How do Dutch GPs address work-related problems? A focus group study

Kock, C A De; Lucassen, Peter; Spinnewijn, Laura; Knottnerus, J. André; Buijs, P.C.; Steenbeek, Romy; Lagro-Janssen, Antoine L. M.

doi:10.1080/13814788.2016.1177507

Cited by 26 publications

(30 citation statements)

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“…It covered six topics: (1) the connection between work and health; (2) usual care for WRPs and ways to improve it; (3) legislation regarding absenteeism and collaboration with OP; (4) gender aspects of work and WRPs; (5) activating care for patients with work-related distress; (6) registration of occupation and WRPs in the electronic medical record (EMR). The programme was based on the results of a focus group study, in which we found that lack of knowledge and counselling skills were barriers for GPs to identify and address WRPs proactively [ 22 ]. The programme ended with instructions about the recruitment of patients for the trial.…”

Section: Methodsmentioning

confidence: 99%

Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Kock

Bor²,

Knottnerus

et al. 2018

European Journal of General Practice

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Background: Paying attention to their patients’ work and recognizing work-related problems is challenging for many general practitioners (GPs).Objectives: To assess the effect of training designed to improve the care for patients with work-related problems in general practice.Methods: A cluster randomized controlled trial among 32 Dutch GPs. GPs in the intervention group received five-hour training. GPs in the control group were not trained. Included patients (age 18–63, working ≥12 h per week) completed baseline questionnaires and follow-up questionnaires planned after one year. Primary outcome at patient level was patients’ expectations about their ability to work, measured using the return-to-work self-efficacy scale (RTW-SE). Primary outcomes on GP level were their use of ICPC-code Z05 (‘work-related problem’) per 1000 working-age patients and percentage of the electronic medical files of working-age patients in which information about occupation had been recorded.Results: A total of 640 patients completed the baseline questionnaire and 281 the follow-up questionnaire. We found no statistically significant differences in patients’ RTW-SE scores: intervention 4.6 (95%CI: 4.2–5.0); control 4.5 (95%CI: 4.1–4.9). Twenty-nine GPs provided data about the GP-level outcomes, which showed no statistically significant differences: use of ICPC code Z05 11.6 (95%CI: 4.7–18.6) versus 6.0 (95%CI: –1.2 to 13.2) per 1000 working-age patients; recording of occupation 28.8% (95%CI: 25.8–31.7) versus 28.6% (95%CI: 25.6–31.6).Conclusion: Training GPs did not improve patients’ work-related self-efficacy or GPs’ registration of work-related problems and occupation.

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Section: Methodsmentioning

confidence: 99%

Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Kock

Bor²,

Knottnerus

et al. 2018

European Journal of General Practice

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“…Although most health professionals, including physical therapists, acknowledge the importance of their patients' work, occupation and the ability to work, these topics are often not addressed within regular Dutch healthcare [14][15][16][17][18]. Recent qualitative research in the Netherlands found that although a patient's work is considered important, physical therapists take work participation insufficiently into account as a determining factor in the treatment of patients with MSDs.…”

Section: Introductionmentioning

confidence: 99%

“…These issues were also seen in qualitative research conducted among general practitioners in the Netherlands which found that general practitioners seemed well aware of the relationship between work and health but needed more knowledge, communication skills and better cooperation with occupational physicians to manage workrelated problems. Participants reported that they lacked the knowledge to advise patients specifically concerning their work environment [16].…”

Section: Introductionmentioning

confidence: 99%

The effects of integrating work-related factors and improving cooperation in musculoskeletal physical therapy practice: protocol for the ‘WORK TO BE DONE’ cluster randomised controlled trial

Hutting

Oswald

Sanden³

et al. 2020

BMC Musculoskelet Disord

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Background: Musculoskeletal disorders (MSDs) are the primary cause of disability worldwide and a major societal burden. Recent qualitative research found that although a patient's work is considered important, physical therapists take work participation insufficiently into account as a determining factor in the treatment of patients with MSDs. Therefore, the aim of this study is to improve the effectiveness of physical therapy (in primary healthcare) with respect to the work participation of employees with MSDs by increasing the knowledge and skills of generalist physical therapists and by improving the collaboration between generalist physical therapists and physical therapists specialised in occupational health. Methods/design: This trial is a two-arm non-blinded cluster randomised controlled trial. Working patients with MSDs visiting a physical therapy practice are the target group. The control group will receive normal physical therapy treatment. The intervention group will receive treatment from a physical therapist with more knowledge about workrelated factors and skills in terms of integrating work participation into the patients' care. Data are gathered at baseline (T0), at four months (T1) and eight months (T2) follow-up. Most outcomes will be assessed with validated patientreported questionnaires. Primary outcomes are the limitations in specific work-related activities and pain during work. Secondary outcomes include limitations in general work-related activities, general pain, quality of life, presenteeism, sick leave (absenteeism), estimated risk for future work disability, work-related psychosocial risk factors, job performance, and work ability. Based on a sample size calculation we need to include 221 patients in each arm (442 in total). During data analysis, each outcome variable will be analysed independently at T1 and at T2 as a dependent variable using the study group as an independent variable. In addition to the quantitative evaluation, a process evaluation will be performed by interviewing physical therapists as well as patients.

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“… 3 33 Yet GPs often have difficulties managing their patients’ work-related mental health problems, as they often lack negotiation strategies regarding sick leave, communication skills and cooperation with occupational physicians. 34 GPs encounter a variety of workers with systematic, unsystematic or non-existing occupational health services at their workplace. A better understanding of work-related factors associated with individuals’ mental health is important to help GPs consider specific actions.…”

Section: Introductionmentioning

confidence: 99%

Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

et al. 2018

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ObjectivesStudies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs.MethodWe use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April–August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates.ResultsAmong study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%).ConclusionsSeveral workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

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How do Dutch GPs address work-related problems? A focus group study

Abstract: The participating GPs seemed well aware of the relation between work and health but need more knowledge, communication skills and better cooperation with occupational physicians to manage work-related problems. [Box: see text].

Cited by 26 publications

References 24 publications

Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

Training GPs to improve their management of work-related problems: results of a cluster randomized controlled trial

The effects of integrating work-related factors and improving cooperation in musculoskeletal physical therapy practice: protocol for the ‘WORK TO BE DONE’ cluster randomised controlled trial

Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

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