Objectives The aim of this study was to (i) explore promoting factors for sustained return to work (RTW), according to vocational rehabilitation professionals (VRP) that are amenable to change for employees who have been on sick leave＞18 months and (ii) gain insight into crucial aspects of interventions.Methods Semi-structured interviews were carried out with 23 VRP. All interviews were transcribed fully verbatim. An inductive analysis of the transcripts was performed, using a process of identifying, coding, and categorizing the primary patterns in the data.Results Key influenceable promoting factors for sustained RTW by long-term sick-listed employees include: employee-based vocational guidance; integral, effective communication between the sick-listed employee and all RTW stakeholders; personal factors; a supportive work environment; and a stimulating social environment.Crucial aspects of interventions include: gathering information and setting priorities; improving qualifications; influencing cognitions; monitoring the sick-listed employee through the rehabilitation process; offering tailormade interventions at different stages within a personal time-bound action plan; and preparing the employee and the work environment for RTW.Conclusions Sustained RTW for long-term sick-listed employees can be achieved by focusing on the influenceable promoting factors for RTW. The use of combined interventions in a holistic approach involving the worker and his environment is considered the best way to address the multicausality of work disability and could help maximize RTW outcomes.

What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals.

Are we failing workers with symptoms suggestive of occupational asthma

BACKGROUND: Issues surrounding sickness absence are of interest due to growing awareness of the costs to employers and the UK economy, a greater understanding of the interaction between health and work, and increasing evidence that work is beneficial to physical and mental well-being. The Health & Occupation Reporting network in General Practice (THOR-GP) is a national source of information on work-related sickness absence. AIMS: To assess the factors influencing work-related sickness absence in the UK. METHODS: General practitioners (GPs) report cases of work-related ill-health via an online web form. Sickness absence information reported with each case was compared by demographic information, diagnosis/symptom and employment factors. RESULTS: Between 2006 and 2009, THOR-GP received 5683 case reports of work-related ill-health; 53% were musculoskeletal diagnoses and 31% were mental ill-health diagnoses. Over half (56%) of cases reported had associated sickness absence. Diagnosis had a highly significant influence on the occurrence of any associated sickness absence. Eighty-one per cent of mental ill-health cases were reported to result in sickness absence compared to 50% of musculoskeletal cases. Public sector employees incurred sickness absence more frequently than those from the private sector. Industries with the highest mental ill-health incidence rates had sickness absence episodes most frequently. Within employment groups, levels of sickness absence were inversely proportional to the level of self-employment. CONCLUSIONS: These data reported by GPs with vocational training in occupational medicine may help to inform policy decisions targeting work-related exposures and the management of sickness absence, thereby reducing the UK burden of work-related sickness absence.

/pdf/work-related-sickness-absence-as-reported-by-uk-general-2bpg6y2dlv.pdf

Work-related sickness absence as reported by UK general practitioners

Purpose
To reach insurance physician (IPs) consensus on factors that must be taken into account in the assessment of the work ability of employees who are sick-listed for 2 years.

/pdf/what-factors-are-most-relevant-to-the-assessment-of-work-3ypvjuxeok.pdf

What factors are most relevant to the assessment of work ability of employees on long-term sick leave? The physicians' perspective.

Background GPs can find their role as issuers of sickness certification problematic, particularly in trying to maintain a balance between certifying absence and preserving the doctor–patient relationship. Little research has been published on consultations in which sickness absence has been certified. Aim To explore negotiations between GPs and patients in sickness absence certification, including how occupational health training may affect this process. Method A qualitative study was undertaken with GPs trained in occupational health who also participate in a UKwide surveillance scheme studying work-related ill-health. Telephone interviews were conducted with 31 GPs who had reported cases with associated sickness absence. Results Work-related sickness absence and patients9 requests for a ‘sick note’ vary by diagnosis. Some GPs felt their role as patient advocate was of utmost importance, and issue certificates on a patient’s request, whereas others offer more resistance through a greater understanding of issues surrounding work and health aquired through occupational health training. GPs felt that their training helped them to challenge beliefs about absence from work being beneficial to patients experiencing ill-health; they felt better equipped to consider patients’ fitness for work, and issued fewer certificates as a result of this. Conclusion Complex issues surround GPs9 role in the sickness-certification process, particularly when determining the patient9s ability to work while maintaining a healthy doctor–patient relationship. This study demonstrates the potential impact of occupational health training for GPs, particularly in light of changes to the medical statement introduced in 2010.

Work-related sickness absence negotiations: GPs' qualitative perspectives.

Aim A random sample of general practitioners (GPs), practice nurses (PNs) and practice managers (PMs) in Sheffield and Manchester was recruited into a study to evaluate the perceptions of occupational health (OH) in primary care. Methods Qualitative data were collected using focus groups with three groups of primary care sector professionals. Quantitative data were collected nationally from 295 GPs using a postal questionnaire. Results GPs and PNs had minimal OH training, and 60% of GPs reported constraints in addressing OH matters with patients. The lack of referral routes (63 and 67%, respectively) was also seen as a barrier. OH was regarded as a speciality, and primary care professionals preferred to refer patients with OH problems to specialist centres because they perceived barriers to their dealing with the issues. A total of 74% of GPs surveyed thought that speedier access to secondary care would help them to address OH problems. Conclusions This study has identified some of the problems associated with delivering OH through primary care. It also demonstrated a need for greater emphasis on OH education in medical and nurse training, and a need for better advice for GPs, PNs and PMs regarding support services for OH.

The perceptions of occupational health in primary care

Mason’s Forensic Medicine and the Law

(052) The Relationship between Sexual Empowerment and Women's Sexual Pleasure

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The perceptions of occupational health in primary care

Mason’s Forensic Medicine and the Law

(052) The Relationship between Sexual Empowerment and Women's Sexual Pleasure