Optimizing cooperation between general practitioners, occupational health and rehabilitation physicians in Germany: a qualitative study

Stratil, Jan M.; Rieger, Monika A.; Voelter-Mahlknecht, Susanne

doi:10.1007/s00420-017-1239-6

Cited by 16 publications

(21 citation statements)

References 36 publications

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“…Other than in the therapeutic setting with patients and their selected therapist, in the occupational setting employees may tend to withhold relevant health-related data from the company-selected OP. 28 The fact that the observed lifetime prevalence of depression is 11.6% 44 and is almost identical with the OPs’ estimation of the percentage of their employees with depression strengthens the validity of our study.…”

Section: Discussionsupporting

confidence: 80%

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

et al. 2018

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ObjectivesTo identify approaches for an effective patient-centred care of depressed employees, we investigated occupational physicians’ (OPs) and psychotherapists’ (PTs) knowledge about job stressors on the development of depression, application of this knowledge, interdisciplinary cooperation and perceived barriers.Study designA cross-sectional online survey.ParticipantsOPs (163; 48.5% male) and PTs (69; 43.5% male) providing complete data on the survey out of 257 OPs and 112 PTs who started the survey. There have been 458 (OPs) and 821 (PTs) initial clicks.MethodsMain outcome measures were the importance ratings of specific job stressors, the frequency of asking patients about those stressors, the need for interdisciplinary cooperation, as well as perceived barriers for cooperation. We performed multivariate analysis of variance, intraclass correlation coefficients (ICCs) and Spearman’s rank-order correlations.ResultsThe achieved response rate for OPs was 56.1% and for PTs 13.6%. Both disciplines agreed on the importance of job stressors regarding depression (ICC=0.90; 95% CI: 0.54 to 0.98), but both ranked these factors differently from the current state of research. As to knowledge application, OPs showed positive associations between the importance of job stressors and the frequency of asking employees about them (eg, job insecurity (rs=0.20, p=0.005)) and PTs for social stressors (eg, interpersonal conflicts (rs=0.38, p=0.001)). OPs (mean=3.41) reported a higher necessity of interdisciplinary cooperation than PTs (mean=3.17; F(1,230)=7.02, p=0.009). Furthermore, cooperation was reported as difficult to implement. PTs perceived barriers (eg, time restriction) as more hindering (mean=3.2) than OPs (mean=2.8; F(1,171)=8.16, p=0.005).ConclusionsBoth disciplines are aware of the relevance of job stressors as risk factors for depression, but should be encouraged to ask employees more frequently about them. The need for interdisciplinary cooperation and possible barriers are discussed. It is crucial to emphasise the meaning of sufficient cooperation, since closing this gap for improving patient-centred care especially for employees suffering from depression is necessary.

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Section: Discussionsupporting

confidence: 80%

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

et al. 2018

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“…This was highlighted by the extensive use of “we” and “they” in the statements. According SIA, the mere perception of belonging to two distinct groups can be sufficient to provoke intergroup competitive or discriminatory responses on the part of the in-group [ 48 ]. As predicted, the protagonists described a positive perception of their own professional group, while maintaining negative or prejudicial perceptions about other professional groups, especially regarding OPs.…”

Section: Discussionmentioning

confidence: 99%

“…This study is based on an explorative, qualitative research design using the Social Identity Approach (SIA) by Tajfel and Turner [ 50 – 56 ] as the theoretical underpinning, eight focus group discussions (FGDs) for data collection, and qualitative content analysis [ 57 ] for data analysis. A more detailed outline of methods and research questions is provided in the study protocol [ 2 ] and the preceding publications [ 47 , 48 ].…”

Section: Methodsmentioning

confidence: 99%

“…As part of a larger research project aimed at identifying barriers and solutions in the cooperation between OPs, PCPs, and RPs [ 2 ], previous studies based on the same data set have outlined various barriers to cooperation [ 47 ] and compiled suggestions of the participants for how the cooperation could be improved [ 48 ]. Although problems at the intersections of different medical disciplines clearly constitute an intergroup issue, the role of group-identity and group-perceptions is often ignored [ 49 ].…”

Section: Introductionmentioning

confidence: 99%

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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

Stratil

Rieger

Voelter-Mahlknecht

2018

BMC Health Serv Res

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BackgroundIn 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.MethodsWe 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.ResultsWhile 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.ConclusionThis 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).Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3564-1) contains supplementary material, which is available to authorized users.

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“…Stapelfeldt et al (2018) reported that several professionals, e.g., employers, occupational and physical therapists, and social workers, should be involved in interventions to support occupationally active cancer survivors to retain work [31]. As in the Netherlands and other Western countries, the healthcare and occupational health systems are not naturally intertwined, it is challenging to ensure structured coordination of care and greater interdisciplinary collaboration [32].…”

Section: Interpretation Of the Findingsmentioning

confidence: 99%

Cancer-related cognitive problems at work: experiences of survivors and professionals

et al. 2019

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Purpose Cancer-related cognitive problems (cancer-related cognitive problems) in working cancer survivors are found to affect work outcomes. We aimed to generate in-depth information regarding cancer-related cognitive problems in working cancer survivors, strategies used to cope with cancer-related cognitive problems at work, and needs of cancer survivors and professionals regarding cancer-related cognitive problems at work. Methods Five focus groups were formed, amongst which three focus groups with cancer survivors (n = 8, n = 7, and n = 8) and two focus groups with professionals (n = 7, n = 8). Thematic analysis of the transcripts was performed to create concepts. Results Both cancer survivors and professionals confirmed that cancer-related cognitive problems, which occurred in several domains of neurocognitive functioning, affect work functioning. Cancer survivors used several strategies (e.g., applying practical adjustments, reorganization of work, and accepting limitations) to cope with cancer-related cognitive problems at work, as did professionals in their attempt at supporting cancer survivors facing these problems. Various needs of cancer survivors (e.g., supportive care options, acknowledgment by others) and professionals (e.g., improvement of expertise, clarity about referral pathways) regarding cancer-related cognitive problems at work were mentioned. Conclusions Due to the growing number of working cancer survivors dealing with cancer-related cognitive problems, it is essential to sustain their employability. Therefore, cognitive rehabilitation interventions should be developed, taking functioning at work into account. Knowledge amongst professionals regarding cancer-related cognitive problems, as well as coordination of care for cancer-related cognitive problems, should be improved. Ensuring professional education regarding cancer-related cognitive problems, within both the healthcare and occupational setting, is of utmost importance. Implications for cancer survivors Support for working cancer survivors who experience cancer-related cognitive problems might increase their employability in the longer term.

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Optimizing cooperation between general practitioners, occupational health and rehabilitation physicians in Germany: a qualitative study

Cited by 16 publications

References 36 publications

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

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

Cancer-related cognitive problems at work: experiences of survivors and professionals

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