Occupational health care return-to-work practices for workers with job burnout

BACKGROUND

Occupational health care supports return to work in cases of burnout; however, there is little research on return-to-work practices.

AIM

To describe occupational health care return-to-work practices for workers with burnout and to identify potential for the development of the practices.

METHODS

Open-ended interviews and essays were used to collect data from 25 occupational health care professionals. A qualitative content analysis method was used.

RESULTS

Occupational health care was involved in the return-to-work support in the off-work, work re-entry and maintenance phases during the return-to-work process. However, occupational health care had no influence in the advancement phase. The key return-to-work actions were: (i) defining burnout, (ii) supporting disengagement from work, (iii) supporting recovery, (iv) determining the return-to-work goal, (v) supporting re-engagement with work, (vi) monitoring the job-person match, (vii) re-evaluating the return-to-work goal, (viii) supporting the maintenance of the achieved return-to-work goal, and, where appropriate, (ix) supporting an alternative return-to-work goal. There were varied return-to-work practices among the occupational health care centers evaluated.

CONCLUSIONS

The occupational health care return-to-work practices for workers with burnout are described with recommendations to further develop common practice guidelines.

Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process

Background

One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process.

Methods

A multidisciplinary community of practice group (n = 16) consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012–December 2013) to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data.

Results

Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group). Fidelity was rated as fairly high.

Conclusions

The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future guideline development; it provides valuable information on how practitioners can be included in the development process, with the aim of increasing the implementability of the developed guidelines.

Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation

BACKGROUND

A systematic review was undertaken to identify regulatory mechanisms aimed at mitigating health care worker absenteeism, to describe where and how they have been implemented as well as their possible effects. The goal was to propose potential policy options for managing the problem of absenteeism among human resources for health in low- and middle-income countries. Mechanisms described in this review are at the local workplace and broader national policy level.

METHODS

A comprehensive online search was conducted on EMBASE, CINAHL, PubMed, Google Scholar, Google, and Social Science Citation Index using MEDLINE search terms. Retrieved studies were uploaded onto reference manager and screened by two independent reviewers. Only publications in English were included. Data were extracted and synthesized according to the objectives of the review.

RESULTS

Twenty six of the 4,975 published articles retrieved were included. All were from high-income countries and covered all cadres of health workers. The regulatory mechanisms and possible effects include 1) organizational-level mechanisms being reported as effective in curbing absenteeism in low- and middle-income countries (LMICs); 2) prohibition of private sector activities in LMICs offering benefits but presenting a challenge for the government to monitor the health workforce; 3) contractual changes from temporary to fixed posts having been associated with no reduction in absenteeism and not being appropriate for LMICs; 4) multifaceted work interventions being implemented in most settings; 5) the possibility of using financial and incentive regulatory mechanisms in LMICs; 6) health intervention mechanisms reducing absenteeism when integrated with exercise programs; and 7) attendance by legislation during emergencies being criticized for violating human rights in the United States and not being effective in curbing absenteeism.

CONCLUSION

Most countries have applied multiple strategies to mitigate health care worker absenteeism. The success of these interventions is heavily influenced by the context within which they are applied.

Factors related to the physician and the employer influencing successful return to work in Korea: results from the first panel study of workers' compensation insurance (PSWCI)

Objectives

This study aims to investigate associated factors including the physician and the employer of successful return to work (RTW) in occupationally injured workers.

Methods

This study is based on the first panel study of workers’ compensation insurance (PSWCI), published in June 2014. The PSWCI is a sample survey of occupationally injured workers who completed medical care in 2012 (89,921 people). A total of 2000 subjects were sampled based on sex, age, nine metropolitan-based regions, disability ratings, duration of rehabilitation, and whether vocational rehabilitation service was used. We divided the study population into two groups: return to work (RTW) group (job retention, reemployment, unpaid family worker, and self-employment), and non-RTW group (joblessness and economical inactivity). The odds ratios (ORs) and 95 % confidence intervals (CI) related to differences in basic characteristics, part of physician and employer-related factors between those who succeeded to RTW and those who did not were measured using multivariable logistic regression model.

Results

The success of RTW is 70.6 % (n = 1412) among participants. The ORs (95 % CI) of the participants belonging to RTW who received periodic recovery assessment from the medical care institution and the physician are 1.51 (1.07–2.13). The ORs (95 % CI) are 1.68 (1.05–2.69) for the RTW group who received work ability assessment and referral for vocational return. When the employer maintains the relationship with the occupationally injured worker, the worker has 1.39 times higher odds (95 % CI: 1.41–2.26) of the RTW group compared to the non-RTW group.

Conclusions

The physician and the employer have a significant impact on the RTW.

Psychological approach of occupational health service to sick leave due to mental problems: a systematic review and meta-analysis

PURPOSE

The effects of interventions by occupational health services on sick leave prompted by psychiatric disorders were examined with respect to intervention method and the number of sick leave days.

METHODS

The intervention methods used by occupational health services were systematically reviewed by searching three databases and manual searching. A meta-analysis of the number of sick leave days comparing the intervention group [intervention + care as usual (CAU)] and control group (CAU alone) was performed. In addition, subanalyses were conducted for the duration until sick-listed workers' return to work after sick leave (Subgroup 1) and the number of non-sick-listed workers' total sick leave days (Subgroup 2).

RESULTS

Ten studies were extracted and integrated, and the subjects were subsequently sorted into the intervention group (n = 434, 322, and 756 in subgroup 1, subgroup 2, and total, respectively) and control group (n = 413, 385, and 798 in subgroup 1, subgroup 2, and total, respectively). All studies employed an intervention method of problem-solving treatment or cognitive behavioral therapy (CBT). There were no significant differences between the intervention and control groups in subgroup 1 or 2. However, the combined intervention group had significantly fewer total sick leave days than the combined control group (mean difference -6.64 days, 95% CI -12.68 to -0.59, I(2) = 0%).

CONCLUSIONS

The combined study of sick-listed and non-sick-listed workers indicates occupational health services implement problem-solving treatment or CBT interventions, which can shorten total sick leave duration.