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      Retorno ao trabalho de professores após afastamentos por transtornos mentais Translated title: Teachers returning to work after sick leave for mental disorders

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          Abstract

          Este estudo analisa os sentidos de retorno ao trabalho atribuídos por professores servidores públicos após afastamentos por transtornos mentais e comportamentais. Tratou-se de pesquisa qualitativa com 20 professores, ativos e em readaptação funcional, do ensino fundamental. A coleta de dados ocorreu entre 2011 e 2012, por meio de entrevistas individuais, grupos focais e questionário socioeconômico e de condições de trabalho. A análise de dados foi realizada por codificação temática para o estabelecimento de uma estrutura de ideias. A maioria dos participantes era de mulheres. A média de idade era 44 anos e de jornada de trabalho de 43,2 horas/semana. Os sentidos de retorno ao trabalho para os professores ativos estavam ancorados nas ideias relacionadas aos motivos do afastamento, à capacidade para o trabalho e à valorização do trabalho. Para os professores readaptados, os sentidos atribuídos refletiram conflitos entre retornar à sala de aula ou manter-se readaptado. Discutir e compreender a identidade profissional foram primordiais no entendimento do processo de retorno dos professores readaptados. Dois temas associados ao retorno foram transversais a ambos os conjuntos de professores: o papel da equipe gestora neste processo e os preconceitos no ambiente de trabalho. Não foi possível abordar o retorno ao trabalho sem considerar o afastamento. A análise sobre os sentidos de retorno ao trabalho, na perspectiva dos próprios professores, disponibilizou uma série de elementos para a compreensão do processo de afastamento e retorno e das condições de vida e trabalho nesta categoria profissional. Observa-se a premência em favorecer ações de retorno ao trabalho no ambiente escolar como determinante da saúde dos professores.

          Translated abstract

          The present study evaluates the significance of the process of public school teachers returning to work following sick leave for mental and behavioral disorders. It is a qualitative study conducted with 20 elementary school teachers currently active or undergoing retraining. Data was obtained thru individual interviews, focus groups and a questionnaire, which included socioeconomic data and work conditions, during 2011 and 2012. Data was analyzed by means of thematic categorization. Most participants were women, average age of 44 years old, and working 43.2 hours per week. Among those who were active teachers, returning to work was associated with the reasons that led to the sick leave, their ability to accomplish actual work and the possibility of being valued at work. Regarding teachers undergoing retraining, the impacts of returning to work included the conflict of returning to the classroom or being away from it. It was paramount to discuss their professional identity in order to understand the process of returning to work for the teachers undergoing retraining. Two themes were common to both groups of teachers: the role of the school managerial team during the process of returning to work and the prejudice they faced in the work environment. It was not possible to approach returning to work without discussing the sick leave process. The performed analyses, by the point of view of the participants, revealed a number of topics to understand the process of sick leave and returning to work, as well as the living and working conditions of the teachers.

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          Prognostic Factors of Long Term Disability Due to Mental Disorders: A Systematic Review

          Introduction In the past few decades, mental health problems have increasingly contributed to sickness absence and long-term disability. However, little is known about prognostic factors of return to work (RTW) and disability of persons already on sick leave due to mental health problems. Understanding these factors may help to develop effective prevention and intervention strategies to shorten the duration of disability and facilitate RTW. Method We reviewed systematically current scientific evidence about prognostic factors for mental health related long term disability, RTW and symptom recovery. Searching PubMed, PsycINFO, Embase, Cinahl and Business Source Premier, we selected articles with a publication date from January 1990 to March 2009, describing longitudinal cohort studies with a follow-up period of at least 1 year. Participants were persons on sick leave or receiving disability benefit at baseline. We assessed the methodological quality of included studies using an established criteria list. Consistent findings in at least two high quality studies were defined as strong evidence and positive findings in one high quality study were defined as limited evidence. Results Out of 796 studies, we included seven articles, all of high methodological quality describing a range of prognostic factors, according to the ICF-model categorized as health-related, personal and external factors. We found strong evidence that older age (>50 years) is associated with continuing disability and longer time to RTW. There is limited evidence for the association of other personal factors (gender, education, history of previous sickness absence, negative recovery expectation, socio-economic status), health related (stress-related and shoulder/back pain, depression/anxiety disorder) and external i.e., job-related factors (unemployment, quality and continuity of occupational care, supervisor behavior) with disability and RTW. We found limited evidence for the association of personal/external factors (education, sole breadwinner, partial/full RTW, changing work tasks) with symptom recovery. Conclusion This systematic review identifies a number of prognostic factors, some more or less consistent with findings in related literature (mental health factors, age, history of previous sickness absence, negative recovery expectation, socio-economic status, unemployment, quality and continuity of occupational care), while other prognostic factors (gender, level of education, sole breadwinner, supervisor support) conflict with existing evidence. There is still great need for research on modifiable prognostic factors of continuing disability and RTW among benefit claimants with mental health problems. Recommendations are made as to directions and methodological quality of further research, i.e., prognostic cohort studies.
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            Intervention Characteristics that Facilitate Return to Work After Sickness Absence: A Systematic Literature Review

            Introduction In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee’s health and participation in labour. Methods We performed a keyword search (systematic literature review) in seven databases (period: 1994–2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Results Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Conclusions Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.
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              CIF: Classificação Internacional de Funcionalidade, Incapacidade E Saúde

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                sausoc
                Saúde e Sociedade
                Saude soc.
                Faculdade de Saúde Pública, Universidade de São Paulo. (São Paulo )
                1984-0470
                September 2015
                : 24
                : 3
                : 841-852
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                Article
                S0104-12902015000300841
                10.1590/S0104-12902015130569
                970e937d-9433-4e71-ba16-a94d947ea5db

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0104-1290&lng=en
                Categories
                PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

                Public health
                Teachers,Return to Work,Mental Disorders,Sick Leave,Prejudice,Occupational Health,Docentes,Retorno ao Trabalho,Transtornos Mentais,Licença Médica,Preconceito,Saúde do Trabalhador

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