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Bègue C, Desmidt L, Bellanger W, Tessier-Cazeneuve C, Petit A, Couturier AL. Pre-return to work consultation and therapeutic part-time work: Cross-sectional study on level of knowledge and use by general practitioners in France. Eur J Gen Pract 2021; 27:158-165. [PMID: 34259583 PMCID: PMC8281089 DOI: 10.1080/13814788.2021.1948007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND In France, general practitioners (GPs) may use two tools specifically designed to help employees who experience difficulties in returning to work after sick leave: the pre-return-to-work (PRW) medical consultation and therapeutic part-time (TPT) work. OBJECTIVES The objective was to investigate the level of knowledge and use of these two tools by GPs in Maine-et-Loire, France. METHODS This cross-sectional study was performed using a telephone questionnaire to evaluate the level of knowledge of GPs and the use of these two tools in patients having difficulties returning to work. RESULTS Among the 200 randomly selected GPs, 122 responded (response rate: 61%). More than half of the interviewed GPs declared they 'often' (46%) or 'always' (14%) contacted the occupational physician in these situations. Moreover, 62.2% and 32.7% believed that they had a 'vague' or 'very good' level of knowledge, and 41% and 51% declared either 'frequent' or 'regular' level of use of the PRW medical consultation, respectively. Regarding TPT work, 47% and 53% reported a 'very good' or 'vague' level of knowledge, and 41% and 51% a 'frequent' or 'regular' level of use, respectively. GPs who had a better level of knowledge of this tool reported a higher level of use (p < 0.001). CONCLUSION This study shows that while the level of knowledge and use of the PRW medical consultation and TPT work is good, it is not optimal. This could be improved by organising training courses for GPs. Obstacles to their wider use could be investigated further in a qualitative study.
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Affiliation(s)
- Cyril Bègue
- Univ Angers, Département de Médecine Générale, Angers, France.,Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, Angers, France
| | - Lucille Desmidt
- Univ Angers, Département de Médecine Générale, Angers, France
| | | | | | - Audrey Petit
- Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, Angers, France.,Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, Angers, France
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2
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Ablewhite J, Coole C, Konstantinidis ST, Fecowycz A, Khan S, Drummond A. Improving occupational therapists’ confidence in completing the Allied Health Professions Health and Work Report: Results from the CREATE feasibility study. Br J Occup Ther 2021. [DOI: 10.1177/0308022621998582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction There is a concern that occupational therapists lack confidence in advising on fitness to work. The aim of this study was to compare two training methods of improving occupational therapists’ confidence in completing the Allied Health Professions Health and Work Report (AHP H&WR). Method A mixed-methods study was conducted. Occupational therapists were recruited to face-to-face ( n = 14) or online ( n = 18) training. Data were collected via questionnaires at baseline, one week and eight weeks post-training, and using semi-structured telephone interviews. Questionnaire data were analysed descriptively; interviews were analysed thematically. Results It was possible to recruit and retain participants to the study. Occupational therapists from both groups reported that the training improved their confidence in completing the AHP H&WR. However, the majority did not have the opportunity to complete an AHP H&WR in practice during the follow-up period. Conclusion Similar results for both training methods shows promise for further development and testing. There is therefore potential to conduct a definitive study in this area.
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Affiliation(s)
- Joanne Ablewhite
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Carol Coole
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Aaron Fecowycz
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Sayeed Khan
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
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3
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MUTO G, ISHII-NAKAMURA R, YOKOYAMA K, KITAMURA F, OMORI Y, SAITO M, ENDO M. Information exchange using a prescribed form and involvement of occupational health nurses promotes occupational physicians to collaborate with attending physicians for supporting workers with illness in Japan. INDUSTRIAL HEALTH 2019; 57:10-21. [PMID: 29269602 PMCID: PMC6363580 DOI: 10.2486/indhealth.2017-0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration ≥10 times/yr (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p<0.05) and the use of prescribed forms for information exchange (OR: 4.21 and 3.63, respectively, p<0.05) but not with the demographic characteristics of the OPs (p>0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.
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Affiliation(s)
- Go MUTO
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
- Department of Global Health and Population, Harvard T.H. Chan
School of Public Health, USA
| | - Rina ISHII-NAKAMURA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Kazuhito YOKOYAMA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Fumihiko KITAMURA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Yuki OMORI
- Department of Hygiene, Kitasato University School of
Medicine, Japan
| | | | - Motoki ENDO
- Department of Public Health, Tokyo Women’s Medical
University, Japan
- Department of Public Health, Juntendo University Faculty of
Medicine, Japan
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4
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Dorrington S, Roberts E, Mykletun A, Hatch S, Madan I, Hotopf M. Systematic review of fit note use for workers in the UK. Occup Environ Med 2018; 75:530-539. [PMID: 29735750 DOI: 10.1136/oemed-2017-104730] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 02/23/2018] [Accepted: 03/09/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The fit note, introduced in England, Wales and Scotland in 2010, was designed to change radically the sickness certification process from advising individuals on their inability to work to advising them on what they could do if work could be adapted. Our review aimed to evaluate the following: (1) Is the 'maybe fit' for work option being selected for patients? (2) Are work solutions being recommended? (3) Has the fit note increased return to work? (4) Has the fit note reduced the length of sickness absence? We considered the way in which outcomes vary according to patient demographics including type of health problem. METHODS Studies were identified by a systematic search. We included all studies of any design conducted in the UK with working age adults, aged 16 or over, from 1 April 2010 to 1 Nov 2017. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. RESULTS Thirteen papers representing seven studies met inclusion criteria. In the largest study, 'maybe fit' for work was recommended in 6.5% of fit notes delivered by general practitioners (GP; n=361 801) between April 2016 and March 2017. 'Maybe fit' recommendations were made in 8.5%-10% of fit notes received by primary care patients in employment, and in 10%-32% of patients seen by GPs trained in the Diploma in Occupational Medicine. 'Maybe fit' was recommended more for women, those with higher socioeconomic status, and for physical, as opposed to psychiatric disorders. The majority of fit notes with the 'maybe fit' option selected included work solutions. There was inconclusive evidence to suggest that the introduction of the fit note has reduced sickness absence among patients in employment. CONCLUSIONS Fit notes represent a major shift in public policy. Our review suggests that they have been incompletely researched and not implemented as intended.
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Affiliation(s)
- Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Emmert Roberts
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Arnstein Mykletun
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway.,Research Unit, Directorate of Labour and Welfare, Oslo, Norway.,Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway.,Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Stephani Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ira Madan
- Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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5
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Brijnath B, Singh N, Mazza D. Stakeholder perspectives on the new sickness certificate in Victoria: results from a mixed-methods qualitative study. AUST HEALTH REV 2016. [DOI: 10.1071/ah14136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective
The aim of this study was to present the views of four stakeholder groups, namely general practitioners (GP), employers (EMP), injured workers (IW) and compensation agents (CA), about the content and usability of the draft of the new Victorian sickness certificate.
Methods
A cross-sectional mixed-methods qualitative study was conducted in GP clinics and community settings in Melbourne, Australia. Interviews were conducted with GPs, EMPs and IWs and one focus group discussion was completed with CAs (n = 29). Data were collected between October and December 2013. Thematic analysis was performed.
Results
All stakeholders viewed the new draft certificate as an improvement on the old one. GPs saw the certificate as a form of communication, whereas EMPs and CAs saw it as a therapeutic device. GPs continued to certify based on incapacity and provided little information about what IWs could do on return to work. All groups said that assessments for mental health needed more clarity and specificity. GPs, EMPs and CAs also said that the new certificates must be electronically available and integrated into existing medical software to streamline uptake.
Conclusions
To ensure appropriate use of the new certificate, stakeholders must share a common understanding about its purpose and the certificate must be incorporated into existing medical software. Content on mental health assessment, an area of continued difficulty, needs additional refinement. The new certificate replaced the old certificate in March 2015; after it has been established in clinical practice, an impact evaluation should be completed to determine whether GPs are certifying capacity and earlier return to work.
What is known about the topic?
When it comes to sickness certification, GPs tend to focus on what injured patients cannot do, rather than what they can do. The new sickness certificate aims to change GP behaviour by focusing the certificate more on capacity (i.e. what the injured patient can do).
What does this paper add?
Four stakeholder groups agreed that the content and usability of the new certificate has improved. However, they agreed that the assessment of mental health capacity needs further specificity. Dissonances also remain between the stakeholders on the purpose of the certificate.
What are the implications for practitioners?
Appropriate use of the new certificate requires a common understanding about the purpose of the certificate, training on its appropriate use, incorporation into existing medical software and clarity on mental health assessment.
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Cohen D, Khan S, Marfell N. Fit for work? Evaluation of a workshop for rheumatology teams. Occup Med (Lond) 2015; 66:296-9. [PMID: 26712845 DOI: 10.1093/occmed/kqv208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with rheumatoid arthritis (RA) may rapidly cease work prematurely due to ill-health. A recent survey noted that a quarter of respondents with RA experienced job loss within a year of diagnosis and 50% stopped work within 6 years. AIMS To develop and pilot workshops to increase the knowledge, skills and confidence of rheumatology team members to support work-related issues in outpatient clinics. METHODS A 3-h interactive workshop, informed by rheumatology experts and the Royal College of General Practitioners (RCGP) National Education Programme (NEP) about work and health, was developed to address both knowledge and skills in the management of health and work consultations in an outpatient setting. Questionnaires were developed for use pre- and immediately post-workshop, with questions that focused on the confidence of delegates in managing these discussions and the importance they placed upon them. RESULTS Ninety-nine participants attended five workshops throughout the UK between 2013 and 2104. Seventy-three per cent (72) completed the post-workshop questionnaire. Eighty-nine per cent found the workshop useful or very useful, 88% found it relevant or very relevant and 79% responded that it had an impact or a considerable impact on their practice. Wilcoxon matched pairs signed rank tests were carried out that showed an overall increase in confidence after training. CONCLUSIONS The results suggest that the workshop was both relevant and useful to participants and had an impact on their practice. This was true for all specialities. The workshops also highlighted participants' desire to understand how to use the 'fit note' to enhance their patient management.
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Affiliation(s)
- D Cohen
- Centre for Psychosocial Research, Occupational and Physician Health, Cardiff University, 53-54 Park Place, Cardiff CF10 3AT, UK,
| | - S Khan
- EEF, Broadway House, Tothill Street, London SW1H 9NQ, UK
| | - N Marfell
- Centre for Psychosocial Research, Occupational and Physician Health, Cardiff University, 53-54 Park Place, Cardiff CF10 3AT, UK
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Evaluation Studies on Education in Occupational Safety and Health: Inspiration for Developing Economies. Ann Glob Health 2015; 81:548-60. [DOI: 10.1016/j.aogh.2015.08.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Coole C, Nouri F, Potgieter I, Watson PJ, Thomson L, Hampton R, Drummond A. Recommendations to facilitate the ideal fit note: are they achievable in practice? BMC FAMILY PRACTICE 2015; 16:138. [PMID: 26463445 PMCID: PMC4603918 DOI: 10.1186/s12875-015-0360-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 10/06/2015] [Indexed: 11/10/2022]
Abstract
Background Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the ‘ideal’ fit note from the perspective of all stakeholders is needed to inform best practice. A recent Delphi study conducted by the authors reached consensus on 67 recommendations for best practice in fit note use for employed patients. However, such recommendations are not necessarily followed in practice. The purpose of this study was therefore to investigate the perceived achievability of implementing these Delphi recommendations with a further reference panel of stakeholders. Methods Potential participants were identified by the research team and study steering group. These included representatives of employers, government departments, trades unions, patient organisations, general and medical practitioners and occupational health organisations who were believed to have the knowledge and experience to comment on the recommendations. The consensus Delphi statements were presented to the participants on-line. Participants were invited to comment on whether the recommendations were achievable, and what might hinder or facilitate their use in practice. Free text comments were combined with comments made in the Delphi study that referred to issues of feasibility or practicality. These were synthesised and analysed thematically. Results Twelve individuals representing a range of stakeholder groups participated. Many of the recommendations were considered achievable, such as improved format and use of the electronic fit note, completion of all fields, better application and revision of guidance and education in fit note use. However a number of obstacles to implementation were identified. These included: legislation governing the fit note and GP contracts; the costs and complexity of IT systems and software; the limitations of the GP consultation; unclear roles and responsibilities for the funding and delivery of education, guidance and training for all stakeholders, and the evaluation of practice. Conclusions This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully.
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Affiliation(s)
- Carol Coole
- School of Health Sciences, University of Nottingham,, A Floor, Medical School, Queens Medical Centre, Nottingham, NG7 2HA, UK.
| | - Fiona Nouri
- School of Health Sciences, University of Nottingham,, A Floor, Medical School, Queens Medical Centre, Nottingham, NG7 2HA, UK.
| | - Iskra Potgieter
- Research Design Service for East Midlands, School of Medicine, C Floor, Room 2400, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Paul J Watson
- New Academic Unit, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.
| | - Louise Thomson
- Institute of Mental Health, Jubilee Campus, Room D16, Wollaton Road, Nottingham, NG8 1BB, UK.
| | - Rob Hampton
- Inclusion Healthcare, Charles Berry House, 45 East Bond Street, Leicester, LE1 4SX, UK.
| | - Avril Drummond
- School of Health Sciences, University of Nottingham,, A Floor, Medical School, Queens Medical Centre, Nottingham, NG7 2HA, UK.
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King R, Murphy R, Wyse A, Roche E. Irish GP attitudes towards sickness certification and the 'fit note'. Occup Med (Lond) 2015; 66:150-5. [PMID: 26452393 DOI: 10.1093/occmed/kqv161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sickness certification poses significant challenges to most general practitioners (GPs). As an alternative form of certification, in 2010, the UK implemented the 'fit note', which focuses on returning to work after illness. It has been well received in the UK but little is known of non-UK GP attitudes towards the fit note. AIMS To evaluate the challenges Irish GPs experience with the current sickness certification system and their attitudes towards the fit note. METHODS A questionnaire assessing attitudes, practices and preferences regarding the fit note was developed, piloted and posted to a representative sample of Irish GPs selected by systematic sampling. Descriptive statistics, chi-square tests and binary logistic regression were used to analyse the results. RESULTS Of 305 GPs surveyed, 64% (196) completed the survey. Ninety per cent (177) of responders reported a lack of available rehabilitation services for patients on sick leave and 66% (124) reported adverse effects of sickness certification on therapeutic relationships with patients. Those who indicated a preference for introducing the fit note (53%; 104) were significantly more likely to endorse both an excessive focus on disability [odds ratio (OR) = 3.16] and lack of GP training (OR = 2.04) in the sickness certification process. CONCLUSIONS Difficulties associated with sickness certification are apparent at GP-patient, GP-employer and GP-health service levels. Addressing these will require intervention at each of these levels and may be facilitated by challenging the assumption that illness equates to disability.
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Affiliation(s)
- R King
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland,
| | - R Murphy
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - A Wyse
- School of Medicine, Royal College of Surgeons of Ireland, 123 St Stephen's Green, Dublin 2, Ireland
| | - E Roche
- School of Health Science, University College Dublin, Belfield, Dublin 4, Ireland
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Coole C, Nouri F, Potgieter I, Drummond A. Completion of fit notes by GPs: a mixed methods study. Perspect Public Health 2015; 135:233-42. [PMID: 26194137 DOI: 10.1177/1757913915594197] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The aim of this study was to investigate the completion of fit notes by UK general practitioners (GPs). A series of actual fit notes issued to employed patients were examined, and their GPs' reflections and experiences of fit note completion explored. METHODS A mixed-methods design was used. Data were collected from copies of 94 fit notes issued to employed patients by 11 GPs, and from 86 questionnaires completed by these GPs reflecting on the fit notes they had issued. Face-to-face interviews were then conducted with each GP. RESULTS Fit note completion is not meeting expectations for a number of reasons. These include the following: limited knowledge and awareness of the guidance in fit note completion; problems with the fit note format; lack of mandatory training in completing fit notes; lack of incentive to change practice; incomplete implementation of the electronic fit note; GPs' lack of confidence in, and doubts about the appropriateness of performing this role. CONCLUSION If UK GPs are to continue their contractual responsibility for completing fit notes, further consideration of their education and training needs is urgently required. Weaknesses in the design and format of the fit note and the availability of the electronic version also need to be addressed.
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Affiliation(s)
- Carol Coole
- School of Health Sciences, University of Nottingham, A Floor, Medical School, Queens Medical Centre, UK
| | - Fiona Nouri
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Iskra Potgieter
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
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11
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de Kock KA, Steenbeek R, Buijs PC, Lucassen PLBJ, Knottnerus JA, Lagro-Janssen ALM. An education programme to increase general practitioners' awareness of their patients' employment: design of a cluster randomised controlled trial. BMC FAMILY PRACTICE 2014; 15:28. [PMID: 24507221 PMCID: PMC3923988 DOI: 10.1186/1471-2296-15-28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 02/04/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Work and being able to work are important prerequisites for health and well being. Health problems can have a negative influence on the ability to work and not being able to work can be detrimental for patients' psychosocial well being. Although GPs are aware of this importance they do not always structurally pay attention to patients' work during their daily practice. METHODS/DESIGN To investigate whether GPs can be trained to increase their awareness of work and improve their skills when dealing with work related problems we designed a cluster randomised controlled trial. The intervention in this trial is a tailored training based on the findings of qualitative research with focus groups of GPs. Gender aspects received specific attention in these focus groups. Primary outcome measures are self efficacy of patients concerning return to work, and GPs' use of ICPC code Z05 (work problems) and registration of patients' occupation. Secondary outcome measures are work awareness of GPs as perceived by patients, quality of life, health, use of care and illness related costs. A process evaluation will be part of our study. DISCUSSION We investigate a training to increase work awareness among GPs, improve their skills in managing work related problems and structurally register work related data in the EMR. We think this study will make a contribution to better health care for workers by motivating GPs to appreciate their specific needs. It will also add to our knowledge of the complex relationship between gender, work and health.
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Affiliation(s)
- Kees A de Kock
- Department of Primary and Community Care, Gender & Women’s Health, Radboud University Nijmegen Medical Centre, Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | | | | | - Peter LBJ Lucassen
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - J André Knottnerus
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Antoine LM Lagro-Janssen
- Department of Primary and Community Care, Gender & Women’s Health, Radboud University Nijmegen Medical Centre, Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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