A New Conceptualization of Occupational Outcome

This thesis presents a new conceptual model of occupational outcome based on the results of input from 5 key stakeholder groups in the field of occupational health including patients, healthcare providers, employers, unions, and insurers. Data from 77 participants who took part in one of either 18 individual interviews or 11 focus groups were qualitatively content analyzed. The goals were to: 1) compare the range of meanings given to the concepts of health, occupational health, and occupational outcome, 2) understand the range of opinions among stakeholders and identify areas of agreement or disagreement and, 3) to develop a framework of occupational outcome incorporating the views of all key stakeholders. Health, occupational health, and occupational outcome were found to have different and complex meanings that extended beyond those in existing research, and that related to the role a variable is hypothesized to have in a larger framework. Stakeholders differed in the depth, breadth, and qualitative nature of the themes discussed. Natural alignments among some stakeholder groups emerged which varied depending on the context, however a specific focus could be identified for each group. No single stakeholder group alone expressed all the themes and the complexity of the relationships among them; the whole could only be understood in terms of the sum of the stakeholder parts. A new model emerges in which occupational outcome is encompassed by the interactions of 3 key factors: Function and Ability, Individual Behaviours, and Environmental Factors. These are embedded within larger models of both occupational health that includes both individual health and workplace health, and of quality which is comprised of the interactions between structure variables, system participant factors, and outcome. The new model and the process undertaken to develop it meet two important needs for occupational health; enhancing understanding and conceptualization of occupational outcome, and enhancing understanding of the perspectives of stakeholders in the occupational healthcare system. The findings have implications for research, and delivery of quality care to patients with occupational disease or injuries. Some next steps include model validation and testing, measurement scale development, clarifying new variables through ongoing stakeholder discussion, and model application.Ph