Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Alan Salmoni

2nd Supervisor

Lynn Shaw

Joint Supervisor

Abstract

Measurement of return to work (RTW) lacks attention to outcomes of relevance to all stakeholders. The objective of this thesis was to define what constitutes a successful RTW outcome from a stakeholder perspective and determine how to best measure it. A concept mapping method was used to create a conceptualization of successful RTW outcome based on indicators of interest and importance to various stakeholders. RTW researchers were questioned and the literature was searched for measures that mapped to the conceptualization and concepts. Stakeholders, made up of RTW consumers and providers, generated 48 indicators of successful RTW which were subsequently grouped into six concepts. Stakeholders also rated the importance of each of the indicators. In preparation for creating a final conceptualization the stakeholder-generated concepts and rating data were presented to a researcher group who were invited to comment and provide further input. The researcher group confirmed the inclusiveness of the generated concepts and discussed various aspects of the resulting conceptualization. Names of measures that appeared to evaluate various concepts were also offered. The final conceptualization was constructed in an attempt to reflect both practice and research realities. The stakeholder-generated data, discussion points from RTW researcher focus groups and the investigator’s intimate knowledge of both practical RTW issues and RTW literature were used in the creation of a logic model. Final concepts were support and collaboration, stakeholder perspectives, rights, respect and dignity, maintenance of well-being, worker job function and worker job satisfaction. The logic model was developed to illustrate temporal aspects and the relationships among the concepts of this RTW outcome evaluation theory. This project is the first that identifies shared and clear goals of RTW program outcomes. Results suggest that there are measures that fully capture some concepts but aspects of other concepts will likely need development of new measures. Further study is needed to determine the ability of the model to differentiate between successful and unsuccessful RTW outcomes and to develop an outcome measure that targets the concepts of the model explicitly.

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