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Sarfo MC, Bertels L, Frings-Dresen MHW, de Jong F, Blankenstein AH, van Asselt KM, de Boer AGEM. The role of general practitioners in the work guidance of cancer patients: views of general practitioners and occupational physicians. J Cancer Surviv 2023; 17:416-424. [PMID: 35469363 PMCID: PMC9038171 DOI: 10.1007/s11764-022-01211-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/10/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore views of general practitioners (GPs) and occupational physicians (OPs) on the role of GPs in work guidance of cancer patients. METHODS Between 2016 and 2019, two focus groups with GPs (N = 17) and two focus groups with OPs (N = 10) were conducted. Focus group discussions were audiotaped and transcribed verbatim. Transcripts were analysed by data-driven analysis. RESULTS GPs generally indicated that they inquire about patients' occupations but do not structurally document these. GPs described offering support and advice to patients regarding their work, while other GPs stated they do not interfere with their patients' work or return to work (RTW) process. In general, GPs stated that they do not aspire a professional role in the work guidance of patients, due to lack of expertise and not having sufficient knowledge in work regulations and legislation. In contrast, OPs anticipated a proactive role from GPs concerning work guidance in cancer patients, and they expected GPs to refer cancer patients to the OP, when required. Moreover, they emphasised the importance of communication between GPs and OPs about patients' work-related problems to achieve common goals. CONCLUSIONS GPs can contribute to cancer patients' RTW process by supporting patients, giving advice and providing referral to other health professionals. Better cooperation between GPs and OPs may improve work guidance in cancer patients. IMPLICATIONS FOR CANCER SURVIVORS When cancer patients with work-related issues get appropriate advice and support from GPs and referred in time to OPs, the RTW process and staying at work of cancer patients may be positively affected.
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Affiliation(s)
- Marie-Christine Sarfo
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucinda Bertels
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
| | - Femke de Jong
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette H Blankenstein
- Department of General Practice/Family Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands.
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Vossen E, van der Gulden JWJ, van Genabeek JA, Schaap R, Anema JR, Schaafsma FG. Process evaluation of the 'Grip on Health' intervention in general and occupational health practice. BMC Health Serv Res 2022; 22:1459. [PMID: 36451237 PMCID: PMC9713133 DOI: 10.1186/s12913-022-08801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND For working patients with a lower socioeconomic position, health complaints often result from a combination of problems on multiple life domains. To prevent long-term health complaints and absence from work, it is crucial for general and occupational health professionals to adopt a broad perspective on health and to collaborate when necessary. This study aimed to evaluate how the 'Grip on Health' intervention is implemented in general and occupational health practice to address multi-domain problems and to promote interprofessional collaboration. METHOD A process evaluation was performed among 28 general and occupational health professionals, who were trained and implemented the Grip on Health intervention during a six-month period. The 'Measurement Instrument for Determinants of Innovations' was used to evaluate facilitators and barriers for implementing Grip on Health. Data included three group interviews with 17 professionals, a questionnaire and five individual interviews. RESULTS While most health professionals were enthusiastic about the Grip on Health intervention, its implementation was hindered by contextual factors. Barriers in the socio-political context consisted of legal rules and regulations around sickness and disability, professional protocols for interprofessional collaboration, and the Covid-19 pandemic. On the organizational level, lack of consultation time was the main barrier. Facilitators were found on the level of the intervention and the health professional. For instance, professionals described how the intervention supports addressing multi-domain problems and has created awareness of work in each other's healthcare domain. They recognized the relevance of the intervention for a broad target group and experienced benefits of its use. The intervention period was, nevertheless, too short to determine the outcomes of Grip on Health. CONCLUSION The Grip on Health intervention can be used to address problems on multiple life domains and to stimulate interprofessional collaboration. Visualizing multi-domain problems appeared especially helpful to guide patients with a lower socioeconomic position, and a joint training of general and occupational health professionals promoted their mutual awareness and familiarity. For a wider implementation, stakeholders on all levels, including the government and professional associations, should reflect on ways to address contextual barriers to promote a broad perspective on health as well as on collaborative work.
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Affiliation(s)
- Emma Vossen
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands ,grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, Laan van Scheut 10, 6525 EM Nijmegen, The Netherlands
| | - Joost W. J. van der Gulden
- grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboudumc, Geert Grooteplein Noord 21, 6525 EZ Nijmegen, The Netherlands
| | | | - Rosanne Schaap
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Johannes R. Anema
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
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3
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Vähätalo L, Siukola A, Atkins S, Reho T, Sumanen M, Viljamaa M, Sauni R. Cooperation between Public Primary Health Care and Occupational Health Care Professionals in Work Ability-Related Health Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11916. [PMID: 36231222 PMCID: PMC9564539 DOI: 10.3390/ijerph191911916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Work disability creates significant expenses for nations and causes human suffering by limiting patients' lives. International studies show that to enhance recognition of and support for work disability, cooperation, mutual trust, and information exchange between public primary health care and occupational health care must be strengthened. However, little is known of how health care professionals experience this cooperation. The aim of this study was to understand how professionals experience the cooperation between public primary health care and occupational health services regarding patients' work ability. Semi-structured interviews were conducted with 29 health care professionals working in five small cities (<10,000 inhabitants) in Finland. Interviews were audio and video recorded, transcribed verbatim, and analyzed through inductive thematic analysis. Three key themes were identified from the interviews: attitudes toward the other health care sector, the exchange of information, and resources for cooperation. Professionals seem to have poor knowledge about the services available and how care is given in the other sector, appearing to lead to weak mutual trust. The public primary health care professionals especially emphasized the benefits of cooperation, but several issues were mentioned as barriers to cooperation. These results can be used when planning effective patient paths and service provisioning models.
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Affiliation(s)
- Lauri Vähätalo
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Anna Siukola
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Salla Atkins
- Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
- Department of Global Public Health, Social Medicine Infectious Disease and Migration (SIM), Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Tiia Reho
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | | | - Riitta Sauni
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
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4
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Schaap R, Schaafsma FG, Huysmans MA, Bosma AR, Boot CRL, Anema JR. A Context Analysis with Stakeholders' Views for Future Implementation of Interventions to Prevent Health Problems Among Employees with a Lower Socioeconomic Position. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:438-451. [PMID: 34731392 PMCID: PMC8564794 DOI: 10.1007/s10926-021-10010-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.
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Affiliation(s)
- R Schaap
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - F G Schaafsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - M A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - A R Bosma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - C R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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RIPABELLI GIANCARLO, SALZO ANGELO, SAMMARCO MICHELALUCIA, TAMBURRO MANUELA. Awareness, knowledge and training gaps regarding asbestos among General Practitioners: a pilot study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E539-E543. [PMID: 34604597 PMCID: PMC8451333 DOI: 10.15167/2421-4248/jpmh2021.62.2.1797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
General Practitioners (GPs) have good knowledge of health status and sociocultural backgrounds of their patients, thus could be decisive in early detection of cases of asbestos-related diseases (ARDs). In this cross-sectional pilot study, we investigated perception and knowledge on asbestos risk amongst a sample of GPs practicing in Molise region, central Italy, who have anonymously completed a 29-items questionnaire specifically developed for this research. Based on GPs’ answers, we obtained scores and classified awareness and knowledge into four percentage quartile classes including inadequate (0-24%), poor (25-49%), moderate (50-74%) and high (75-100%), and scarce (0-24%), sufficient (25-49%), good (50-74%) and optimal (75-100%), respectively. Twenty-eight GPs (median age 63 years; 82% male) participated. Perception and knowledge among participants varied from 62 to 84% and from 18 to 42%, respectively, with 65 and 42% showing an adequate level, respectively. Our survey revealed a satisfactory perception and knowledge of general features about this topic, while a poor awareness of detailed aspects, underlining the need of continuing medical education in the field of occupational medicine. The study remarks that criteria for ARDs diagnosis should be better specified, introducing a detailed list to harmonize medical protocols for symptoms identification and patients’ examination. Hence, increasing awareness of asbestos risk and ARDs among GPs represents a crucial opportunity, because of their prominent position to promptly take care of patients and provide targeted information.
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Affiliation(s)
- GIANCARLO RIPABELLI
- Correspondence: Giancarlo Ripabelli, Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, via De Sanctis, 86100 Campobasso, Italy - Tel.: +39 0874 404961/743 - Fax: +39 0874 404778 - E-mail:
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6
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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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7
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Hultén AM, Dahlin-Ivanoff S, Holmgren K. Positioning work related stress - GPs' reasoning about using the WSQ combined with feedback at consultation. BMC FAMILY PRACTICE 2020; 21:187. [PMID: 32917138 PMCID: PMC7488670 DOI: 10.1186/s12875-020-01258-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 08/31/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs' awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs' reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave. METHODS A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger. RESULTS Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs' regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress. CONCLUSIONS The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC's responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated. TRIAL REGISTRATION ClinicalTrials.gov, NCT02480855 . Registered 20 May 2015.
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Affiliation(s)
- Anna-Maria Hultén
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Synneve Dahlin-Ivanoff
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Holmgren
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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8
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Rivière M, Toullic Y, Lerouge P, Blanchon T, Leroyer A, Plancke L, Prazuck T, Melchior M, Younès N. Management of work-related common mental disorders in general practice: a cross-sectional study. BMC FAMILY PRACTICE 2020; 21:132. [PMID: 32615930 PMCID: PMC7331173 DOI: 10.1186/s12875-020-01203-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 06/19/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs' management and patterns of referral to other health professionals of patients with work-related CMD and associated factors. METHOD We used data from a cross-sectional study of 2027 working patients of 121 GPs in the Nord - Pas-de-Calais region in France (April - August 2014). Statistical analyses focused on patients with work-related CMD detected by the GP and examined the ways in which GPs managed these patients' symptoms. Associations between patient, work, GP and contextual characteristics and GPs' management were explored using modified Poisson regression models with robust variance. RESULTS Among the 533 patients with work-related CMD in the study, GPs provided psychosocial support to 88.0%, prescribed psychotropic treatment to 82.4% and put 50.7% on sick leave. Referral rates to mental health specialists and occupational physicians were respectively 39.8 and 26.1%. Several factors including patients' characteristics (occupational and sociodemographic), GPs' characteristics and environmental data were associated with the type of management used by the GP. CONCLUSION Our study emphasizes the major and often lonesome role of the GP in the management of patients with work-related CMDs. Better knowledge of the way GPs manage those patients could help GPs in their practice, improve patients care and be a starting point to implement a more collaborative care approach.
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Affiliation(s)
- M Rivière
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, 75012, Paris, France.
- Department of Infectious Diseases, Réseau Sentinelles, Centre Hospitalier Régional, d'Orléans 14 avenue de l'hôpital, 45000, Orléans, France.
| | - Y Toullic
- University department of general practice, Université Lille 2, Lille, France
| | - P Lerouge
- University department of general practice, Université Lille 2, Lille, France
| | - T Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, 75012, Paris, France
| | - A Leroyer
- Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - L Plancke
- Regional Federation of Research in Psychiatry and Mental Health Hauts-de-France, Lille, France
| | - T Prazuck
- Department of Infectious Diseases, Réseau Sentinelles, Centre Hospitalier Régional, d'Orléans 14 avenue de l'hôpital, 45000, Orléans, France
| | - M Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, 75012, Paris, France
| | - N Younès
- Université de Versailles Saint-Quentin, Université Paris Saclay, CESP, Team DevPsy, 94807, Villejuif, France
- Centre Hospitalier de Versailles, Hospital Academic Unit of psychiatry for adults, Le Chesnay, France
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Holmgren K, Hensing G, Bültmann U, Hadzibajramovic E, Larsson MEH. Does early identification of work-related stress, combined with feedback at GP-consultation, prevent sick leave in the following 12 months? a randomized controlled trial in primary health care. BMC Public Health 2019; 19:1110. [PMID: 31412832 PMCID: PMC6694585 DOI: 10.1186/s12889-019-7452-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/07/2019] [Indexed: 11/16/2022] Open
Abstract
Background Experiencing work-related stress constitutes an obvious risk for becoming sick-listed. In primary health care, no established method to early identify, advise and treat people with work-related stress exists. The aim was to evaluate if the use of the Work Stress Questionnaire (WSQ) brief intervention, including feedback from the general practitioner (GP), had an impact on the level of sickness absence. Method/design In total 271 (intervention group, n = 132, control group, n = 139) non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers participated in this two-armed randomized controlled trial. The main outcomes were the number of registered sick leave days and episodes, and time to first sick leave during the 12-months follow-up. The intervention included early identification of work-related stress by the WSQ, GP awareness supported by a brief training session, patients’ self-reflection by WSQ completion, GP feedback at consultation, and initiation of preventive measures. Results The mean days registered for the WSQ intervention group and the control group were 39 and 45 gross days respectively, and 31 and 39 net days respectively (ns). No statistical significant difference for the number of sick leave episodes or time to first day of sick leave episode were found between the groups. Conclusions The WSQ brief intervention combined with feedback and suggestions of measures at patient–GP-consultation was not proven effective in preventing sick leave in the following 12 months compared to treatment as usual. More research is needed on methods to early identify, advise and treat people with work-related stress in primary health care, and on how and when GPs and other professionals in primary health care can be trained to understand this risk of sick leave due to work-related stress, on how to prevent it, and on how to advise and treat employees at risk. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.
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Affiliation(s)
- K Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - G Hensing
- Section for Epidemiology and Social Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E Hadzibajramovic
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,Health Metrics, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M E H Larsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Närhälsan Research and Development, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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Who Should Play a Key Role in Preventing Common Mental Disorders that Affect Employees in the Workplace? Results of a Survey with Occupational Health Physicians, Primary Care Physicians, Psychotherapists, and Human Resource Managers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081383. [PMID: 30999612 PMCID: PMC6517970 DOI: 10.3390/ijerph16081383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/02/2019] [Accepted: 04/15/2019] [Indexed: 11/17/2022]
Abstract
The rising burden of common mental disorders (CMDs) in employees requires strategies for prevention. No systematic data exist about how those involved perceive their roles, responsibilities, and interactions with other professional groups. Therefore, we performed a multi-professional standardized survey with health professionals in Germany. A self-administered questionnaire was completed by 133 occupational health physicians (OHPs), 136 primary care physicians (PCPs), 186 psychotherapists (PTs), and 172 human resource managers (HRMs). Inter alia, they were asked which health professionals working in the company health service and in the outpatient care or in the sector of statutory insurance agents should play a key role in the primary, secondary, and tertiary prevention of CMDs in employees. The McNemar test was used in order to compare the attributed roles among the professionals involved. With regard to CMDs, all the professional groups involved in this study declared OHPs as the most relevant pillar in the field of prevention. In primary prevention, HRMs regarded themselves, OHPs, and health insurance agents as equally relevant in terms of prevention. PTs indicated an important role for employee representatives in this field. In secondary prevention, PCPs were regarded as important as OHPs. HRMs indicated themselves as equally important as OHPs and PCPs. In tertiary prevention, only OHPs identified themselves as main protagonists. The other groups marked a variety of several professions. There is a common acceptance from the parties involved that might help the first steps be taken toward overcoming barriers, e.g., by developing a common framework for quality-assured intersectional cooperation in the field of CMD prevention in employees.
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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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Beyer S, Gouyet T, Letourneux VD, Mener E, Huge S, Petit A, Begue C. Interprofessional Communication Concerning Work-Related Musculoskeletal Disorders: A Qualitative Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:721-729. [PMID: 29411307 DOI: 10.1007/s10926-018-9755-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose Understanding and treating musculoskeletal disorders (MSDs) requires coordination between the numerous healthcare professionals involved, including occupational physicians (OPs), general practitioners (GPs) and social insurance physicians (SIPs). The main objective of this study was to assess communication between OPs, GPs and SIPs in the management of MSDs. Methods This is a qualitative study in the form of semi-structured interviews with OPs in the French region of Brittany. The interviews were conducted until data saturation was achieved. The interviews were fully coded and analysed thematically using NVivo® software. Results The interviews were carried out among 17 OPs from companies and external occupational healthcare services who treated employees from various activity sectors. Different communication channels were used depending on the interlocutor, though they were mainly contacted by mail or phone. Most of the communication passed through the patient, either verbally or in writing. No major failure was detected in communication between the various types of practitioners, but instances of communication were influenced by various factors such as differences in perception, representation and objectives, as well as by how well the physicians knew each other. A number of instances of non-communication were found. Conclusion This study showed that patients play a key role in the interactions between different practitioners. It also revealed that different types of professional relationships depend on the objectives of the various interlocutors, which in turn vary according to their roles and competences.
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Affiliation(s)
- Séverine Beyer
- Department of Occupational Health, Faculty of médecine, University of Rennes 1, 2, Avenue du Professeur Léon Bernard, 35000, Rennes, France
| | - Thomas Gouyet
- Department of Occupational Health, Faculty of médecine, University of Rennes 1, 2, Avenue du Professeur Léon Bernard, 35000, Rennes, France
| | - Véronique Daubas Letourneux
- EHESP, Avenue du Professeur Léon Bernard CS 74312, 35043, Rennes Cedex, France
- Epidemiology in Occupational Health and Ergonomics (ESTER), University of Angers, 28 rue Roger Amsler Cedex 74521, 49045, Angers Cedex 01, France
| | - Eric Mener
- Department of General Practice, Faculty of médecine, University of Rennes 1, 2, Avenue du Professeur Léon Bernard, 35000, Rennes, France
| | - Sandrine Huge
- Department of General Practice, Faculty of médecine, University of Rennes 1, 2, Avenue du Professeur Léon Bernard, 35000, Rennes, France
| | - Audrey Petit
- Epidemiology in Occupational Health and Ergonomics (ESTER), University of Angers, 28 rue Roger Amsler Cedex 74521, 49045, Angers Cedex 01, France
- Department of Occupational Health, Faculty of Medicine, CHU Angers, University Hospital of Angers, 4 Rue Larrey, 49933, Angers, France
| | - Cyril Begue
- Epidemiology in Occupational Health and Ergonomics (ESTER), University of Angers, 28 rue Roger Amsler Cedex 74521, 49045, Angers Cedex 01, France.
- Department of General Practice, Faculty of Health, University of Angers, 28 rue Roger Amsler Cedex 74521, 49045, Angers Cedex 01, France.
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Stratil JM, Rieger MA, Voelter-Mahlknecht S. Image and perception of physicians as barriers to inter-disciplinary cooperation? - the example of German occupational health physicians in the rehabilitation process: a qualitative study. BMC Health Serv Res 2018; 18:769. [PMID: 30305099 PMCID: PMC6180505 DOI: 10.1186/s12913-018-3564-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the German rehabilitation system, primary care physicians (PCPs), occupational health physicians (OPs), and rehabilitation physicians (RPs) fulfill different distinct functions and roles. While effective cooperation can improve outcomes of rehabilitation, the cooperation between these groups of stakeholders has been criticized as lacking or insufficient. This article proposes an approach to understand the low levels of cooperation by examining the role of group perception and group identity in intra-professional cooperation as a barrier to cooperation between physicians in different roles. Group perception was evaluated in terms of (1) negative views about another group of medical specialists and (2) differences between the perception of members and non-members of a medical specialty group. To examine this issue, we focused on the role of OPs in the German rehabilitation process. METHODS We implemented a qualitative study design with eight focus group discussions with PCPs, OPs, RPs, and patients (two focus group discussions per stakeholder group; 4-10 participants) and qualitative content analysis. We used the Social Identity Approach by Tajfel and Turner as a theoretical underpinning. RESULTS While all protagonists reported a positive perception of their own professional group, we found numerous negative perceptions about other groups, especially regarding OPs. Negative perceptions of OPs included 1) apparent conflict of interest between employer and employee, 2) lack of commitment to patient outcomes, 3) lack of useful specialized knowledge which could have a bearing on rehabilitation outcomes, and 4) distrust on the part of their patients. We also found divergent perceptions regarding roles, responsibilities, and capabilities among the specialist groups. Both negative and conflicting perceptions about roles were characterized as barriers to cooperation by study participants. CONCLUSION This example of cooperation between RPs, OPs, and PCPs suggests that negative and diverging perceptions about an out-group could create barriers in intra-professional and inter-disciplinary cooperation between physicians. These perspectives might also be useful in explaining problems at intersections between different specialties. We suggest examining the inter-group dimension of perception-based barriers to cooperation in future interventions to overcome problems caused by intra-professional and inter-disciplinary conflicts in addition to other barriers (i.e. organizational hurdles).
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Affiliation(s)
- Jan M Stratil
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany
| | - Susanne Voelter-Mahlknecht
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstrasse 27, 72074, Tuebingen, Germany
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Muto G, Yokoyama K, Endo M. [Solutions against Declining Birthrates Confronting Japan's Aging Society by Supporting Female Workers in Harmonizing Work with Their Health and Social Issues: Fertility, Chronic Illness, and Raising Children]. Nihon Eiseigaku Zasshi 2018; 73:200-209. [PMID: 29848872 DOI: 10.1265/jjh.73.200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Japan is currently facing serious social problems related to low birth rates and aging. We propose two possible solutions from the perspective of occupational health. First, companies should establish support systems to help working women with pregnancy and childbirth. Such systems would require the cooperation and understanding of coworkers, including men, and the introduction of flexible work schedules that are also designed to allow workers to care for family members with disabilities. Additionally, with regard to the protection and promotion of the fertility of working women, occupational health staff members should provide education to working women regarding appropriate lifestyle choices in areas such as diet, prevention of work-related health problems, and mental health before and after childbirth. Moreover, workers undergoing assisted reproductive technology procedures should be supported as they experience physical, mental, and economic burdens associated with this process. Second, companies should guarantee the right of workers to take a sick leave and then return to work so they can balance work and the need to treat chronic conditions. Occupational staff members should follow up employees who return to work, by offering, for example, mental health care to cancer survivors. They should also play important roles in preventing the exacerbation of disease and empowering workers to continue their visits to medical institutions. Collaborative study bridges between companies and medical institutions are necessary for the promotion of these harmonization schemes.
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Affiliation(s)
- Go Muto
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine
| | - Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine
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Rothermund E, Michaelis M, Jarczok MN, Balint EM, Lange R, Zipfel S, Gündel H, Rieger MA, Junne F. Prevention of Common Mental Disorders in Employees. Perspectives on Collaboration from Three Health Care Professions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020278. [PMID: 29415515 PMCID: PMC5858347 DOI: 10.3390/ijerph15020278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/01/2018] [Accepted: 02/04/2018] [Indexed: 11/25/2022]
Abstract
Collaboration among occupational health physicians, primary care physicians and psychotherapists in the prevention and treatment of common mental disorders in employees has been scarcely researched. To identify potential for improvement, these professions were surveyed in Baden-Württemberg (Germany). Four hundred and fifty occupational health physicians, 1000 primary care physicians and 700 resident medical and psychological psychotherapists received a standardized questionnaire about their experiences, attitudes and wishes regarding activities for primary, secondary and tertiary prevention of common mental disorders in employees. The response rate of the questionnaire was 30% (n = 133) among occupational health physicians, 14% (n = 136) among primary care physicians and 27% (n = 186) among psychotherapists. Forty percent of primary care physicians and 33% of psychotherapists had never had contact with an occupational health physician. Psychotherapists indicated more frequent contact with primary care physicians than vice versa (73% and 49%, respectively). Better cooperation and profession-specific training on mental disorders and better knowledge about work-related stress were endorsed. For potentially involved stakeholders, the importance of interdisciplinary collaboration for better prevention and care of employees with common mental disorders is very high. Nevertheless, there is only little collaboration in practice. To establish quality-assured cooperation structures in practice, participants need applicable frameworks on an organizational and legal level.
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Affiliation(s)
- Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany.
- Leadership Personality Centre Ulm, Ulm University, 89073 Ulm, Germany.
| | - Martina Michaelis
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, 72074 Tübingen, Germany.
- Research Centre for Occupational and Social Medicine (FFAS), 79098 Freiburg, Germany.
| | - Marc N Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany.
| | - Elisabeth M Balint
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany.
| | - Rahna Lange
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, 72074 Tübingen, Germany.
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany.
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, 89081 Ulm, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, 72074 Tübingen, Germany.
| | - Florian Junne
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany.
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Abstract
BACKGROUND People with mental health issues usually access primary health care services but employment status and/or return to work is not typically an explicit focus of a general practice consultation. OBJECTIVE This scoping review aims to investigate the broad range of interventions used in primary health care to effectively support people with mental health issues to choose, get, or keep employment. METHODS A literature search was conducted using five electronic databases. Peer reviewed research articles published between 1996 and February 2016 were included in the review. RESULTS Twelve studies explored work related interventions for people with mental health issues in the primary health care context. The most commonly used intervention was sickness certification, other interventions that show promise were identified but there is limited empirical evidence to show their effectiveness in relation to improving employment outcomes. General practitioners identified a range of barriers in terms of focusing on employment outcomes for patients including knowledge and confidence in understanding the impact of work on symptoms and limited access to advice or services to refer patients to. CONCLUSIONS This review suggests that work focused interventions situated in primary health care settings appear to be a promising approach for people with mental health issues. However, various barriers impact the implementation of an employment approach, with limited comparisons between different effective interventions. In the context of increasing numbers of people presenting with mental health issues, future research should address the implementation and effectiveness of work-focused interventions based in primary health care.
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Affiliation(s)
- Kirk Reed
- Department of Occupational Science and Therapy, Auckland University of Technology, New Zealand
| | - Halina Kalaga
- Department of Occupational Science and Therapy, Auckland University of Technology, New Zealand
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McInnes S, Peters K, Bonney A, Halcomb E. Understanding collaboration in general practice: a qualitative study. Fam Pract 2017; 34:621-626. [PMID: 28334812 DOI: 10.1093/fampra/cmx010] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An increased incidence of chronic and complex conditions in the community is placing pressure on human resources in general practice. Improving collaboration between GPs and registered nurses may help alleviate workforce stressors and enhance health outcomes. OBJECTIVE To explore the facilitators and challenges of collaboration between GPs and registered nurses in Australian general practice. METHODS Eight GPs and 14 registered nurses from general practices in New South Wales, Australia, participated in semi-structured face-to-face interviews. Recordings were transcribed verbatim and underwent thematic analysis. RESULTS The overarching theme 'Understanding collaboration in general practice' comprises four sub-themes, namely (i) interpreting collaboration in general practice, (ii) modes of communication, (iii) facilitators of collaboration and (iv) collaboration in practice. CONCLUSION Our findings suggest that regular, formal avenues of communication, professional development and non-hierarchical environments facilitated collaboration between nurses and GPs. Implementing strategies to promote these features has the potential to improve inter-professional collaboration and quality of care within primary care.
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Affiliation(s)
- Susan McInnes
- School of Nursing, University of Wollongong, Wollongong, Australia
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Andrew Bonney
- School of Medicine, University of Wollongong, Wollongong, Australia
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PERSECHINO B, FONTANA L, BURESTI G, RONDINONE BM, LAURANO P, FORTUNA G, VALENTI A, IAVICOLI S. Collaboration of occupational physicians with national health system and general practitioners in Italy. INDUSTRIAL HEALTH 2017; 55:180-191. [PMID: 27733729 PMCID: PMC5383415 DOI: 10.2486/indhealth.2016-0101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/30/2016] [Indexed: 06/06/2023]
Abstract
A good cooperation between occupational physicians and other healthcare professionals is essential in order to achieve an overall improvement of workers/patients' well-being. Unfortunately, collaboration between occupational physicians and other physicians is often lacking or very poor. In this context, using a self-administered questionnaire, we investigated the cooperation of Italian occupational physicians with the National Health System (NHS) facilities and with the general practitioners in order to identify any potential critical issues that may hinder an effective and collaborative relationships between these professionals. The survey was conducted from October 2013 to January 2014. Nearly all of the interviewed occupational physicians have had contacts with colleagues of the Departments for Prevention and Occupational Health and Safety of the NHS. Regarding the relationship between occupational physicians and general practitioners findings showed that their cooperation is quite difficult and it would not seem a two-way collaboration. Cooperation between occupational physicians and NHS would benefit from the development of communication strategies and tools enhancing the support and assistance functions of the NHS facilities. The elaboration and subsequent application of operational guidelines and standardized procedures of communication would also improve collaboration between occupational physicians and general practitioners that is currently considered rather insufficient and incomplete.
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Affiliation(s)
- Benedetta PERSECHINO
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Luca FONTANA
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Giuliana BURESTI
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Bruna Maria RONDINONE
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Patrizia LAURANO
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Grazia FORTUNA
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Antonio VALENTI
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
| | - Sergio IAVICOLI
- INAIL, Italian Workers’ Compensation Authority, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italy
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Holzinger F, Dahlendorf L, Heintze C. 'Parallel universes'? The interface between GPs and dentists in primary care: a qualitative study. Fam Pract 2016; 33:557-61. [PMID: 27411729 DOI: 10.1093/fampra/cmw058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Patient care by GPs and dentists is organizationally separated in many health systems. Studies on how dentists and GPs cooperate and interact in daily care are scarce. OBJECTIVE We aimed to explore the experiences of GPs and dentists as well their views and opinions regarding the inter-professional interface. METHODS Qualitative semi-structured interviews were conducted with GPs (n = 8) and dentists (n = 8). The pre-developed interview guideline included questions concerning participant's experiences with the other specialty, important interdisciplinary medical issues and diseases and potential for improvement of cooperation. Interviews were transcribed verbatim and analyzed with qualitative content analysis. RESULTS GPs and dentists perceived knowledge deficits in members of the other specialty and frequently criticized aspects of each other's patient management. Cooperation worked better if based on local networks of personally known colleagues. Participants reported many medical situations and diseases of common concern, most frequently diabetes and oral anticoagulation. There seemed to be considerable uncertainty about the management of anticoagulant therapy in patients undergoing invasive dental procedures in members of both specialties, despite existing guidelines. The separation of medical and dental university education and the lack of joint training were suggested by interviewees as reasons for the lack of interdisciplinary thinking. CONCLUSION Except in cases of personal contact, interaction between GPs and dentists is often limited and sometimes difficult-despite numerous inter-professional issues. Interdisciplinary approaches in continuing education, medical and dental school teaching and guideline development are potentially promising for promoting cooperation.
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Affiliation(s)
- Felix Holzinger
- Institute of General Practice and Family Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lisanna Dahlendorf
- Institute of General Practice and Family Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Heintze
- Institute of General Practice and Family Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Christiaens A, Sari-Minodier I, Tardieu S, Ianos O, Adnot S, Courbiere B, Perrin J. A pilot study about infertile men's awareness of their reprotoxic exposures and the intervention of occupational medicine to assess them. Basic Clin Androl 2016; 26:9. [PMID: 27512580 PMCID: PMC4979153 DOI: 10.1186/s12610-016-0036-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Male infertility related to professional reprotoxic exposure has been assessed in several studies. Collaboration between occupational physicians and patients can yield information about the preventive measures that can be taken to avoid such exposure. The use of preventive measures is determined by the collaboration between reproductive medicine and occupational medicine and also by the patient's awareness of reprotoxic occupational exposures. Our andrology laboratory developed a systematic environmental interview that an occupational physician administers before semen analysis to assess patients' occupational reprotoxic chemical and physical exposures. This observational prospective study evaluated patients' feelings regarding this interview. The main outcome measure was the participants' score to determine their general reprotoxicant knowledge. The study also evaluated the patients' satisfaction about the interview with occupational physician and their attitude about reproductive toxicants. RESULTS The mean score for general knowledge of reprotoxicants was 9.6 ± 2.7/16. The most frequently underestimated reprotoxic factor was excessive heat (34.7 % correct responses). In cases of semen parameter abnormalities AND recognized occupational reprotoxic exposure, 63.2 % of the patients said they would use individual protective devices, and 55.1 % said they would temporarily adapt their workstation. Regarding the interview with the laboratory's occupational physician, 80.7 % considered it moderately or very useful. Of the interviewed patients, 46.2 % reported having changed their living habits 2 months after the interview, and 88.5 % were satisfied or very satisfied with the care they received. All of the respondents said it would be useful to extend the interview to include their wives. CONCLUSIONS The data suggest that patients' knowledge about reprotoxic exposures can be improved, particularly knowledge related to physical exposure. The vast majority of patients were satisfied with the introduction of this new collaboration between reproductive and occupational medicine.
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Affiliation(s)
- Amélie Christiaens
- CECOS Laboratory of Reproductive Biology, AP-HM La Conception, Pole femmes parents enfants, Marseille, France ; Department of General Practice, Faculty of Medicine - Aix Marseille Univ, 13005 Marseille, France
| | - Irène Sari-Minodier
- Department of Occupational Health, AP-HM La Timone, Marseille, France ; Aix Marseille Univ, CNRS, IRD, IMBE, Marseille, France
| | - Sophie Tardieu
- Department of Public Health, Pole Santé Publique, AP-HM La Conception, Marseille, France
| | - Oana Ianos
- Department of Occupational Health, AP-HM La Timone, Marseille, France
| | - Sébastien Adnot
- Department of General Practice, Faculty of Medicine - Aix Marseille Univ, 13005 Marseille, France
| | - Blandine Courbiere
- Aix Marseille Univ, CNRS, IRD, IMBE, Marseille, France ; Department of Reproductive Medicine, AP-HM La Conception, Pole femmes parents enfants, Marseille, France
| | - Jeanne Perrin
- CECOS Laboratory of Reproductive Biology, AP-HM La Conception, Pole femmes parents enfants, Marseille, France ; Aix Marseille Univ, CNRS, IRD, IMBE, Marseille, France
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Preiser C, Rothermund E, Wittich A, Gündel H, Rieger MA. Psychosomatic consultation in the workplace: opportunities and limitations of the services offered--results of a qualitative study. Int Arch Occup Environ Health 2016; 89:599-608. [PMID: 26559948 PMCID: PMC4828480 DOI: 10.1007/s00420-015-1098-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 10/18/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE In Germany, innovative concepts of anchoring psychotherapeutic consultations within an occupational setting emerge in models like the "psychosomatic consultation in the workplace" (PCIW). Characteristic quality is the close cooperation between company-based occupational health physicians (OPs) and external psychotherapeutic consultants. Little is currently known about the attitudes of OPs and other stakeholders in companies in terms of possible contributions of these offers to their tasks within the field of mental health and work. METHODS Data were collected via individual interviews with different stakeholders (n = 8) and two OP focus groups (each n = 5) with and without experience with PCIW. Data were analysed with content analysis. RESULTS Common mental disorders (CMD) were perceived as occurring increasingly but still being stigmatized. PCIW allows employees quick access to a neutral psychotherapist and thus might help to avoid chronification of CMD. For companies, this may mean that longer periods of absenteeism (and presenteeism) can be avoided. The interviewees also feel that the ongoing collaboration with a psychotherapeutic specialist may sensitize OPs to recognize mental disorders earlier and provide basic treatment. PCIW was stated as an early, easy and fast first access to psychotherapy. The effort of PCIW is limited if structural changes in the workplace are necessary to reduce mental stressors. Also, if financed by the company, PCIW should have clear time limits and cannot aim to replace health insurance benefits. CONCLUSIONS Taking above-mentioned limitations into account, PCIW appears to be a promising tool to bridge the gap between OP-conducted company-based health promotion and early secondary care.
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Affiliation(s)
- Christine Preiser
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Andrea Wittich
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany.
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Moßhammer D, Michaelis M, Mehne J, Wilm S, Rieger MA. General practitioners' and occupational health physicians' views on their cooperation: a cross-sectional postal survey. Int Arch Occup Environ Health 2015; 89:449-59. [PMID: 26259728 DOI: 10.1007/s00420-015-1084-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 08/05/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Prevention, rehabilitation and reintegration into the workplace are examples of overlapping work fields of general practitioners (GPs) and occupational health physicians (OPs). In Germany, however, cooperation between GPs and OPs is often lacking or suboptimal. In this article, we present GPs' and OPs' views on a variety of aspects of their cooperation and differences between them. METHODS Survey questionnaire was developed on the basis of literature research and results of focus group interviews. Cross-sectional postal survey among GPs (n = 1000) and OPs (n = 383) was performed in the federal state of Baden-Württemberg, Germany. Explorative descriptive and logistic regression analyses were carried out (controlling for potential confounders). RESULTS Response rates were 31 and 48 %, respectively. Mutual telephone calls were the most frequent contact medium (49 and 91 %, respectively). Both groups considered themselves to have clearly separate areas of responsibility (median = 4, rating scale from 1 "agree not at all" to 5 "agree definitely"). Necessity to cooperate and need to improve cooperation were both rated as 4 (by GPs) and 5 (by OPs), respectively (p < 0.001, Wilcoxon test). Several variables were found to be different by logistic regression analysis of answers from the two groups (e.g. in regard to importance of rehabilitation, primary prevention services, caring for chronically ill workers or changing of workplace conditions). Sensitive topics (e.g. concerning mutual rivalry, remuneration or adherence to medical confidentiality) were also found to be rated differently. CONCLUSION The data show potential interest of both physicians groups to develop cooperation. As the ratings often differed significantly, particularly in regard to statements presented, answers influenced by social desirability are generally unlikely.
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Affiliation(s)
- Dirk Moßhammer
- Institute of General Practice/Family Medicine, University Hospital Tübingen, Österbergstraße 9, 72074, Tübingen, Germany.
| | - Martina Michaelis
- Freiburg Research Centre for Occupational and Social Medicine, Bertoldstraße 27, 79098, Freiburg, Germany
| | - Jakob Mehne
- Institute of General Practice/Family Medicine, University Hospital Tübingen, Österbergstraße 9, 72074, Tübingen, Germany
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Stefan Wilm
- Institute of General Practice, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
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