Self management and employability of workers with complaints of the arm, neck and / or shoulder.

The increased use of computers in many professions in recent decades has been accompanied by an increased incidence of pain and symptoms in the upper extremity in the execution of repetitive work. These RSI (Repetitive Strain Injury) complaints not only lead to great discomfort and pain but in some cases also to non-attendance at work and / or work disability. In the absence of effective interventions, many employees continue to perform their work with pain and limitations resulting in a reduced work capacity, reduced productivity at work (presenteeism), decreased job satisfaction and possibly in absenteeism and disability. Focussing on an active coping strategy in which employees learn how to deal with the symptoms and limitations seems advisable (Heemskerk et al, 2009). Self-management can both influence physical and psychosocial risk factors of CANS. Because CANS have a chronic of intermittent course in many cases, such an intervention seems ideal for workers with persistent CANS.



Study design:

The study is a randomized controlled trail in which employees are randomly assigned to a self-management intervention and an e-health program or to usual care. Participants are recruited through a call on the websites and newsletters and through health coordinators, occupational health physicians and managers. The self-management intervention consists of six group sessions over 2 months. The e-health is available for participants from the start of the intervention till the end of the follow-up period. The follow-up period is 12 months.



Objective:

The objective of the study is to investigate the effectiveness of a combined intervention on the disabilities, self-efficacy and long-term employability of workers with complaints of the arm, neck and / or shoulder. Through a self-management program - complemented by an e-health program – the employees is given insight into the causes of the symptoms and disabilities and they get better equipped to deal with these complaints and lower the risk of persistence of the complaints and control to workplace absenteeism.

The objective of the study is to investigate the effectiveness of a combined intervention on the disabilities, self-efficacy and long-term employability of workers with complaints of the arm, neck and / or shoulder. Through a self-management program - complemented by an e-health program – the employees is given insight into the causes of the symptoms and disabilities and they get better equipped to deal with these complaints and lower the risk of persistence of the complaints and control to workplace absenteeism.

T0: Baseline;

T1: 3 months;

T2: 6 months;

T3: 12 months.

A self-management intervention offered to the participants (8-12 participants in each group). The total program consists of six group meetings of two and a half hours each. The meetings are weekly. Topics such as dealing with pain, disability and fatigue, the balance between workload and capacity, communication skills, stress management, (muscle) relaxation exercises, problem solving, use of facilities, working with others and asking for help, dealing with negative emotions and positive thinking will be discussed.
To influence the determinants of behaviour various techniques are used in the course. Such as consciousness raising, risk perception, positive (re)-formulation, self-(re) evaluation), obtaining confidence en mobilizing social support, skill training, reinterpretation of symptoms, goal setting, social comparison and modelling (Bandura 1986). To set targets (SMART and formulated in terms of behaviour), action plans will be made (Lorig et al, 2006). A goal about management behaviour (eg exercises, take breaks at work, ask the manager for a tool), including a statement of the employee on which he / she indicates how confident he / she is in achieving the goal, will be formulated weekly. Thus unrealistic goals can be adjusted.



The group meetings are complemented by an e-health module. In the e-health module the subjects of self-management training are also discussed and assignments can be made. Also, participants can keep a diary. There is also additional information about self-management and on specific topics of CANS availible, such as: etiological factors (physical, psychological and social (work) factors), prognostic factors, lifestyle factors, and other modifiable factors.



The control group will receive care as usual.