Characteristics of Multiprofessional and Client-Oriented Approach in Occupational Health Services: A Cross-Sectional Survey Among Occupational Health Professionals

Background

Multiprofessional and client-oriented approaches are considered key factors for successful occupational health services, and for impressive occupational health cooperation between a client organisation and occupational health service provider. The purpose of this study was to find out the views of occupational health physicians, occupational health nurses, occupational physiotherapists, and occupational health psychologists about multiprofessional and client-oriented working methods. These working methods describe the guidelines for good occupational health practice in Finland, also serving the framework of the present study.

Material and Methods

The survey was conducted in May and June 2022. The data consisted of answers to open-ended questions of a larger questionnaire. The data was analysed with the method of theory-related thematic analysis. Seven occupational health service providers committed to the study. Altogether 121 professionals responded to the question surveying the multiprofessional approach, and 119 professionals responded to the question of client-oriented approach.

Results

The results showed that both the multiprofessional and client-oriented approaches are closely related to each other, and the views of these approaches are in line with the good occupational health practice. Multiprofessional approach was most commonly described with the theme of sharing expertise. Respectively, the theme of smooth cooperation most commonly described the client-oriented approach. At its best, the answers showed that a multiprofessional working strategy takes into account the expertise of different professionals so that the client can be offered high-quality, accurate content and timely occupational health services.

Conclusion

The results provide up-to-date information on working strategies of occupational health services in Finland. The results can be used in further development of multiprofessional and client-oriented work in occupational health services.

Exploring the use, usefulness and ease of use of digital occupational health services: A descriptive correlational study of customer experiences

Objective

This study examined the customer experiences of use, perceived usefulness and ease of use of digital occupational health (OH) services.

Methods

A cross-sectional study based on an electronic survey was conducted between December 2022 and January 2023. A total of 9871 OH customers responded to the survey. The sample was restricted to respondents who used digital OH services (n = 7275). An analysis of variance was run to test the relationships between respondents' characteristics and the rate of usefulness, and ease of use variables.

Results

The most commonly used digital services were appointment booking, access to health information recorded by professionals and prescription renewal, and the digital services provided by physicians and nurses. Respondents expressed quite high satisfaction with the digital services, but not as much with their usefulness and ease of use. Females, individuals under 50 years of age, those with higher education, working in white-collar or managerial positions and possessing proficient information and communication technology (ICT) skills gave the most positive evaluations regarding usefulness and ease of use.

Conclusions

There was a certain level of mixed experiences among respondents regarding the usefulness and ease of use of digital OH services. We can also conclude that individuals who possess the necessary ICT skills can more easily take full advantage of the available digital services. When customers are proficient in using digital services, they can confidently interact with professionals. Regardless of the user's age, gender, education or profession, it is crucial for service providers always to strive to improve the usability of digital services.

Participatory Ergonomics Intervention to Prevent Work Disability Among Workers with Low Back Pain: A Randomized Clinical Trial in Workplace Setting

Purpose In order to support people with low back pain (LBP) to stay at work, work arrangements are regarded important. This study aimed to evaluate the effectiveness of a workplace intervention using a participatory approach on work disability of workers with ongoing or recurrent LBP. Methods A total of 107 workers with LBP, with duration of pain for at least two consecutive weeks or recurrent pain of any duration during the last year, were randomized either to the intervention (n = 51) or control group (n = 56). The intervention included arrangements at the workplace, along with individual guidance provided by an occupational physiotherapist (OPT). The randomized intervention study used standard counselling and guidance by an OPT without workplace intervention as a comparison. Surveys were completed at baseline, and 6 and 12 months after baseline. Results There were no statistically significant differences between the intervention and control groups on the primary outcome measure, i.e. self-assessed work ability. We found no between-group differences in perceived health, self-assessed work productivity, number of sickness absence days and severity of back pain. However, there were significant positive within-group changes in the intervention group in the intensity of LBP, perceived health and the number of sickness absence days due to LBP. Conclusion Workplace arrangements are feasible using participatory ergonomics, but more quantitative and qualitative research is needed on its utilization and effectiveness among workers with LBP.

Safe patient handling education: analysis from European higher education institutions

OBJECTIVES

According to current research, patient handling is not universally taught in academic nursing programs in Europe. Miscellaneous patient handling education may expose students and novice health care workers to occupational hazards, especially if the evidence-based contents of safe patient handling are not recognized. Health care workers deal with high physical workloads daily, which points out the importance of evidence-based curricula contents from the early phases of education. The aim of this study was to describe the patient handling education and to analyse the differences in curricula among higher education institutions (HEIs) in Europe.

MATERIAL AND METHODS

The study used a cross-sectional design and was conducted in HEIs educating health care professionals in Europe. The data was collected through a Webropol questionnaire consisting of structured and open-ended questions.

RESULTS

Only 68.4% of the respondents stated that they have a framework that guides the patient handling education. Additionally, some answers referred to guidelines that are not adequate to be referred to as evidence-based guidelines on patient handling. There is variation in emphasizing workplace safety and risk assessment issues in the curricula, and variation in teaching of assistive aids.

CONCLUSIONS

Currently the patient handling education in the studied HEIs does not meet the requirements of evidence-based practice. The establishment of a European-wide framework, including both theoretical and practical training for safe patient handling is needed. The inclusion of risk assessment and workplace safety issues is essential to improve the risk management knowledge and skills and further avoid work-related musculoskeletal disorders. Int J Occup Med Environ Health. 2022;35(5):615-23.

Työpaikkaselvityksen digitaaliset ratkaisut ja kehittämistarpeet työterveyshuollossa

Työpaikkaselvitys on työterveyshuollon ja työpaikan yhteistyön lähtökohta ja osa työpaikan työsuojelutoimintaa. Työpaikkaselvityksessä työterveyshuolto arvioi toistuvin työpaikkakäynnein työhön, työympäristöön ja työyhteisöön liittyvien terveysvaarojen, kuormitustekijöiden ja voimavaratekijöiden terveydellistä merkitystä ja merkitystä työkyvylle. Muuttunut työelämä ja digitalisaatio ovat kuitenkin lisänneet työn monimuotoisuutta ja työtä tehdään yhä enemmän virtuaalisissa työyhteisöissä. Siksi digitalisoitu työpaikkaselvitys on yleistynyt työterveyspalveluissa. Tutkimuksen tavoitteena oli tuottaa tietoa työterveyshuollon digitalisoidusta työpaikkaselvityksestä. Tutkimus tehtiin laadullisena tutkimuksena elo-syyskuussa 2019. Tutkittavat (n = 18) olivat työterveysammattilaisia, jotka työskentelivät kahdeksalla eri työterveyshuollon palveluntuottajalla. Aineisto kerättiin ryhmähaastatteluina (n = 8), joiden teemat liittyivät työterveyshuollon työpaikkaselvitysprosessin eri vaiheisiin. Aineisto analysoitiin sisällönanalyysimenetelmällä. Haastattelujen mukaan digitalisoitu työpaikkaselvitys sisälsi yleisimmin esihenkilöille ja työntekijöille kohdennetun sähköisen kyselyn työn vaara- ja kuormitustekijöistä sekä digitaalisen alustan työterveyshuollon ja työpaikan yhteiseen dokumenttien hallintaan ja yhteydenpitoon. Kehitystarpeina mainittiin sähköisten kyselyjen yhtenäistäminen sekä mahdollisuus hyödyntää aiempia työpaikkaselvitysraportteja. Lisäksi työpaikkaselvitysraportit pitäisi pystyä näyttämään työpaikoille visuaalisemmassa muodossa. Digitalisoitu työpaikkaselvitys on useimmiten sähköinen kyselylomake. Vaikka teknologian käytössä on tapahtunut pientä edistystä, on välttämätöntä jatkaa työpaikkaselvitysprosessin digitaalista kehittämistä. Teknologia mahdollistaa työn reaaliaikaisen havainnoinnin, jopa niillä työpaikoilla, joissa työterveyshuollon ammattilaiset eivät voi käydä fyysisesti paikalla.

Co-operation in the prevention of work disability due to musculoskeletal disorders: A cross-sectional study among occupational health professionals in Finland

BACKGROUND: Occupational health service (OHS) providers and their client organizations are obligated to collaborate in promoting health and work ability. Little is known how this multiprofessional co-operation is implemented in relation to the prevention of musculoskeletal disorders (MSD). OBJECTIVE: The aim of this study was to investigate the working practices of co-operation among OHS professionals, and between the OHSs and workplaces. METHODS: In 2015 a web-based questionnaire was sent to 3900 OHS professionals in Finland. A total of 589 responded: 106 physicians, 322 nurses, 134 physiotherapists and 27 psychologists. RESULTS: The co-operation within OHS personnel was regarded to strengthen the processes to promote work ability of workers with MSD. Despite the positive expectations of co-operation, there is a problem of having enough time to put good ideas into practice. Four main possibilities to develop co-operation were identified: creating proactive working models with defined roles; increasing awareness of importance of early intervention models; implementing the principles of good OH practice; and adopting the knowledge of the latest information to promote work ability. CONCLUSIONS: Despite its recognized importance, co-operation both with OHS colleagues and with the workplaces was not always optimal. There is a need for defined roles and common proactive working models between each stakeholder for more effective co-operation.

Ergonomics in the arctic - a study and checklist for heavy machinery in open pit mining

BACKGROUND

Heavy mining vehicle operators at arctic mines have a high risk of discomfort, musculoskeletal disorders and occupational accidents. There is a need for tailored approaches and safety management tools that take into account the specific characteristics of arctic work environments.

OBJECTIVE

The aim of this study was to develop a holistic evaluation tool for heavy mining vehicles and operator well-being in arctic mine environments.

METHODS

Data collection was based on design science principles and included literature review, expert observations and participatory ergonomic sessions.

RESULTS

As a result of this study, a systemic checklist was developed and tested by eight individuals in a 350-employee mining environment.

CONCLUSIONS

The checklist includes sections for evaluating vehicle specific ergonomic and safety aspects from a technological point of view and for checking if the work has been arranged so that it can be performed safely and fluently from an employee's point of view.

User-oriented evaluation of mechanical single-channel axial pipettes

Hand tools should be designed so that they are comfortable to use, fit the hand and are user-oriented. Six different manual, single-channel axial pipettes were evaluated for such objective outcomes as muscular activity, wrist postures and efficiency, as well as for subjective outcomes concerning self-assessed features of pipette usability and musculoskeletal strain. Ten experienced laboratory employees volunteered for the study. The results showed that light and short pipettes with better tool comfort resulted in reduced muscular activity and perceived musculoskeletal strain when they were compared with a long and heavy pipette. There were no differences in the efficiency between the different pipettes. Combining both the objective and subjective measures enabled a broader evaluation of product usability. The results of this study can be used both in product development and as information on which to base the purchase of new pipettes for laboratory work.

Muscular activity and thermal responses in men and women during repetitive work in cold environments

Thermal responses and muscular activity in repetitive work were studied in eight women and eight men at 19 degrees C (thermoneutral) and at 4 degrees C (cold). Furthermore, effect of a heating vest was studied at 4 degrees C. Women had lower (p < 0.05) mean skin temperature compared with men at each thermal condition. Muscular activity (microV) was generally higher in women compared with men, being significantly higher in m. deltoideus (p < 0.05). Women had lower (p < 0.01) maximal isometric strength compared with men, which may have influenced the observed higher muscular activity during work in women. However, compared with thermoneutral, working in cold increased (p < 0.05) muscular activity in the forearm and upper arm extensors only in men. The vest did not significantly counteract the increase in muscular activity. In conclusion, sex differences should be considered when evaluating cold protection and work load reduction in repetitive work in cold environments. Present results indicate that in identical work, sex affects thermal responses and muscular activity during repetitive work in conditions comparable with cooled departments in the food-processing industry. Sex differences should be considered when evaluating cold protection and preventive measures for work load reduction.

Factors associated with self-estimated work ability and musculoskeletal symptoms among male and female workers in cooled food-processing facilities

This questionnaire study evaluates how work ability and musculoskeletal symptoms associate with physical work factors and individual characteristics of the workers in cooled food-processing facilities. A total of 1,117 workers (response rate 85%) responded to the study. Poor work ability was significantly associated with longer work duration, experience of draught at the workplace, absence from work due to health reasons, and physical inactivity during free time. The amount of local cooling experienced was significantly associated with the risk for musculoskeletal symptoms in the neck-shoulder region, shoulders, wrists and lower back. Additionally, female gender, longer work duration and poor work ability were associated with the increased prevalence of the symptoms. The prevalence of musculoskeletal symptoms was significantly higher among older employees (40 to 64 yr) than among younger employees (18 to 39 yr) for all regions except wrists. Cold discomfort and unpleasant sensations due to the physical factors of work were significantly more common among females than males. The results showed that, in addition to individual characteristics of workers, factors related to work in a cool environment (experience of draught and cooling and long exposure to cold) are associated with poor work ability and musculoskeletal symptoms.

Changes in neuromuscular function due to intermittently increased workload during repetitive work in cold conditions

OBJECTIVES

This study attempted to determine whether repetitive work in the cold affects the number of electromyographic (EMG) gaps and whether cold-induced deterioration in neuromuscular function can be restored by altering work intensity.

METHODS

During 2 hours of simulated sausage packing, the occurrence of EMG gaps was studied in eight upper-extremity muscles at 19 degrees C and 4 degrees C. The additional effect of continuous, light repetitive work [wrist flexion-extension 10% of the maximal voluntary contraction (MVC), Cwork] and intermittently increased workload (10% or 30% MVC) (Iwork) on forearm muscle EMG gaps, the median frequency of the EMG spectrum, EMG activity, and muscle fatigue (as indicated by changes in the MVC of wrist flexion) at 4 degrees C was studied.

RESULTS

During work simulation, the mean skin temperature decreased from 33.3 (SD 0.1) degrees C to 30.6 (SD 0.2) degrees C (P<0.05), and the number of EMG gaps diminished in seven muscles by 1.4-68.2% (P<0.05). During Iwork there were 44% and 37% more EMG gaps in the forearm flexors and extensors, respectively, and the median frequency shifted to higher frequencies (P<0.05) as compared with the situation in Cwork. The average EMG activity of the forearm flexors was 13% lower (P<0.05) during Iwork than during Cwork. Wrist flexion MVC decreased 18% and 15% in Cwork and Iwork, respectively.

CONCLUSIONS

The cold-induced decrease in the number of EMG gaps and increased muscle strain and fatigue can be, at least partially, restored by intermittently increasing the workload (ie, breaking the monotonous work cycle).