid becoming involved in the claims management process and the determination of eligibility.

Question 110

Jurisprudence in most countries suggest that…

Answer 110

The organization needs only the amount of information that is necessary to plan, implement and monitor the RTW.

Question 111

Privacy laws prevent…

Answer 111

Doctors and medical practitioners from providing a DX or specific information unless written authorization is offered.

Question 112

In many cases a RTWC does not need to know the…

Answer 112

DX – only an indication from the doctor about the person’s limitations and restrictions and ideally some advice about the activities that they can carry out.

Question 113

To ensure that an employee’s doctor understands the RTW program and what can be done, most RTW programs have developed…

Answer 113

Information packages that can be sent to the employees doctor describing the program and outlining the employee’s current job requirements.

Question 114

In cases where an employer appeals a workers compensation claim as part of the appeal process, the employer..

Answer 114

May actually have access to the claim file.

Question 115

RTW plans will include information on:

Answer 115

Requirements for ongoing treatment
Support services to be provided
The timing of the return
The accommodation details: Limitations, modifications, AD, and job schedule.
Any retraining
Implementation and progress checks.

Question 116

Length of the RTW process

Answer 116

Ranges from three weeks to three months, depending on the particular situation.

Question 117

Accommodations may be temporary or…

Answer 117

Permanent.

Question 118

In the event that a worker is not able to perform the majority of their pre–injury/illness job tasks but has been medically cleared to return…

Answer 118

A transitional RTW can provide alternate duties to maintain the worker attachment to the workplace.

Question 119

Graduated RTW

Answer 119

A time limited work opportunity that involves a plan of gradual reintroduction of work hours, work duties or both.

Question 120

RTW Planning: Monitoring and Adaptation

Answer 120

Involves answering questions, finding out if there any problems, determine whether the person’s health condition is improving, change or adapt elements of the plan.

Question 121

RTW Planning: Evaluation

Answer 121

Over the time period of the RTW plan is over, the plan should be evaluated.

Question 122

Evaluating the RTW plan, employees can be asked:

Answer 122

If their condition improved
If they were satisfied with rehab services
They thought the RTW plan had been fully implemented
The plan targets had been met if not – why not
Any problems had occurred throughout the process

Question 123

Job Accommodation

Answer 123

Is a change to the work environment or job tasks that enables a person with an impairment to participate in workplace activities safely and productively.

Question 124

Different Types of Accommodation (Transitional)

Answer 124

Transitional work process in which the employee gradually increases number of hours per week or the difficulty of job tasks as he/she gains strength.

Question 125

Different Types of Accommodation (Modification)

Answer 125

Modifying some tasks temporarily or permanently – possibly using a job bank that includes tasks that can be assigned to an employee with restricted activities.

Question 126

Different Types of Accommodation (Job Design)

Answer 126

Changing the way that tasks are organized, chucked or shared.

Question 127

Different Types of Accommodation (Ergonomic Changes)

Answer 127

Such as work station reconfiguration

Question 128

Different Types of Accommodation (Assistive device/AT)

Answer 128

Talking calculators, telephone adaptation, replacing knobs with handles, and using stools or foot rests

Question 129

Different Types of Accommodation (Reassignment)

Answer 129

To a vacant position

Question 130

Hierarchy of Options for RTW

Answer 130

RTW to the same job, same employer
RTW to a different job, same employer
RTW with a different employer

Question 131

Training for Self–Employment

Answer 131

Refer the worker to vocational assessment services to determine his potential for benefiting from training for self–employment. Review the marketability of skills for self–employment. Provide the worker with entrepreneurial skills.

Question 132

Transferable work skills

Answer 132

Used when an employee cannot RTW to their job. It typically requests for employee skills, tools/equipment they are familiar with, and what previous education and training has the individual completed.

Question 133

Barriers to RTW (Individual)

Answer 133

Job dissatisfaction prior to the injury
Prior difficulty performing job tasks
The ability to cope with stress from the job.
Fear of re–injury
Incorrect assessment of their ability to be productive.
Family circumstances

Question 134

A worker whose spouse is also working and who has taken on the child care responsibilities…

Answer 134

May find that not paying for child care results in a very small reduction in the family income overall, and therefore they aren’t motivated to RTW.

Question 135

Workers who were unhappy with the response to claims in their workplace…

Answer 135

were found to be 1.5 times as likely not to RTW when compared to those who were satisfied with the processes even when other factors were considered.

Question 136

Lack of support in the workplace

Answer 136

Lack of skills / training of the part of the person with the disability
Lack of knowledge on the part of the supervisor on how to make accommodations
Attitudes or stereotypes among co–workers and supervisors

Question 137

Supervisors need to be aware of the costs of having…

Answer 137

Employees away from work including insurance premiums, time spent training replacement workers, and human rights penalties.

Question 138

Conflicts between the supervisor and a returning employee or performance issues can…

Answer 138

derail a RTW even though they are not the responsibility of the RTW coordinator.

Question 139

Co–workers may not understand their role in RTW and why it is important

Answer 139

They may not support a RTW if they think they may have to spend time helping the individual with a temporary or permanent impairment, or believe they may have more physically taxing duties added to their own job activities.

Question 140

RTW Coordination and Their Own Attitudes / Bias

Answer 140

RTWC need to ask themselves if they feel uncomfortable when introduced to someone with a disability…do they treat them differently?

Question 141

The Six Stages of Grief

Answer 141

Research suggest that people who incur disabilities go through a number of stages including – in no specific order:

Denial
Anger
Depression
Resignation
Acceptance
Action

Question 142

Overestimating people with disabilities

Answer 142

This problem is compounded by the fact that many individuals overestimate the productivity of someone who has no visible disabilities and underestimate what people with impairments can do in a work environment that fits their capabilities

Question 143

Shop Steward

Answer 143

For unions
In RTWC, they provide information on how elements of the RTW program fit with the collective agreement
Provide union with union about the RTW plan
Encourage RTW
Contribute to the evaluate of the RTW plan

Question 144

The Skeletal System

Answer 144

Comprised of the bones and joints

Question 145

How many bones do humans have?

Answer 145

206

Question 146

Bones provide structure…

Answer 146

For the body, attachment for the muscles, and produce blood in the marrow located within the centre of the bone.

Question 147

What is the term for when a bone breaks?

Answer 147

Fracture

Question 148

Simple fractures

Answer 148

Generally heal well because the bone has a direct blood supply

Question 149

Why do simple fractures heal so well?

Answer 149

The bone has a direct blood supply

Question 150

Comminuted fractures

Answer 150

Where the bone is fragmented

Question 151

Comminuted fractures can take longer to heal as…

Answer 151

It may be difficult to get all the fragments in alignment.

Question 152

Compound fracture

Answer 152

Bits sticking out through the skin

Question 153

ORIF

Answer 153

Open Reduction and Internal Fixation

Question 154

What does the ORIF procedure do?

Answer 154

Surgery to expose the fracture and then metal rods (for large bones) or pins/plates are used to hold the bone fragments in place while healing.

Question 155

Joints

Answer 155

Hinges between the adjacent bones to allow movement.

Question 156

To allow a smooth, fiction free movement…

Answer 156

Two bony ends are coverage in the cartilage and enclosed within a capsule that is filled with viscous synovial fluid

Question 157

Arthritis

Answer 157

Cartilage gets worn down, the fluid becomes too thick and the joint becomes painful and perhaps even inflamed (swollen and warm to the touch).

Question 158

Joints have…

Answer 158

Ligaments to attach them to one another and hold them in place.

Question 159

A sprain…

Answer 159

Is a tear in a ligament.

Question 160

Sprains are often considered less..

Answer 160

Severe than fractures, but a severe pain may take longer to heal a fracture and may require surgery.

Question 161

Muscles

Answer 161

Work in groups and allow us to move.

Question 162

Skeletal muscles

Answer 162

Cross one or more joints and help attach the bones. They allow us to move – to reach, to grasp and to stand/walk.

Question 163

Cardiac muscle

Answer 163

Is responsible for moving blood around the body.

Question 164

The muscles of the body make up

Answer 164

For about half our weight.

Question 165

The force of a muscle contraction depends on two factors

Answer 165

How man fibres of muscle there are
How much stimulation the muscle receives from the nervous system

Question 166

Skeletal muscles

Answer 166

End in tendons, which are the fibrous structures that actually attach to the bones.

Question 167

Injury to a muscle or tendon is called

Answer 167

A strain, usually caused by overuse. Because muscles have direct blood supply, strains usually heal well, but severe strains may require surgery.

Question 168

Nervous System

Answer 168

The brain, spinal cord, sensory organs, and all the nerves in the body.

Question 169

The Central Nervous System

Answer 169

Includes the brain and spinal cord.

Question 170

Peripheral Nervous System

Answer 170

Organs and nerves

Question 171

The brain is responsible for…

Answer 171

interpreting sensory information (perception) and thinking.

Question 172

The brain on an conscious level

Answer 172

Produces electrochemical signals carried by the nerves to control muscles, movements, and so forth.

Question 173

The brain on the unconscious level

Answer 173

Controls basic homeostatic functions like breathing, heart rate and so forth.

Question 174

The brain is protected within the skull on a cushion…

Answer 174

of cerebrospinal fluid.

Question 175

Any interruption of the blood circulation to the brain can cause…

Answer 175

Major disability, and anything that increases pressure within the skull cavity

Question 176

Brain tissue does not actually heal..but

Answer 176

some function may be regained, particularly in young people, through mechanisms of brain plasticity.

Question 177

Sensory organs

Answer 177

Eyes, ears, tongue, and noise.

Question 178

Balance

Answer 178

Is based on sensory organs in the inner ear

Question 179

Kinaesthesia

Answer 179

Sense of movement that allows us to control our movements very precisely.

Question 180

Prescycusis

Answer 180

Age related hearing loss

Question 181

Presbyopia

Answer 181

Age related vision changes.

Question 182

The spinal cord

Answer 182

Travels within the spinal column, protected by bony rings, and again – cushioned in cerebrospinal fluid – it relays signals between the brain and the peripheral nerves.

Question 183

Injury to the spinal cord

Answer 183

Can cause paralysis and loss of sensation.

Question 184

Typical health problems with the spinal cord

Answer 184

Congenital malformation
Injury due to fracture of the spinal bones

Question 185

Congenital Malformation

Answer 185

Spina bifida

Question 186

Injury due to fracture of the spinal bones

Answer 186

Spinal cord injury

Question 187

Nerves are covered in…

Answer 187

Myelin sheath that insulates them.

Question 188

Myelin

Answer 188

Makes conduction of the impulse faster and preventing dissipation of the impulse before it reached the intended receptor.

Question 189

Multiple sclerosis

Answer 189

Attacks the myelin sheath

Question 190

Damaged peripheral nerves

Answer 190

Do not have the potential to regenerate (heal), but this is slow and not guaranteed.

Question 191

Neuralgia

Answer 191

Inflammation of a nerve – it is painfully acute and may be disabling.

Question 192

The respiratory system

Answer 192

Includes the lungs and airways to the lungs, plus the muscles involved in breathing

Question 193

Muscles involved in breathing

Answer 193

Diaphragm and intercostal muscles.

Question 194

The diaphragm

Answer 194

Is a large muscle that forms an arch above the abdomen, it moves down to create a vacuum in the upper chest cavity, thus sucking in air and up to reduce the vacuum –– allowing exhalation.

Question 195

The intercostal muscles (between the ribs)

Answer 195

Move the chest bones up and with creating a vacuum. The intercostal muscles are particularly involved in deep breathing, during forced exhalation, or when someone is having trouble breathing.

Question 196

Typical problems in the respiratory system

Answer 196

Includes infection in the upper/lower respiratory system.

Question 197

Tuberculosis

Answer 197

A persistent lower respiratory bacterial infection.

Question 198

Chronic respiratory illnesses

Answer 198

Respiratory allergies
Astma
Chronic obstructive pulmonary disease (COPD)

Question 199

The cardiovascular system

Answer 199

Includes the heart, blood vessels, and blood.

Question 200

The heart

Answer 200

pumps the blood through the system, going first to the lungs to pick up oxygen and then through the arteries to the body.

Question 201

Veins

Answer 201

Rely on gravity and skeletal muscle action to return blood to the heart.

Question 202

Blood

Answer 202

Carries nutrients, oxygen, hormones and waste products.

Question 203

Capillaries

Answer 203

Tiny blood vessels that are the point of the exchange with tissues – where nutrients and oxygen are dropped off and waste products –– including carbon monoxide –– are picked up to be taken away.

Question 204

Red blood cells

Answer 204

Carry oxygen

Question 205

White cells

Answer 205

Part of the immune system

Question 206

Platelets

Answer 206

Allow clotting and scab formation

Question 207

Plasma

Answer 207

The liquid part of the blood that allows it to flow.

Question 208

Bruise

Answer 208

Hematoma

Question 209

What is a bruise

Answer 209

It happens when the vessel wall is compressed and blood leaks out.

Question 210

A cute to an artery

Answer 210

It can be serious or even fatal

Question 211

Arteries may develop balloon–like sacs

Answer 211

may develop an aneurysm (due to the pressure of pumping blood and developing a balloon–like sac).

Question 212

Aneurysms can occur…

Answer 212

In the Vena Cava –– the main blood vessel running from the heart to the lungs.

Question 213

Blood vessels can only develop fatty plaques…

Answer 213

along the inner walls, these plaques compromise circulation, which is particularly serious if they occur in the blood vessels of the heart, lungs or brain.

Question 214

Thrombus

Answer 214

Blood vessels blocked by a clot

Question 215

Deep Vein Thrombosis (DVT)

Answer 215

Occurs in the limb.

Question 216

Hypotension

Answer 216

Low blood pressure
Can cause you to lose consciousness.

Question 217

Hypertension

Answer 217

High blood pressure
If left untreated, hypertension gradually damages the blood vessels and heart, and it can contribute to stroke.

Question 218

The Endocrine System

Answer 218

System of all the glands in the human body as well as the hormones they secrete. Together, they operate to control homeostasis which is the healthy and balanced functioning of the body.

Question 219

The Thyroid Gland

Answer 219

Regulates the body’s metabolic rate and can be hypo (under) and hyper (over) active.

Question 220

The pancreas

Answer 220

Controls blood glucose levels, and the most prevalent serious disorder associated with the pancreas is diabetes.

Question 221

Of the 2 million Canadian adults living with disability, roughly…

Answer 221

45% were in the labour force.

Question 222

Unemployment is higher for persons with disabilities…

Answer 222

and varies by disability.

Question 223

80% of adults will experience one episode of…

Answer 223

Back pain during their lifetime

Question 224

Rheumatoid arthritis

Answer 224

one of the more prevalent and disabling forms of arthritis

autoimmune disease where theimmune system attacks the joints, tendons, and bones, causing inflammation anddestruction of these structures

Question 225

The joints most commonlyaffected by rheumatoid arthritis are?

Answer 225

the fingers, thumb, and the wrists. The course ofrheumatoid arthritis is quite varied, but about half of those with rheumatoid arthritis will develop joint erosion, and a significant portion of these people will have a progressiveand debilitating course. During periods of acute flare, joints become swollen, warm,painful, and red, with a reduced range of movement

Question 226

One of the major disabling characteristics of rheumatoid arthritis is…

Answer 226

its impact on handfunction. The involvement of feet and toes may make it difficult to find comfortablefootwear

Question 227

Fatigue is anotherdisabling symptom of rheumatoid arthritis

Answer 227

affecting up to 80% of people with rheumatoidarthritis

Question 228

Epilepsy

Answer 228

the most common neurological disorder. It isparticularly problematic for workers who must drive, operate machinery, or work atheights, and there are a few occupations closed to those with epilepsy, such as airlinepilot, transport driver, and the military

Question 229

Brain injury and stroke may result….

Answer 229

in motorproblems, abnormal gait, and problems with both oral and written communication.

Question 230

Cognitive impairments from brain injury and stroke may include

Answer 230

attention andconcentration, memory (and thus learning), information processing, safety awarenessand judgement, planning and organization, and abstract thinking

Question 231

Multiple sclerosis is an…

Answer 231

autoimmune disease thatattacks the myelin sheath that surrounds nerves.

Question 232

There are various sub–types of multiplesclerosis that have different patterns of progression, but the most common is relapsing–remitting

Answer 232

This means that the person hasperiods when they are worse (relapse) and better (remission). Remissions may lastweeks to months

Question 233

Someindividuals with multiple sclerosis also experience cognitive symptoms

Answer 233

like decreasedattention span, poor judgment, memory loss, and difficulty with reasoning and problem solving…Disabling fatigue affects up to 90% of people with ms.

Question 234

Angina

Answer 234

When blood flow to the heart muscle is reduced, it may cause pain in the chest,experienced as squeezing or pressure

Question 235

Stable angina

Answer 235

experienced in response to exertion, such as climbingstairs, and it is relieved with nitroglycerine

Question 236

Unstable angina

Answer 236

less common and moreserious. It may occur at rest and is not relieved with nitroglycerine. It may be a precursor to a heart attack

Question 237

Myocardial infarction

Answer 237

If the artery becomes completely blocked, the heart muscle dies

Question 238

Heart disease is very stressful, and many individuals experience fear and anxiety…

Answer 238

whenattempting to resume normal activities such as work. However, because so much work isnow mechanized, most workers can remain in or return to work despite cardiac healthconcerns

Question 239

10% of asthma cases in adults..

Answer 239

Are due to occupational factors such as exposure to dust, smoke, mold, chemicals, animals or plants.

Question 240

Occupational asthma should be considered…

Answer 240

In cases of adult–onset asthma, particularly if the person notices a link between work and symptoms.

Question 241

Chronic obstructive pulmonary disease has two sub–types

Answer 241

Chronic bronchitis
Emphysema

**most have both!

Question 242

Those with asthma and COPD

Answer 242

Have the greatest level of disability.

Question 243

COPD is strongly associated with occupational exposure…

Answer 243

to vapours, gases, dust, fumes and smoking. The association with workplace exposure is more than doubled for those who never smoked.

Question 244

Industries such as coal mining, welding, solvent manufacturing or use, and factor work are all associated with…

Answer 244

The development of chronic obstructive pulmonary disease.

Question 245

To assist workers with chronic obstructive pulmonary disease…

Answer 245

Any occupational exposure should be discontinued and the individual should be assigned lighter duties.

Question 246

Approximately 90% of people with diabetes

Answer 246

Have Type 2

Question 247

Left untreated, diabetic hypoglycaemia can lead to…

Answer 247

seizures and loss of consciousness

Question 248

Early signs of hypoglycemia

Answer 248

include shakiness, dizziness, sweating, hunger,irritability or moodiness, anxiety, and headache, whereas more severe signs may includeincoordination, muscle weakness, slurred speech, sudden vision changes, drowsiness,confusion, and seizures

Question 249

Diabetic ketoacidosis

Answer 249

aserious acute complication of diabetes that occurs when the body produces high levelsof blood acids called ketones

Question 250

Diabetic retinopathy

Answer 250

is the leading causeof blindness in adults

Question 251

Peripheral sensory neuropathy affects sensationto…

Answer 251

feet, legs, and hands

Question 252

Peripheral nerve and artery complications of diabetes…

Answer 252

causeapproximately one–half of all non–traumatic lower extremity amputations in the UnitedStates

Question 253

The most commoncancer in women

Answer 253

breast cancer, although rates have been dropping with morescreening and earlier diagnosis and treatment

Question 254

The most common cancer in men

Answer 254

Prostate cancer

Question 255

Pancreatic cancer is the….

Answer 255

deadliest type, but because of its higher prevalence, lung cancer causes the mostdeaths per year from cancer

Question 256

International Classification of Functioning (ICF)

Answer 256

provides a structure for considering theintersectionality between health conditions and contextual factors (personal andenvironmental) and how they mutually influence body structures and functions, activities,and participation in the lives of individuals and populations

Question 257

The ICF consists of a set of elements which are structured into four high–levelcategories:

Answer 257

Body function, Body structure, Activity and Participation, and Environmental factors

Question 258

prefix—peri—

Answer 258

which translates to surrounding

Question 259

The root—card—

Answer 259

—which refers to the heart

Question 260

The suffix—itis—

Answer 260

which indicates that inflammation is involved.

Question 261

Occupational Medicine

Answer 261

is a specialty that covers employee physical health andmanagement of injury. Activities in occupational medicine would include diagnosing,managing, and preventing work–related medical problems; carrying out complex casemanagement of occupational illness; promoting optimal health and safety in theworkplace; and facilitating accommodation in the workplace in a safe and timely fashionto encourage return to work, rehabilitation, and prevention of disability

Question 262

Occupational Health Nurses

Answer 262

involved in a variety ofactivities, including pre–placement screening, periodic physicals, providing advice toemployees about minor illnesses and injuries, assisting employees in implementing theadvice of physicians and other medical service providers, advising supervisors andmanagers about potential health risks in the workplace, developing and implementinghealth promotion programs and activities, and planning for emergencies

Question 263

Allied health professionals

Answer 263

specialists in exercise, nutrition, health education, speech,and daily function. They provide comprehensive, patient–centred care to help people withdisabilities regain or attain physical and social skills and to live and work asindependently and productively as possible

Question 264

Occupational therapists

Answer 264

concerned with promoting health and wellbeing through occupation. Occupational therapists define an occupation as everythingthat people do during everyday life, including self–care, work, study, volunteerism, andleisure.

Question 265

Mental Health

Answer 265

Mental health is not the absence of mental illness. It is aboutsubjective well–being. If a person feels that they are coping, somewhat in controlof life, can cope with challenges and take on responsibility, they can be viewedas being mentally healthy. It is manifested by successfully performing of mentalfunctions and being engaged in productive activities, rewarding relationshipsand the capacity to change and cope with challenge

Question 266

Mental Illness

Answer 266

Mental illness refers diagnosable mental health problems whichhave a clinical dimension and where, in most cases, professional intervention ortreatment is needed. It covers more serious or prolonged conditions, rather than,those requiring temporary assistance.

Question 267

Difference between mental health disorders vs. mental illness

Answer 267

For example, depression and anxiety areclassified as common mental disorders whereas schizophrenia and bipolardisorder as considered to be serious mental disorders.

Question 268

Anxiety disorders

Answer 268

reacts to specific contexts,experiences or objects with physical signs of anxiety or panic. These includeaccelerated heartbeat and excessive perspiration. A diagnosis is assigned where theresponse is inappropriate to the context, a lack of control of the response, or whennormal life functioning is disrupted. The main disorders include generalized anxietydisorder (GAD), panic disorder, social anxiety disorder, and specific phobias.

Question 269

Mood disorders

Answer 269

involves feelings of persistent sadness or periods ofinappropriate elation, or cycles of extreme feelings of joy and sadness. The main diagnostic categories include depression, dysthymia, bipolar disorder, and cyclothymicdisorder.

Question 270

Schizophrenia

Answer 270

This is a psychotic disorder which involves a split from reality.Perception and thinking are distorted which can lead to hallucinations or delusions. Ahallucination refers to seeing or hearing things that are not there and delusions refer tobeliefs that are no supported by reality.

Question 271

Impulse control and addiction disorders

Answer 271

Alcohol and drug are common impulsecontrol disorders, as is compulsive gambling. These disorders can have seriousimplications in the workplace in terms of health and safety, dishonesty andrelationships.

Question 272

Personality disorders

Answer 272

People with inflexible personality characteristics can be havedifficulties in work and social relationships. In extreme cases, because a person’sbehaviour or values differ from societal norms, they can be assigned this diagnosticlabel. Personality disorders can be resistant to usual treatments for mental illness.Examples include antisocial personality disorder, obsessive–compulsive personalitydisorder, and paranoid personality disorder.

Question 273

Obsessive–Compulsive Disorder (OCD)

Answer 273

This condition causes a person to beinundated with constant thoughts or fears. This can cause him or her to engage inritualistic behaviour (compulsions) or disturbing thoughts (obsessions). Not engaging inthese thoughts and behaviours can result in feelings of anxiety and discomfort.

Question 274

Depression and anxiety disorders (including GAD, panic disorder, phobias, socialanxiety disorder, OCD and PTSD) are referred to…

Answer 274

as Common Mental Health Disorders

Question 275

Serious Mental Health Disorders or Illness

Answer 275

involve psychosis (losing touch with reality or experiencing delusions)or high levels of care and may need in–patient treatment

Question 276

The leading cause of disability worldwide and is a major contributor to theoverall global burden of disease

Answer 276

Depression

Question 277

Mental Health 2012 estimated that 1 in 3Canadians (about 9.1 million people)…

Answer 277

met the criteria for at least one of six selectedmental or substance use disorders at some point in their life

Question 278

Over five percent of the Canadian population aged 15 years and over reportedsymptoms that met the criteria for a mood disorder in…

Answer 278

the previous 12 months, including4.7% for major depression and 1.5% for bipolar disorder

Question 279

Mental health problems in the workplace are currently one of the main causes of…

Answer 279

workabsence, a phenomenon that has seen a marked increase in the last two decades.

Question 280

Over 25% of all new disability pension claimants have a…

Answer 280

mentalhealth condition (35% in the Netherlands).

Question 281

The economic burden of mental illness in Canada is…

Answer 281

estimated at $51billion per year. This includes health care costs, lost productivity, and reductions inhealth–related quality of life.

Question 282

The cost to the Canadian economy resulting from the six most common mental healthconditions, including depression, dysthymia, bipolar disorder, social phobia, panicdisorder, and agoraphobia, has been estimated to be in region of…

Answer 282

$20.7 billion annuallyas a result of lost productivity and sickness absence. It is accepted that these costs willgrow over the coming years and could reach $29.1 billion by 2030

Question 283

The Conference Board analysis indicates that 425,000 more people in Canada would bein the working…

Answer 283

…if they were not dealing with the impacts of mental illness.

Question 284

An Ontario report that focused on three companies with a combined total of 60,000employees found that over a three–year period…

Answer 284

….2.5 % of employeeshad a least one depression–related disability episode resulting in 144,731 lost work dayson short–term disability. More thanthree–quarters of workers returned to work while 16 percent went on to long termdisability and eight percent quit, retired or were terminated.

Question 285

Based on a study involving 18 countries, the Organization for Economic Cooperationand Development (OCED), concluded that the health–related absence rate foremployees with mental health conditions…

Answer 285

…was 32 percent compared to 19 percent ofother workers.

Question 286

It is accepted that stress is one….

Answer 286

….of the more common causes ofemployee absence

Question 287

The biological basis for psychological stress

Answer 287

The fight or flight response involves the brain, body, emotions, andactions. It is driven by a combination of hormonal and neurological processes that resultin a person being activated to either “Fight or Flight”

Question 288

The hypothalamus plays an essential role in keeping usalive—

Answer 288

—it controls breathing, digestion, and other basic bodily functions.

Question 289

The amygdala

Answer 289

located in the limbic region of the brain is most strongly associated with fearresponses

Question 290

The pituitary gland

Answer 290

an important part of the stressresponse because it acts in concert with the hypothalamus to tell the adrenal glands torelease stress hormones

Question 291

Making the connection between stressors (event) and a stress reaction (symptoms ofstress)…

Answer 291

is key to identifying appropriate psychosocial accommodations for the employeeand recommending useful strategies to cope with the stress.

Question 292

The amygdala cannot distinguish…

Answer 292

…between non–lifethreatening and life–threatening stressors. It is also involved in the storage of emotionalmemories. As a result, it can fire at inappropriate stimuli which can result in a panicreaction

Question 293

The stress response can also be triggered…

Answer 293

…by thinking. Situations that cause orcontribute to stress can be experienced or re–experienced, consciously orunconsciously, by a person. There is some evidence that personal factors can increasea person’s sensitivity to the experience of stress.

Question 294

The tend and befriend theory” describes….”

Answer 294

…a way of dealing withstress that has been observed most frequently in women. Women respond to stressful situations by protectingthemselves and their young through nurturing behaviours (the “tend” part of the theory)and cope with stress by forming alliances with a larger social group

Question 295

Person–Environment Fit

Answer 295

work–related stress arises, if aworker’s characteristics are not a good fit with the features and processes of the workenvironment….. this occursif workplace demands require ability, attitudes, skills or other attributes that a workerdoes not possess or if the opportunities available within a workplace do not fit with theaspirations and values of a worker.

Question 296

Burnout

Answer 296

a condition in which a worker becomes negativeabout the work situation and as a result develops a cynical attitude to work and hasfeelings of reduced confidence

Question 297

Burnout occurs when workers arechronically exposed to stressful work conditions…

Answer 297

….and when they are not offered anyopportunity for recovery.

If a person is exhausted and experiences a reduced capacityto cope with the demands of the job, this can affect his or her motivation andcommitment, as well as the quality of the work produced.

Question 298

Transactional model

Answer 298

if a worker is experiencing occupational stress and cannot access supportin his or her relationships, the probability of a negative stress reaction is enhanced.

Personal relationships play a central part in the majority of organizations. Humaninteraction both between workers and for those in customer facing roles, can impact onfeelings and emotions. There are some occupations where relationships with otherpeople core are including social work, disability management or teaching.

Question 299

Demand–Control–Support model

Answer 299

Attempts to capture the interaction of threekey variables (i.e. demand, control and support) in determining the extent to which aparticular job role is perceived by a worker to be stressful.

For example, a job in which a worker has high control and where the demands arelow could be considered to be relatively stress–free and relaxed. However, where thereis a risk of redundancy, these circumstances could also be associated with substantialstress.

Question 300

Effort–Reward–Imbalance model

Answer 300

model focuses on the perception that aworker has that the effort invested in the job is being acknowledged and rewarded. If there is an imbalance between effort and reward, this can lead to dissatisfaction on thepart of the worker which can, in extreme cases, result in negative perceptions ofoccupational stress. Evidence suggests that this can lead to an enhanced risk ofcommon mental disorders

Question 301

In January 2018, the WSIB in Ontario formally recognized

Answer 301

….mental stress as awork–related injury worthy of compensation

Question 302

Acute stress, (sometimes called short–term stress or incidental stress)

Answer 302

….the mostcommonly experienced kind of stress. Acute stress comes from the demands andpressures of everyday living.

Question 303

Toomuch acute stress is experienced…

Answer 303

…as headaches, stomach upset, sleeping problems,etc.

Question 304

Acute stress is highly responsive to intervention or treatment and will usually remit or“go away” once…

Answer 304

….the stressor or trigger is removed or has abated.

For example, theexperience of a racing heart beat (acute stress) when rushing to meet a deadline(stressor) will abate once the deadline has been successfully met.

Question 305

Episodic Acute Stress

Answer 305

a subjective dimension, for example, the chronic worrier orthe person who seems always under pressure.

These individuals tend to be chronicallyanxious, rushed, and easily agitated. It is as if they are experiencing acute stress, butrepeatedly so.

Question 306

Chronic stress

Answer 306

…can causesignificant disruption in a person’s personal and/or work life. Examples include being trapped in a hated job or unhappy relationship. Often, the personexperiencing chronic stress becomes so used to, or familiar with, the stressors that theyignore the consequences.

Question 307

Generalized Anxiety Disorder (GAD)

Answer 307

characterized by unrealistic and excessiveanxiety/worry about most aspects of one’s life, e.g., constantly worrying about financialmatters. Individuals with will tend to report feeling shaky or on the edge. They may alsoexperience blanks or black outs as a result of the overwhelming anxiety and tensionthey are experiencing

Question 308

Panic Attacks and Panic Disorder

Answer 308

unexpected episode of intense, overpowering fear for no obvious reason. Repeatedepisodes are termed a panic disorder. Each episode is short, between one and tenminutes, although panic attacks have been reported to last up to an hour.

People oftenreport feeling like they are being paralyzed by the fear, that they are going mad, and thatthey may do something embarrassing in public. Attacks occur spontaneously,seemingly, in the absence of an environmental trigger.

Question 309

Phobia

Answer 309

experience of an unreasonable fear in the presence of a particularobject, circumstance, or activity.

Question 310

Agoraphobia

Answer 310

a fear of being in a situation where a panicattack could occur and where escape would be difficult, and social phobia, a fear ofbeing acutely embarrassed in front of other people, can have the most disabling impacton a person’s life.

Question 311

Obsessive–Compulsive Disorder (OCD)

Answer 311

an anxiety disorder in which a person engages in a pattern of senseless anddistressing repetitive thoughts and behaviors. It is a difficult condition to cope with andcan easily overwhelm an individual’s life.

Question 312

Obsessions

Answer 312

These are unwanted thoughts or impulses that repeat in one’s mind. Theycan be associated with irrational fear of harm to someone close or oneself.

Question 313

Compulsions

Answer 313

The behavioral response to obsessive thoughts.Common compulsive behaviors include washing, checking things (such as locks, orwindows), or counting. Repeating things, relentlessly hoarding or rearranging objects tokeep them aligned are also common.

Question 314

Tx for GAD

Answer 314

Cognitive behavior therapy (CBT)Relaxation, yoga, meditation
Psychotherapy,
Stress management training
Relaxation techniques sometimes using biofeedback to control muscle tension
Anti–anxiety medications

Question 315

Tx for Panic Attacks / Panic Disorders.

Answer 315

Psychotherapeutic Interventions (CBT), Medication.

Question 316

Social Phobia TX

Answer 316

Medications and CBT

Question 317

TX for OCD

Answer 317

Behaviour therapy (to control habits and rituals), and medication.

Question 318

Bipolar

Answer 318

the person alternates between oneemotional pole (depression) and another (manic).

Question 319

Depression is one of the most common…

Answer 319

…mental health disorders. It affects about 350million people worldwide.

It was the fourth leading contributorto the global burden of disease in 2000 and is likely to reach second place in theranking of Disability Affected Life Years (DALYs) by 2020. It is already the second rankedcause of DALYs for people of all genders between the ages of 15–44 years, impactingpeople in their prime working years.

Question 320

Tx for depression

Answer 320

Good treatment choices derive from the biopsychosocial model. Environmental factorssuch as medication (e.g., antidepressant medication, anti–anxiety or anxiolyticmedications for stress–related agitation) and cognitive–behavioural therapy orinterpersonal therapy can play important roles in the return to work process.

Question 321

There are three goals of treatment for depression, regardless of the type.

Answer 321

● Relieve unhappy symptoms (e.g., improve mood and energy, reduce tension)● Return to normal functioning at home, work, and socially● Reduce the likelihood that stress or depression will recur.

Question 322

DM professionals must not feel uncomfortable interjecting themselves into thetreatment process.

Answer 322

If an employee does not appear to be improving after a reasonableperiod, it is important to question the extent to which the treatment the employee isreceiving is adequate. This can be addressed directly with the treating professional, withthe person’s permission or through the employee.

Question 323

The advantages of medications are that:

Answer 323

● They are easy to take. ● They may begin to relieve the symptoms faster than therapy (e.g. relievedepressed mood).
● Most currently prescribed medications are not addictive.
● Most medications do not prevent return to work and, in fact, may hasten a returnto productive functioning at work and at home. Nevertheless, some medicationmay require that the employee report their use depending on the nature of theirjob—for example, operating heavy machinery.)

Question 324

The disadvantages of medications are:

Answer 324

– Not everyone benefits from them.– Some people don’t like consuming drugs
– Some drugs have side effects that cause the person to stop taking them.
– Some drugs require adherence to a strict regimen or diet.
– The first medication chosen may not be the one that eventually changes themood or symptom.
– In the case of depression, drugs may temporarily resolve a suicidal crisis butthey are no guarantee against future attempts.

Question 325

Reliance and compliance are the two most limiting factors…

Answer 325

…as to whether medication willwork or not.

Question 326

30 and 40 percent ofpeople prescribed antidepressant medications…

Answer 326

….do not comply with the instructions foruse in the first month. That is, they forget to take their medication, stop taking theirmedication, or modify something about their treatment regime

Question 327

Cognitive–behavioural and interpersonal therapy are two frequently used psychologicaltherapies for depression and stress–related problems.

In general, these therapies helppeople to:

Answer 327

● Recognize the connection between thought, feeling, and action ● Identify exaggerated beliefs of inadequacy (e.g., “I am worthless” or “I can’tcope”)
● Challenge these beliefs and substitute more reasonable ones
● Understand and change relationship conflicts or workplace circumstances thatcontribute to the depression and stress.

Question 328

Effective therapy can:

Answer 328

● Empower the person to change their situation or their perceptions of thatsituation ● Teach skills that can be used beyond the end of therapy
● Be more appealing to people who refuse to, or cannot, take medication
● In some cases, have longer lasting effects than medication, and
● Have no physical side effects.

Question 329

The disadvantages of therapy techniques are:

Answer 329

● They may take longer to relieve some symptoms than medication ● The selection of techniques must be tailored to each individual
● They do not affect the mania characteristic of bipolar depression
● They are not the first treatment choice for severely depressed individuals orthose who are suicidal.

Question 330

Primary Prevention of Psychological Disorders/Illness

Answer 330

Managing the workplaceconditions that can result in psychological health problems. It addresses thepotential risks to mental health by removing those that can be eliminated andmanaging those that cannot. It involves providing support or coping strategies toworkers to manage possible risks and changing workplace factors that have thepotential to result in PH&S incidents or events.

Question 331

Secondary Prevention of Psychological Disorders/Illness

Answer 331

Involves the early identification ofworkers who are at risk of developing a mental health problem. By interveningbefore a mental health problem has yet to develop into a more serious condition,it is possible to reduce the incidence of mental health disorders in a workplace.The Guide suggests three interventions that can support secondary prevention.

Question 332

Tertiary Prevention of Psychological Disorders/Illness

Answer 332

is about preventing workers who havedeveloped a mental health condition from exiting the workforce. It focuses onassisting them to retain their jobs or return to work after absence. It is aboutensuring access to health interventions, rehabilitation and developingperson–centered return to work plans.

Question 333

Counselling

Answer 333

The provision of individual counselling for employees experiencing mentalhealth difficulties in coping with the work situation is common in many countries. Themain objective of individual counselling is to assist the employee to explore the natureof the difficulties which he or she is experiencing both at home and in the workplace.

Question 334

Psychotherapy

Answer 334

While counselling tends to deal with life challenges and assistingindividuals to come to terms with personal issues that are affecting their lives,psychotherapy is more inwardly–focused—exploring and working towards resolvingdeeper emotional and psychological distress.

Question 335

Cognitive Behaviour Therapy (CBT)

Answer 335

one of the few interventions that hasemerged in research as being particularly effective in assisting the RTW process forpeople with stress–related conditions and mental health disabilities

Question 336

Psychoeducation

Answer 336

refers to the education offered to individuals witha mental health condition and their families to help empower them to deal with theircondition in an optimal way. Provides the people with educationspecifically targeting the difficulties they are experiencing

Question 337

Group Therapy

Answer 337

Is recommended less often than other mental healthinterventions. In general, it can provide support to other interventionstargeted at the RTW process rather than to directly address that particular goal.

Question 338

Vocational rehabilitation (VR)

Answer 338

most frequently involves career counselling, job searchtechniques and skills training for new jobs or careers.

Question 339

Personal Capacity Building

Answer 339

Interventions targeted at enhancing the worker’s capacity to deal with stress situationsand personal psychological difficulties were commonly recommended in the StressImpact study

Question 340

Vocational Training

Answer 340

In the case where the absent employee has a skill or knowledgedeficit in relation to the demands of the job role, the provision of vocational training (VT)and re–skilling becomes an essential part of the RTW plan.

Employees who have beenabsent over an extended period of time become deskilled in two ways. In the first place,they lose some of the skills that they originally had while in work; and secondly, theskills required for their job role may change while they are absent from the workplace

Question 341

Conflict Management and Problem Resolution

Answer 341

Both are particularly important capacity building interventions in thecase where someone has experienced relationship difficulties at work prior to his or herwithdrawal from work.

Question 342

Confidence Building

Answer 342

A key challenge for a person who has experienced a mentalhealth difficulty is the extent to which it undermines self–esteem and self–confidence.Things that would have been considered relatively straightforward and uncomplicatedprior to an episode of mental illness can become major stumbling blocks for a personreturning to work.

Question 343

Coaching and Mentoring

Answer 343

It is often useful to provide the returning worker with accessto mentoring and coaching support during the process.

Many employers alreadyoperate such schemes and thus it can be a more acceptable way to provide supportthan supported employment or individual placement support

Question 344

Stress Management Training

Answer 344

An important component of CBT, which is also availablefrom other sources, is stress management training. There are many stress managementtraining programmed available. Some of the more physiologically based approaches willuse bio–feedback to provide the participant with tangible evidence of the extent towhich they are tensing their body

Question 345

Bio–feedback combined with relaxation exercisessuch as deep breathing can…

Answer 345

…assist an individual to begin to control the physiologicalsymptoms that can cause discomfort in a stressful situation.

Question 346

Maintaining Positive Contact between the Employee and Employer

Answer 346

One of the keyinterventions in facilitating a successful RTW is the facilitation of positive andconstructive contact between the employer/manager and the absent employee.

Thiscan be a particular challenge especially in the event of a contested claim or workplaceissue. This is an important role for the DM professional.

Question 347

Workplace Adaptations

Answer 347

Once an initial, positive contact has been made between theabsent worker and the employer representative, negotiating appropriateadaptations/accommodations and transitional arrangements for the worker is moreeasily facilitated.

A particularly useful model when considering workplace adaptations isthe Demands, Control, and Support model” of stress”

Question 348

Strategy in the Demands, Control and Support Model” – Adapting Demands and Control”

Answer 348

Involves conducting a psychological demandsanalysis of the targeted job.

Psychological demands can arise from a number ofworkplace sources, including deadlines, the requirement for dealing withcustomers, or even the demands of repetitive work. Alternative demands andcontrol arrangements might include the provision of work that is a good matchfor the worker’s skills.

Question 349

Strategy in the Demands, Control and Support Model” – Providing Support”

Answer 349

The final workplace variable in theDemands–Control–Support model considers support. Support is a variable thatthe DM professional can manipulate in developing an effective reintegration planfor someone returning to work following an absence for mental health reasons.

Question 350

Intervening Factors: Working Relationships

Answer 350

Prior to embarking on a return to work process, it isessential that the DM professional clarifies the employee’s motivation to RTWand estimate the extent to which an employer is willing to accommodate theemployee’s needs. Workplace relationships are a key factor in effective return towork.

Question 351

Intervening Factors: Legislation

Answer 351

For example, equality andnon–discrimination legislation places the responsibility upon employers to makereasonable accommodation for employees who experience impairment ordisability. In this respect, the DM professional is often in a good position toadvise the employer regarding reasonable accommodation and inclusivemeasures.

Question 352

Intervening Factors: Precipitating Workplace Factors

Answer 352

This is an important variable in determining thelikelihood of RTW and the nature of the reintegration plan.

For example, in thesituation where an employee is in conflict with the employer due to acompensation claim, or where it is obvious that the employee is more interestedin taking a constructive dismissal action against the employer than in returningto work, the likelihood of RTW may be compromised.

Question 353

Mental Health Awareness Training

Answer 353

Can behelpful in educating all organizational employees of the prevalence of mental healthproblems in the workforce and of the potential influence of psychosocial factors onproductivity and well–being in the workplace.

Question 354

Psychological Risk Assessment

Answer 354

A pre–condition for the development of areintegration plan is a comprehensive risk assessment of the psychosocial factors thatcould jeopardize a successful RTW.

It is typically basedupon a site visit to the workplace, in–depth interviews with the Human Resourcedepartment and the person’s supervisor, and an in–depth discussion with the absentworker regarding their RTW ideas.

It includes apsychosocial job demands analysis, and also takes into consideration thecharacteristics of their health condition, in addition to behavioural and emotionalvulnerabilities.

Question 355

Redeployment to an Alternative Position

Answer 355

There are cases where the DM professionalin collaboration with the employer and the worker that returning to the original jobrepresents a significant risk that the mental health of the worker will be jeopardized.

This could be the case in Post–Traumatic Stress Disorder where the precipitators offlashbacks are context or occupationally specific or where workplace relationships havedeteriorated to the extent that return to the same position could aggravate the workersmental health difficulties. In such case, redeployment is a potential strategy.

Question 356

Redeployment within the Company

Answer 356

The first redeployment option is negotiatingwith the employer the idea of offering alternative positions within theorganization, in the event that the original position cannot be accommodated orthe employee does not want to return to the same position.

If the employer iswilling to offer an alternative job role, it is important for the DM professional toexplore with the employer available options for redeployment within theorganization.

Question 357

Redeployment to another Employer

Answer 357

Where redeployment to another employeremerges as the only viable option for the absent worker, the RTW process shiftsto a more supportive function, and the DM professional closes the case.

In some cases, the insurer may also provide DM support.Whichever is the case, there are a number of vocational rehabilitation strategieswith which all DM professionals need to be familiar whether consulting to theemployer, working for the employer, or for a third party, such as an insurancecompany

Question 358

When returning to work, it is important not to confuse the ability to work with the abilityto perform at….

Answer 358

….a maximum level or with a complete absence of discomfort, challenge orfrustration. It is important to ensure that the employee is prepared for this and hascoping mechanisms and strategies (e.g. learned through counselling or treatment) inplace to proactively respond to this

Question 359

‘Give it a try and see whathappens’

Answer 359

To encourage theperson to suspend judgement about what will work and what won’t and to frame thereturn to work experience as an exploration or experiment

Question 360

Enlist support

Answer 360

It is important to enlist the support of the employer, supervisor, or manager. To this end,the employee needs to understand their rights and their responsibilities, as well asthose of the employing organization.

Question 361

Anticipate co–worker discomfort

Answer 361

Some co–workers express concern and support toward employees who have beenabsent due to a stress or depression–related disability.

Others may appear to ignore theemployee for fear of saying the wrong thing and causing more stress. When moresevere mental health conditions are involved, lack of knowledge about mental healthissues may increase discomfort. It is important that the employee understands that theirco–workers may be uncomfortable and that this discomfort usually stems from genuineconcern, not criticism.

Question 362

An imbalance of neurotransmitters (usually too little) is thought to…

Answer 362

….contribute todepression much like missed telephone calls or misdirected mail causescommunication breakdown between people.

Question 363

Most antidepressant medications work byincreasing the number of available…

Answer 363

….neurotransmitters traveling between neurons so thatproper communication can occur. The result is improved mood and fewer physicalsymptoms.

Question 364

Depression isconsidered to be both a cause and an effect of….

Answer 364

….poor relationships.

People who aredepressed can be slow to engage in conversation and speak slowly and monotonously.They may not maintain appropriate eye contact, be slow to respond, and theirresponses badly timed.