Occupational Health Physicians Research Articles

Perceived mental health skills and competence among occupational health physicians.

Mental-health-based consultations in occupational health (OH) are increasing due to ongoing changes in working life. We studied the self-assessed mental health competence of trainees and trainers in OH specialist physician training. We conducted an online survey from June to August 2022. We analysed how trainees and trainers in OH assessed their own competence in mental health practice with N (%) and means (standard deviation [SD]). We analysed the underlying assumptions about competences specific to OH using an explanatory factor analysis. We applied the Kruskal-Wallis test to determine differences between trainees and trainers using the variables in the factor analysis. Respondents' perceptions of mental health competence were more positive among trainers (mean 3.97, SD 0.72) than trainees (mean 3.66, SD 1.08, P = 0.2123). Based on trainee physicians' own assessments, more experience increases competence, until after 7 years, when the perceived competence seems to decrease. The trainer physicians' self-assessed mental health competence decreased over time. With factor analyses, we identified five competence factors: general mental health, workplace risks and resources, rehabilitation, promotion and prevention, and special skills. In our results, individual-level mental health competences such as work ability evaluation and to manage return-to-work processes were evaluated better than community-based proactive processes. Physicians in OH specialist physician training self-assessed their mental health competence better at the employee level than at the workplace level. Based on our results, we need to develop the curriculum of OH specialist physician training to meet the needs of working life in support of mental health.

"We just take care after each other": Relational health strategies of nurses and nursing aides working in residential long-term care as a mechanism of in- and exclusion in care teams.

The health of care workers in residential long-term care (LTC) is under pressure. Scholars emphasize the importance of gender-sensitive and intersectional approaches to occupational health. To unravel how the health of nurses and nursing aides is shaped by gender, class, age, sexuality and race. A qualitative participatory study. A participatory research team, consisting of academic scholars and nursing aides, conducted semi-structures interviews (N = 20) and one natural group discussion (N = 8 participants) to validate our findings. Thematic data-analysis was guided by gender and intersectionality theory. Empirical findings suggest that gendered norms limit possibilities for self-care for female nurses and nursing aides. Feeling uncared for by society and LTC organizations, paid care workers describe how they take care of each other. These relational health strategies require a feeling of sameness, limiting space for diversity and disability within care teams. Care workers seen as 'cultural other', or those who experienced (chronic) health issues, financial struggles or informal caregiving, risked being excluded from relational care within care teams, which negatively impacted their health. Care workers' relational health strategies are a gendered and care ethical response to the lack of societal and political care for LTC, but can become mechanisms of exclusion within care teams. This can be understood as a sign of exhaustion, shaped by adverse working conditions and leading to moral stress. The lack of societal appreciation needs to be addressed by occupational health physicians and LTC organizations, to counter mechanisms of exclusion among paid care workers.

Work ability meetings - Challenges and Resolutions, a survey to Finnish occupational physicians.

Work ability meetings (WAM) are an essential and common tool of disability management in occupational health services in Finland. Meetings are held between an employee, a supervisor, and an occupational physician (OP). The aim is mainly to support work ability. To describe challenges and resolutions in the meetings as described by OPs. An internet survey was emailed to the members (n = 1304) of the Finnish Society of Occupational Health Physicians in August 2014. We asked physicians to describe those WAMs they had attended, especially challenges and resolutions concerning WAM. A total of 302 (23%) OPs responded to the survey. Most severe of the challenges were personal conflicts and a lack of confidence between the parties at the workplace. Also, the participants' views may differ about the purpose and goal of the meeting. The respondents noted that the employer might be unable to organize modified work for disabled employees. As a resolution, OPs need to prepare well and maintain their professional and neutral role in WAMs in all cases. OPs also mentioned the need for training in insurance medicine and rehabilitation as well as skills as a mediator. WAM is a potential tool for return to work and disability management in collaboration between employees, employers, and occupational health when all the participants reach a common goal and become aware of their role in the process. OPs need to recognize possible conflicting interests and contact each party before WAM. Keeping confidentiality in WAMs is a crucial matter.

Evolution of work conditions for employees driving for work in France based on data from the 2003, 2010 and 2017 SUMER surveys (Surveillance Médicale des expositions aux risques Professionnels)

Introduction: The occupational road-accident risk on public roads and the work conditions for professional driving is still an important issue in occupational health despite lower road-accident rates. This study presents the evolution over time of the work-related constraints for these employees based on the Sumer surveys carried out in 2003, 2010 and 2017. Method: Data from the 2010 and 2017 surveys were restricted to match the scope of the 2003 survey in order to enable prevalence data to be compared in equivalent populations. The main variable of interest was “driving (car, truck, bus, and other vehicles) on public thoroughfares” for work (during the last week of work: yes/no). Work time characteristics, work rhythm, autonomy and scope for initiative, collective work group, standards and evaluations variables were completed by the occupational health physicians. A self-administered questionnaire was also provided to employees and contained the Job Content Questionnaire, which assesses decision latitude, social support and psychological demands, the reward scale of Siegrist questionnaire, the hostile behaviour with inspired questions for Leymann, sick leave and work accidents during the past 12 months and job satisfaction. Finally, prevention in the workplace was also completed by the occupational health physicians. Results: About 25% of employees in France were exposed to work-related driving in 2017, which was stable in comparison with 2003 and 2010. However, the population was older and there were more females, more often from the clerical staff/middle manager category and working in companies with fewer than 10 employees. Employees exposed to work-related driving were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks. Conclusions: The percentage of employees exposed to occupational road accident risk, i.e., exposure to work-related driving, remained stable at about 25% in 2017 compared with previous surveys. These employees were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks. Practical Applications: Prevention campaigns on work-related road accident risk should be provided to all employees in all companies since all jobs can be concerned.

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

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. 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. 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. 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.

Telephone consultation as a sustainable method of service delivery in occupational medicine: results of a qualitative study

Since the pandemic, telephone consultation is still widely used in Occupational medicine practice, but with a seemingly huge variety depending on the different occupational medicine departments and companies. Telephone consultation could be considered a sustainable alternative to face-to-face consultation in the long term. The aim of this research project was to start an evidence base for the opinions of Occupational Health Physicians (OHPs) regarding telephone consultation. This study also sought to gather further information on the perceived benefits and limitations of telephone consultation as per its current users (OHPs) and identify ways to improve the practice of telephone consultation. This research project involved interviewing Occupational Health Physicians and analysing the data collected (using thematic analysis) so that the utility of telephone consultation as a means of consultation could be reviewed [12-16]. Semi-structured interviews were carried out with eighteen specialist occupational medicine physicians in Ireland. Data was initially coded and then organised into themes. The main findings from this research project identified five themes: Quality of Care, Professional Standards, Barriers to Telephone Consultation, Optimal Use of telephone Consultation, and Potential Improvements and Useful Change for Telephone Consultation. Some of these themes have previously been identified in research from other medical specialities. Upon consideration of the themes and subthemes identified in this study, telephone consultation could be used by Occupational Health Physicians as an adjunct to face-to-face consultations and in some cases as a direct alternative. Further research into this area with pilot studies or comparative trials will provide definitive answers as to the role of telephone consultation in occupational medicine into the future. Telephone consultation would appear to be a sustainable method of service delivery in occupational medicine. Clinical governance for telephone consultation in Ireland is currently lacking with no clinical guidance available specific for occupational medicine. If telephone consultation is to be considered a sustainable method of service delivery in Occupational medicine, a solid foundation of clinical guidance and governance will be required.

The Effectiveness of the Third Dose of COVID-19 Vaccine: When Should It Be Performed?

COVID-19 vaccination is the most significant step toward the long-term mitigation of SARS-CoV-2-related complication, avoiding disease and death and decreasing virus spread. This study aimed to evaluate, in a real-world setting, booster dose effectiveness to reduce COVID-19 risk considering the amount of time after the end of the two-dose vaccination cycle. A sub-analysis was conducted to adjust the booster dose effect for occupational and demographic factors. About 16,000 COVID-19-vaccinated HCWs of three University Hospital Networks in Milan (HN1/HN2/HN3) were included in the study. Data were collected by Occupational Health Physicians of the HNs within specific computerized databases. In univariable analysis, booster dose administration displayed a slightly higher risk of infection with respect to not receiving it, OR = 1.18, with 95% confidence interval (C.I) [0.99, 1.41]. When the model was adjusted with the modulating effect of time from the completion of the vaccination cycle on booster dose administration, the latter resulted in strong protective effect against infection, OR = 0.43, 95% CI [0.26, 0.74]. However, considering the modifying influence of time from the vaccination cycle's completion, the administration of booster doses appeared to have a protective effect against infection. In HN1, students and resident physicians displayed lower odds of infection with respect to physicians. Lastly, a non-linear effect of age was reported. Our findings suggest that the correct timing in vaccine scheduling and administration is critical to vaccine effectiveness. These findings, applicable to all vaccinations, should help in setting up more effective vaccination strategies.

Gender differences in long term sickness absence

PurposeSickness absence is a major public health problem, given its high cost and negative impact on employee well-being. Understanding sickness absence duration and recovery rates among different groups is useful to develop effective strategies for enhancing recovery and reducing costs related to sickness absence.MethodsOur study analyzed data from a large occupational health service, including over 5 million sick-listed employees from 2010 to 2020, out of which almost 600,000 cases were diagnosed by an occupational health physician. We classified each case according to diagnosis and gender, and performed descriptive statistical analysis for each category. In addition, we used survival analysis to determine recovery rates for each group.ResultsMean sickness duration and recovery rate both differ significantly among groups. Mental and musculoskeletal disorders had the longest absence duration. Recovery rates differed especially during the first months of sickness absence. For men the recovery rate was nearly constant during the first 1.5 year, for women the recovery rate was relatively low in the first three months, and then stayed nearly constant for 1.5 year.ConclusionAcross almost all diagnostic classes, it was consistently observed that women had longer average sickness absence durations than to men. Considering mental disorders and diseases of the musculoskeletal system, women had relatively lower recovery rates during the initial months compared to men. As time progressed, the recovery rates of both genders converged and became more similar.

Collaboration between occupational health professionals in smoking cessation treatment and support.

Promoting health is an important part of occupational health (OH) professionals' daily practice. Occupational health services (OHS) support work ability and prevent both work-related diseases and lifestyle-related illnesses. We focused on how interprofessional collaboration (IPC), regardless of whether the OHS provider is public, private or in-house, influences the implementation of smoking cessation treatment and support (SCTS). We studied IPC of OH professionals in SCTS and whether they differ depending on OHS providers. We collected data through an online survey of a cross-sectional sample of OH professionals of physicians (n = 182), nurses (n = 296) and physiotherapists (n = 96) at two different time-points, in 2013 and 2017. The questionnaire contained questions on interprofessional SCTS practices, so that we could assess how the professionals' experiences differed from each other. We used explanatory factor analysis to study the collaboration, and the Kruskall-Wallis test to detect the differences between the OH professional groups as a post-hoc data analysis. OH physicians (mean 3.4, SD 1.2) and OH nurses (mean 3.2, SD 1.1) experienced smooth collaboration in SCTS whereas OH physiotherapists (mean 2.5, SD 1.1) felt excluded from IPC. In-house OH centres (mean 3.5, SD 1.0) seemed to offer the best opportunities for implementing IPC in SCTS comparing to public (mean 3.1, SD 0.9) or private (mean 2.9, SD 0.9) OHS. The IPC of OH professionals in SCTS interventions need to be rearranged. This requires boundary-crossing SCTS practices involving all professionals. All OH professionals should implement IPC in SCTS and share their specific competence.

Occupational Asthma Prevalence among Migrant Workers Attending Shuaiba Industrial Medical Center in Kuwait.

Specific work environments, such as exposure to chemicals emitted during industrial processes, are related to occupational asthma. From 1985 to 2012, Kuwait was expected to have the highest asthma prevalence rate among Middle East nations, at 15%. This cross-sectional study was conducted using secondary data from occupational health physicians' records in the Shuaiba Industrial Medical Center (SIMC) extracted and analyzed using SPSS. Chi-square test and logistic regression were used to check the association between risk factors and bronchial asthma (BA). The data sample size was 3478 in 2018 and 3807 in 2019. In 2018, BA had a significant relationship with age categories, work year groups, and determinants of fitness. Migrant workers above 51 years of age had a high risk of developing BA (p-value = 0.012). There was a high risk of developing BA in workers who worked > 21 years (p-value < 0.001) and in workers who worked between 11 and 20 years (p-value = 0.042). Overweight workers had a risk of developing BA (p-value = 0.042). In 2019, BA had an associated relationship with age categories and determinants of fitness. Workers above 51 years of age had about a 39% risk of developing BA (p-value = 0.009). Otherwise, the BMI, working year groups, marital status, and smoking status had no association with BA. In conclusion, BA is prevalent among migrant workers at the SIMC. Long hours, low income, and a lack of PPE are just a few of the issues that migrant workers have been exposed to, raising their risk of poor health.

Evidências sobre os Riscos Psicossociais e o Teletrabalho

Introduction Teleworking is a reality for many workers around the world, and although it has advantages, there are recent studies indicating that it can have a negative impact on workers’ mental health, increasing the risk of anxiety, depression and stress. Methodology ​​A literature search was conducted in March 2023 in the Scopus, SciELO, PePSIC, PsycInfo, PubMed, Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science databases. Contents Telework allows the execution of work tasks without the need to physically move to the workplace. It is a practice that has advantages such as greater flexibility, autonomy, cost reduction and increased productivity, but can also have disadvantages and psychosocial risks for workers. The COVID-19 pandemic was a milestone of revolution in several aspects worldwide and, in this particular context, it marked a massive adoption of the Telework model by several companies. However, it is imperative to define strategies to prevent psychosocial risks and implement a sustainable model in order to ensure the physical and psychological well-being of individuals. The selected articles highlight as the main psychosocial risk factors the “work-family” conflict and its and demands. Discussion and Conclusions It is important that all health professionals, and in particular occupational health physicians, recognize the main psychosocial risks associated with Telework. Only through the development and implementation of preventive measures will be possible to minimize the consequences of telework and ensure a healthy working environment for all employees. Keywords: Psychosocial Risks, Telework, Occupational Health, Mental Health, Occupational Medicine, Occupational Nursing.

Analyse du profil des salariés déclarés inaptes au poste de travail : quelle place pour les facteurs sociétaux ou extra-professionnels et quelles conséquences sur l'emploi ?

IntroductionProfessional career can be modified by health problems. Professional impairment, certified by an occupational health physician, can be followed by a redeployment or occupational disintegration. ObjectivesTo describe the profiles of workers declared unfit for their workplace and the profiles of those who have no remaining work capacity (RWC). MethodsThe workers followed by an inter-enterprise occupational health service composed of 20 occupational physicians. The characteristics of workers declared unfit for work were extracted from the medical files: age, gender, activity sector (Naf), socioprofessional category (PCS), pathology leading to professional impairment (CIM10), status of obligation to employ disabled workers (BOETH). Factors associated with unfitness to work due to no remaining work capacity (RWC) were identified by logistic regression models. ResultsIn 2019, 82678 workers in France were followed by the SPSTI and 554 (0.67%), of whom 162 had no RWC, were declared unfit to work by an occupational health physician. Professional impairment rates were highest for women and workers > 55 years old. Psychological (29%) and rheumatic (50%) pathologies were the most frequent causes of professional impairment. BOETH status was identified among 63%. Age > 45 and psychological pathology were significantly associated with absent RWC, whereas gender, activity sector and PCS were not. DiscussionNo comprehensive public administration records of professional impairment exist in France. While past studies have described the profiles of workers who were unfit for their workplace, none have characterized those without RWC, who are high risk of precarity. ConclusionsPsychological pathologies generate the most professional impairment in persons without RWC. Prevention of these pathologies is essential. While rheumatic disease is the first cause of professional impairment, the proportion of workers with these diseases who have no remaining work capacity is relatively low; this may be due to the efforts made to facilitate their return to work.

Assessing Attitudes and Participation Regarding a Pilot COVID-19 Workplace Vaccination Program in Southern Germany Considering the Occupational Health Perspective-A Mixed Methods Study.

This mixed methods study retrospectively assessed attitudes and participation of employees, occupational health personnel, and key personnel regarding the rollout of a pilot COVID-19 workplace vaccination program in five German companies in May/June 2021 in Baden-Württemberg (Southern Germany) by combining survey data and qualitative interviews. A total of 652 employees completed a standardized questionnaire and we conducted ten interviews with occupational health personnel and key personnel with other professional backgrounds organizing the pilot workplace vaccination program. Survey data were analyzed descriptively and interviews were audio recorded, transcribed verbatim, and analyzed using qualitative content analysis. Employees participated widely in COVID-19 vaccinations at their workplaces, and most employees (n = 608; 93.8%) had a full COVID-19 immunization at the time of the survey. The main advantages of the pilot COVID-19 workplace vaccination program were seen in the flexible and time-saving vaccination offer as well as the trust in and long-standing relationship with occupational health physicians. The main disadvantage of the pilot vaccination offer was increased workload for occupational health personnel, especially during the roll-out phase of the program. The pilot COVID-19 workplace vaccination program was predominantly positively assessed, and the important role of occupational health services in managing the COVID-19 pandemic was highlighted. The main criticisms of the COVID-19 workplace vaccination program related to the high organizational and administrative burden. Findings from our study can support the development of future programs for the administration of generally recommended vaccination in the workplace setting in Germany.

Factors associated with return to work after acute myocardial infarction in Tunisia

Return to work is an important indicator of recovery after acute myocardial infarction. Little is known, however, about the rate of returning to work within the year after an acute myocardial infarction in Tunisia, as well as the factors associated with returning to work after an acute myocardial infarction. To determine the rate of return to work within 12 months after acute myocardial infarction, and identify patient factors associated with returning to work. This cross-sectional study, conducted in the cardiology department of Charles-Nicolle Hospital (Tunisia) identified 193 patients under 65 years of age who were employed at the time of the index acute myocardial infarction hospitalization during the period between January 2019 and December 2021. Of 193 patients (mean age of 51.62 years, with a maximum of 65 years and a minimum of 28 years), 155 patients (80.3%) returned to work after a median of 39.3 days off work. Among them, 132 patients (68.4%) returned to the same job, 8 patients had their jobs adapted and 4 patients changed their occupation. The factors that favored return to work were: age under 55 years (P = 0.004), a low to medium socio-economic background (P = 0.0001 and P = 0.005, respectively), a hospital stay of less than 7 days (P = 0.002), a primary level of education (P = 0.013), job satisfaction (P = 0.03) and the cardiologist's opinion of disability (p = 0.0001). On the other hand, recurrence of angina, dyspnea and fatigue were factors of work cessation (P = 0.0001), as well as jobs with a high physical workload (P = 0.001). The identification of factors influencing work resumption time after acute coronary syndromes may allow a better social and occupational reintegration. Therefore, a cooperation between cardiologist and occupational health physician is essential since the acute period of the myocardial infarction.

Patients' Experiences, Needs, and Expectations of Cooperation Between Medical Specialists and Occupational Health Physicians: A Qualitative Study.

Cooperation between clinical and occupational health care practitioners is a key aspect of clinical work-integrating care. This study aimed to gain insight into patients' experiences, needs, and expectations regarding cooperation between medical specialists and occupational health physicians. A thematic qualitative study was conducted involving a total of 33 participants in eight online focus groups. Participants indicated practitioners are currently working in an isolated manner. However, participants desired for partnership between specialists and occupational health physicians to address work-related concerns and showed a need for explanation of the consequences of their diagnosis, so this can be translated into their ability to work. Currently, cooperation between clinical and occupational health care is lacking. Yet, some participants experienced that these disciplines could complement each other by working together to support patients in work participation.

Occupational physicians dealing with mental health: between employee and company interests: a qualitative study

BackgroundOccupational health physicians are increasingly confronted with mental health issues at their workplace. Facing them, most of them feel insecure and not sufficiently trained. Employee’s mental well-being depends at the same time on individual and significantly on organizational variables. This complicates the physician’s position, since they have to serve many interests. The focus of the present study is to investigate what difficulties occupational health physicians face and how organizational culture and management influence their work.MethodsInterviews were conducted with N = 25 physicians as part of a training for basic mental health care. Interviews were interpreted using qualitative content analysis.ResultsWorking with mentally ill employees was difficult for the physicians interviewed. Many felt insecure managing and preventing mental health issues. A need for further education was observed. Environmental factors (organizational culture, management) have a strong impact on the work of an occupational health physician and highlight its systemic dimension. Even though many of our participants report a meanwhile more open attitude towards mental disorders at their workplace, on the level of direct contact to the management prevail descriptions of little acceptance and a high priority of economic outcomes.ConclusionsMore education on topics of mental health is needed for occupational health physicians. Future trainings should consider the intertwined nature of their work and enable them in dealing consciously with other actors in the company. For enhancing employee’s mental well-being occupational health physicians could be granted a strengthened position in companies or be supported through more exchange with colleagues in other companies.

The Japanese Law Regulating Underwater and Caisson Work: Current Issues and Future Developments

The Japan "Ordinance on Safety and Health of Work under High Pressure", which is the law regulating health conditions for workers under high pressure environments, was amended in 2014. The revised regulations have highlighted other difficulties and new problems, but they have not yet written an appropriate amendment based on the aspect of occupational and environmental health. Health management for occupational divers and caisson workers in accordance with the new regulations has not determined the best approach to reducing related disorders and will cause other legal problems. This paper presents some issues in the new regulations for hyperbaric workers, which directly or indirectly involve occupational health physicians. Health checkups and work limitations should be done in consideration of the occupational characteristics of the undersea and hyperbaric environment. Regular examinations using specific studies are useful to diagnose the early stages of chronic conditions for workers, and are also useful for determining the hiring suitability for hyperbaric workers. Work limitations should be decided by the conditions that induce serious accidents or disorders that result from exposure to hyperbaric environments, and depend on the obstacles for work due to sequelae of decompression sickness. The new regulations need to be properly revised, based on scientific evidence, to include health management for workers in undersea and hyperbaric environments.

Evaluation of an e-learning on involving significant others in occupational health care

Abstract Background Significant others (SOs) like partners, family members or friends can play an important role in how workers cope with chronic disease, thereby influencing work and health outcomes. Despite the potential benefits of involving SOs in the return-to-work (RTW) process of workers with chronic diseases, guidance and training on how to manage this is scarce. Educating work and health professionals on this topic could lead to better RTW support for workers and prevention of long-term sickness absence. Objectives This study aimed to determine the effectiveness of an e-learning for improving occupational health physicians’ (OHPs) knowledge, attitudes, and self-efficacy regarding involving SOs in the RTW process. In addition, we explored OHPs’ responses to and satisfaction with the e-learning. We conducted a randomized controlled trial with 87 OHPs, involving an intervention group and a waitlisted control group. Between-group differences in knowledge, attitude, self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning were analyzed with descriptive statistics and thematic analysis. Results We found moderate to large effects on OHPs’ knowledge (p &amp;lt;.001, ηp2 = .202), attitudes (ηp2 = .098), and self-efficacy (p &amp;lt; .001, ηp2 = .237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the e-learning increased their awareness of the role of SOs in RTW and encouraged them to address this more often. Conclusions The developed e-learning is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of OHPs with regard to involving SOs in the RTW process of workers with chronic diseases. The e-learning and accompanying materials can encourage work and health professionals to more often address the role of significant others in the work re-integration process. Key messages • The developed e-learning is effective in increasing occupational health physicians’ knowledge, attitudes and self-efficacy with regard to involving significant others in the return-to-work process. • The e-learning and accompanying materials can encourage professionals to more often address the role of significant others in the work re-integration process to prevent long-term sickness absence.

A comprehensive diagnostic service to clarify intervention needs when work participation is at risk: study protocol of a randomized controlled trial (GIBI, DRKS00027577)

BackgroundEffective care services for people whose work participation is at risk require low-threshold access, a comprehensive diagnostic clarification of intervention needs, a connection to the workplace and job demands, and interdisciplinary collaboration between key stakeholders at the interface of rehabilitation and occupational medicine. We have developed a comprehensive diagnostic service to clarify intervention needs for employees with health restrictions and limited work ability: this service is initiated by occupational health physicians.Methods/designOur randomized controlled trial tests the effectiveness of a comprehensive diagnostic service for clarifying intervention needs (GIBI: Comprehensive clarification of the need for intervention for people whose work participation is at risk). The comprehensive intervention comprises three elements: initial consultation, two-day diagnostics at a rehabilitation center and follow-up consultations. We will include 210 employees with health restrictions and limited work ability, who are identified by occupational health physicians. All individuals will receive an initial consultation with their occupational health physician to discuss their health, work ability and job demands. After this, half the individuals are randomly assigned to the intervention group and the other half to the waiting-list control group. Individuals in the intervention group start two-day diagnostics, carried out by a multi-professional rehabilitation team in a rehabilitation center, shortly after the initial consultation. The diagnostics will allow first recommendations for improving work participation. The implementation of these recommendations is supported by an occupational health physician in four follow-up consultations. The control group will receive the comprehensive two-day diagnostic service and subsequent follow-up consultations six months after the initial consultation. The primary outcome of the randomized controlled trial is self-rated work ability assessed using the Work Ability Score (0 to 10 points) six months after study inclusion. Secondary outcomes include a range of patient-reported outcomes regarding physical and mental health, impairment, and the physical and mental demands of jobs.DiscussionThis randomized controlled trial is designed to test the effects of a new complex intervention involving a comprehensive clarification of intervention needs in order to promote work participation and prevent the worsening of health and work disability.Trial registrationGerman Clinical Trials Register (DRKS00027577, February 01, 2022).

Training for occupational health physicians to involve significant others in the return-to-work process of workers with chronic diseases: a randomized controlled trial

Purpose To determine the efficacy of the “Training for Occupational health physicians To Involve Significant others” (TOTIS) e-learning module for improving occupational health physicians’ (OHPs) knowledge, attitudes, and self-efficacy regarding involving significant others in the return-to-work process. Materials and methods A randomized controlled trial with 87 OHPs, involving an intervention group and a wait-listed control group. Between-group differences in knowledge, attitude, and self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning module were analyzed with descriptive statistics and thematic analysis. Results We found moderate to large effects on OHPs’ knowledge (p < 0.001, η p 2 = 0.202), attitudes (p = 0.003, η p 2 = 0.098), and self-efficacy (p < 0.001, η p 2 = 0.237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning module with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the module increased their awareness of the role of significant others and encouraged them to address this more often. Conclusions The TOTIS e-learning module and accompanying materials are valuable resources for OHPs to learn how significant others influence work outcomes of workers with chronic diseases and to manage their involvement in the re-integration process. Trial registration This study is registered in the Netherlands Trial Register under trial number NL8744; https://www.trialregister.nl/trial/8744. Implications for rehabilitation The TOTIS e-learning module is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of occupational health physicians with regard to involving significant others in the re-integration process of workers with chronic diseases. The e-learning module and accompanying tools can increase the awareness of occupational health physicians about the role of significant others and encourage them to address the role of significant others in the re-integration process of sick-listed workers. It could be beneficial to expand on the e-learning module with a face-to-face training program involving group interaction, peer discussion, and skills development.