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      A municipality-based vocational rehabilitation programme for occupationally marginalized citizens: a study protocol for a mixed methods study

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          Abstract

          Background

          In 2013 vocational rehabilitation programmes (VRP) were given official and legal approval under Danish law to assist occupationally marginalized citizens in gaining general life skills, building their work ability, and increasing their chances of entering the work force. The project’s aim is to develop a detailed understanding of the health, psychosocial and work circumstances of participating citizens, and of the important processes and mechanisms underlying the potential effects of participating in the VRP.

          Methods

          This study uses an exploratory mixed methods approach with sequential use of quantitative and qualitative methods. Participants are citizens assigned to an individually tailored VRP in the municipality of Sonderborg, Denmark. The quantitative part of the study consists of a longitudinal survey in which participants complete questionnaires at baseline and at follow-up one year later. Variables include demographic and personal characteristics, the latter ascertained through validated questionnaires on well-being, physical activity, interpersonal problems, general health, work ability, kinesiophobia, self-efficacy, depression and anxiety. The qualitative part of the study consists of semi-structured interviews and observations that explore experiences related to VRP. Participants will be recruited and data collected from questionnaires, interviews and observations in the period February 2016 – March 2018.

          Discussion

          This research will assemble a unique corpus of knowledge about the characteristics, experiences and outcomes of occupationally marginalized citizens participating in a VRP. It will identify potential enablers and barriers to a successful outcome, and ultimately this knowledge will help inform the future design of individually tailored VRP’s.

          Trial registration

          ClinicalTrials.gov Identifier: NCT02641704, date of registration December 29, 2015.

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          Most cited references27

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          Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.

          Two studies are presented that investigated 'fear of movement/(re)injury' in chronic musculoskeletal pain and its relation to behavioral performance. The 1st study examines the relation among fear of movement/(re)injury (as measured with the Dutch version of the Tampa Scale for Kinesiophobia (TSK-DV)) (Kori et al. 1990), biographical variables (age, pain duration, gender, use of supportive equipment, compensation status), pain-related variables (pain intensity, pain cognitions, pain coping) and affective distress (fear and depression) in a group of 103 chronic low back pain (CLBP) patients. In the 2nd study, motoric, psychophysiologic and self-report measures of fear are taken from 33 CLBP patients who are exposed to a single and relatively simple movement. Generally, findings demonstrated that the fear of movement/(re)injury is related to gender and compensation status, and more closely to measures of catastrophizing and depression, but in a much lesser degree to pain coping and pain intensity. Furthermore, subjects who report a high degree of fear of movement/(re)injury show more fear and escape/avoidance when exposed to a simple movement. The discussion focuses on the clinical relevance of the construct of fear of movement/(re)injury and research questions that remain to be answered.
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            Inventory of interpersonal problems: psychometric properties and clinical applications.

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              Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five well-being scale

              The health status questionnaire Short‐Form 36 (SF‐36) includes subscales measuring both physical health and mental health. Psychometrically, the mental health subscale contains a mixture of mental symptoms and psychological well‐being items, among other things, to prevent a ceiling effect when used in general population studies. Three of the mental health well‐being items are also included in the WHO‐Five well‐being scale. In a Danish general population study, the mental health subscale was compared psychometrically with the WHO‐Five in order to evaluate the ceiling effect. Tests for unidimensionality were used in the psychometric analyses, and the sensitivity of the scales in differentiating between changes in self‐reported health over the past year has been tested. The results of the study on 9,542 respondents showed that, although the WHO‐Five and the mental health subscale were found to be unidimensional, the WHO‐Five had a significantly lower ceiling effect than the mental health subscale. The analysis identified the three depression symptoms in the mental health subscale as responsible for the ceiling effect. The WHO‐Five was also found to be significantly superior to the mental health subscale in terms of its sensitivity in differentiating between those persons whose health had deteriorated over the past year and those whose health had not. In conclusion, the WHO‐Five, which measures psychological well‐being, reflects aspects other than just the absence of depressive symptoms. Copyright © 2003 Whurr Publishers Ltd.
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                Author and article information

                Contributors
                lonygaard@health.sdu.dk
                m.jensen@nikkb.dk
                kroessler@health.sdu.dk
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                3 July 2018
                3 July 2018
                2018
                : 18
                : 517
                Affiliations
                [1 ]ISNI 0000 0001 0728 0170, GRID grid.10825.3e, Department of Sports Science and Clinical Biomechanics, , University of Southern Denmark, ; Odense, Denmark
                [2 ]ISNI 0000 0004 0402 6080, GRID grid.420064.4, Nordic Institute of Chiropractic and Clinical Biomechanics, ; Odense, Denmark
                [3 ]ISNI 0000 0001 0728 0170, GRID grid.10825.3e, Department of Psychology, , University of Southern Denmark, ; Odense, Denmark
                Author information
                http://orcid.org/0000-0003-3501-5547
                Article
                3322
                10.1186/s12913-018-3322-4
                6029077
                29970107
                2190226a-d38a-4a23-8a14-f5c4c9c9c416
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 April 2017
                : 24 June 2018
                Funding
                Funded by: Sonderborg Municipality, Denmark
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2018

                Health & Social care
                vulnerable citizens,unemployed,social worker,interdisciplinary rehabilitation,work ability,work force,longitudinal survey,interview,social service interventions

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