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Spring 2018 HRmatters Magazine – CPHR Manitoba

Fear of Re-Injury – What Part Do We Play to Keep Employees at Work?

See the article published in HRmatters Magazine

JOHN INJURED HIS back, and when he came back to work he only lasted a few days before he went off work again. Yet when Phil injured his back, he missed very little time and seems to be managing fine being back at work.

Does this sound familiar? How can the outcomes of two employees with similar injuries and job duties be so different?

Though we know that there are individual differences with recovery times, we now also know that psychological factors are more important than physical factors regarding return to work outcomes.

In a recent study conducted in conjunction with the Institute for Work and Health (IWH), an independent non-profit research organization, fear of re-injury is a strong predictor of delayed return to work. The findings discuss how workplace factors could influence the employees’ perception regarding re-injury risk in the workplace. The employees’ perceptions include confidence that the source of injury had been addressed, and the availability of alternate duties. The study speaks to fear avoidance and return to work behavior being influenced not only by the employees’ emotions and thought processes, but also by the beliefs of important people surrounding them such as the employer and other employees, family members, and health care providers.

Similar studies by IWH regarding readiness return to work speak of the employees’ confidence with their ability to obtain help from co-workers and supervisors in the form of physical assistance as well as emotional support such as listening and talking about their concerns.

Given these findings, what can we do? How can the employees’ perceptions and beliefs be influenced so as to reduce their re-injury fears resulting in successful sustainable return to work?

The IWH researchers suggest health belief models may provide useful frameworks for interventions targeting the affective, cognitive, social, organizational and policy factors that can influence fear avoidance or facilitate return to work following injury.

Yes, of course having policies in place is paramount, however what the individual employee experiences is the employer behaviour. “They only called me a few times in the beginning when I first went off work, now I do not hear from anyone at work.” Or, “I have to get the work done, I am trying my best, I am not sure if anyone even notices.” I have heard these words spoken many times.

To assist with decreasing this re-injury fear, how about some simple effective employer actions that will not add extra time to already busy schedules? What first comes to mind is using active listening techniques; which include giving the individual your undivided attention. For example, when meeting with the employee repeat back to the individual a few things they said such as key words and phrases. This is also an effective technique to use when speaking with employees on the telephone. These simple behaviours unconsciously register in our brains as “they really are listening.” During meetings, have your body facing the individual, provide appropriate eye contact and stay away from the computer and the phone. The demonstrated behaviour will unconsciously register in our brains as “I matter.” Establish the follow up meeting plan and book the date/time with the individual at the end of the meeting. These concrete actions can register in our brains as “I really am important, my efforts are being noticed.”

At workplaces I have coached supervisors while daily walking through their departments, to make a point of casually stopping by the injured employees’ workstation and simply say “Hi, how is it going today, any questions so far?” This method gives the signal that the employer is open to hearing their suggestions and concerns. That they do not have to wait until a scheduled meeting, rather the employee can openly ask questions and share their progress. This technique assists to minimize the build-up of fear and worry which our brains can unconsciously perceive as a greater problem. In other words, it assists to decrease the likelihood of our brains strongly reacting and “making a mountain out of a mole hill.” Keeping in mind that return to work follow up meetings can be anxiety provoking for some individuals, when discussion regarding progress and concerns has occurred all along, the “pre-meeting worry” is typically reduced.

Successful and sustainable return to work is not straight forward or easy. These simple employer behavioural actions are effective for building self-efficacy or confidence that the employee can successfully manage the return to work transition, and that they are not alone in doing so. The unconscious message in our brains of “I am important, I am valued” is not only effective for injured employees, but for all of the employees observing the employer behaviours.

Bunzli S, Singh N, Mazza D, Collie A, Kosny A, Ruseckaite R, Brijnath B, “Fear of (re)injury and return to work following compensable injury: qualitative insights from key stakeholders in Victoria, Australia”, BMC Public Health Journal, April 11, 2017.

Article by Lorraine Mischuk O.T. Reg. (MB)

Lorraine Mischuk O.T. Reg. (MB) is an Occupational Therapist and has been providing return to work and stay at work services for Manitoba employers for over 25 years.

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