Abstract Introduction In Belgium, 500.000 employees are on long-term sick leave. Legislation recently changed to increase the employment rate. Adapted work must be proposed for all Return To Work ...(RTW) trajectories without medical contraindications. For the Determination of final incapacity (DFI) a new procedure is introduced. Objectives Comparison of RTW trajectories carried out by a large Occupational Health Service in 2022 (Q1) to those in 2023 (Q1). Methods 815 RTW Trajectories of 2022 (37.5% for mental disorders, 29.7% for musculoskeletal problems) and 143 Trajectories of 2023 (37.5% mental, 29.7% musculoskeletal problems), were analyzed descriptively. Results of 397 DFI trajectories were also analyzed – 28.7% for mental, 28.5% for musculoskeletal problems. Results and discussion In 2022 (Q1), the occupational physician allows RTW after job adjustments for 30.3% of the employees. Re-integration was more successful for musculoskeletal disorders (36% allowed adapted work) compared to mental problems (23.2%) (p=0.001). In 2023 (Q1), after the new legislation, adapted work was possible for 59.4% (65.5% when musculoskeletal problems versus 53.7% when mental reasons) (p=NS). In DFI trajectories, 87.6% was definitively unfit for the job (87.7% when mental and 88.4% when musculoskeletal problems) – 6.5% of the employees asked for adapted work (2.6% when a mental disorder and 8.8% when musculoskeletal problems) (p=0.05). Conclusion The adjustments in the RTW legislation caused a significant decrease in RTW trajectories. There is a higher demand for adapted work in case of musculoskeletal problems versus mental problems. Early guidance to re-employment into a more suitable job is necessary to increase the employment rate in Belgium.
Burnout is a work-related mental health problem and may cause long-term sickness absence. Return-to-work interventions for burned-out people on sick leave aim to prevent long-term work disability. ...Based on a systematic literature review and focus groups with professionals we made a care pathway that supports return to work for sick-listed people with burnout. This multidisciplinary care pathway contains three essential elements: 1) cooperation between a general practitioner (GP) and a psychologist to correctly diagnose burnout 2) quick referral to a psychologist after start of sickness absence and 3) efficient communication between all stakeholders (including the insurance physician and the occupational physician). The aim of this study is to undertake a process evaluation of the care pathway to assess its feasibility and acceptability.
This study is a cluster-randomised feasibility trial, with an embedded process evaluation. Fifty-one general practices and 50 burned-out patients were recruited. Thirty-five patients received the care pathway (intervention group) and 15 patients received care as usual (control group). We used a mixed-Methods: approach: we collected demographic data, logbooks, questionnaires, verbal feedback and conducted semi-structured interviews with patients, GPs and psychologists. The Medical Research Council Framework was used as a guideline to analyze context, reach, dose delivered and dose received of the care pathway.
Patients and GPs are of the opinion that the care pathway can support communication between different care givers (e.g. GP, insurance physician, occupational physician). Patients allow GPs to share information with insurance/occupational physicians because they believe this potentially facilitates their return to work. However, GPs do not often share information with insurance/occupational physicians: they forget to share information, lack of time, they don’t know how to contact the insurance/occupational physician.
These findings give insight in the communication between different stakeholders, and can be used to further adjust the care pathway.
In the original publication of this article 1 the author Marc Du Bois was omitted. In this correction article the author and the corresponding details are provided. The publisher apologizes to the ...readers and authors for the inconvenience.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Introduction Within the Belgian context, a lot is known about the well-being and the work-related psychosocial risks for employees. However, we know less about the work-related well-being ...and psychosocial risks of the self-employed. The aim of this study was to develop and validate a holistic job – life demands – resources model to measure risk factors and well-being outcomes specific to the self-employed. Methods We tested this model in a cross-sectional online study with 4358 self-employed participants. To test the relationship between different risk factors and well-being indicators, we used correlation and regression analyses. To examine socio-demographic differences (e.g., gender, age, sector) in both risk factors and well-being indicators, we used Chi-square tests. The analyses were performed in SPSS. Results As expected, we found significant positive relationships between job resources (e.g., recognition) and well-being indicators (e.g., passion for the job), and between job demands (e.g., financial insecurity) and ill-being indicators (e.g., rumination) and significant negative relationships between job resources and ill-being indicators and job demands and well-being indicators. Also as expected, we found several significant differences in job demands – resources and well- and ill-being indicators based on characteristics such as gender, age and sector. Discussion Further research may validate this model in other national contexts. Also, longitudinal studies may shed light on the causal relationship between risk factors and well-being. Conclusion We found evidence for a holistic job – life demands – resources model for the self-employed. The findings from our study may inform programs and campaigns to foster the well-being of the self-employed.
Abstract Introduction Burnout is a work-related mental health problem and causes long-term work disability. Return-to-work interventions for burned-out employees aim to prevent long-term work ...disability. Research on the effectiveness of return-to-work interventions for burned-out employees shows inconclusive results due to heterogeneity of study population and intervention type (person-directed, workplace-directed). This study aims 1) to synthesize qualitative research evidence perceptions and experiences regarding return-to-work interventions and 2) to identify hypotheses about why some return-to-work interventions are more effective than others. Methods We conducted a systematic search of PubMed, Embase and CINAHL from January 2000 to June 2023. We searched for qualitative or mixed methods studies that included qualitative findings on the experiences and perspectives of people with burnout, care givers, employers or other stakeholders on return-to-work interventions. We identified factors influencing effectiveness of return-to-work interventions using a framework thematic synthesis approach. We assessed the methodological limitations of included studies using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. Results We identified 481 articles after removal of all duplicates. Twelve studies met inclusion criteria and we identified 3 key themes: 1) Burned-out people think the support of health professionals and their family promotes the return-to-work process 2) Adaptations in the workplace are considered to be essential by burned-out patients and line managers 3) Communication between all stakeholders is needed to prepare return to work. Discussion Stakeholders from different domains need to be involved in the return-to-work process of burned-out people. Conclusion An effective return-to-work intervention supports communication between health professionals, the workplace and burned-out people..
Abstract Introduction With the impact of Covid-19, maintaining good air quality in workplaces has become essential for employee well-being. Occupational Health Services (OHS), including IDEWE, play a ...significant role in assessing implementation of prevention policies within companies. This study presents the results of air quality improvement measures in small to medium-sized enterprises (SMEs). Methods Between January 1, 2022 and April 1, 2023, IDEWE reference nurses or prevention advisors conducted 15,015 air quality assessments during company visits, assisting employers in implementing Well-being -at-Work recommendations. Results and discussion The findings indicate that 53% of SMEs regulated air quality through mechanical ventilation, with offices being the primary users (61.2%). SMEs made good use of natural ventilation and aeration, especially in nurseries (98.1%), industry (96.8%), and education (93.3%). 40.7% of SMEs use CO2 meters to measure, monitor, and adjust air quality. Education (79.7%), elderly care (65.9%), nurseries (66.7%), and hairdressing salons (66.2%) were the sectors with highest usage of CO2 meters. The use of air purifiers remained relatively low (11.4%), with hairdressers having the highest percentage of usage (22%). Encouragingly, 86.3% of employers took measures to educate their employees about the importance of ventilation, and all nurseries visited responded positively to this aspect. However, only 49.1% of SMEs demonstrated a comprehensive implementation plan incorporating all identified measures to ensure good air quality. Conclusion this study highlights the prevailing ventilation practices in Belgian SMEs and emphasizes their efforts to achieve good air quality. Nevertheless, further improvement is needed in the form of a comprehensive implementation plan.
Background
Long-term sickness absence is a growing concern in Belgium and other European countries. Since 2017, Belgian physicians of the sickness funding organisations are required to assess the ...re-integration possibilities within the first two months of sickness absence. Given the shortage of physicians in the assessment of work disability and the growing number of people in sickness absence, there is a need for a triage tool, allowing to assign return-to work support to patients having a high-risk profile not to resume work.
Methods/design
The current study comprises a comprehensive validation process of a screening tool that supports Belgian physicians in guiding people back to work. The study consists of a theoretical construct validation (face validity and content validity), and an empirical construct validation (concurrence validity, factorial validity, predictive validity, hypothesis testing validity and known- group validity).
Expected impact of the study for Public Health
The screening instrument assessing the risk for long-term sickness absence is a tool developed to support physicians who work for sickness funds and for occupational health and safety organisations. Both professionals play an important role in the return to work process and the prevention of long-term sickness absence. The screening tool aims at making a distinction between people who will resume their work independently and people who will need support to do so. Generation of this prediction model will help physicians to focus effort and resources in the high-risk group. Results may also help understand the relationship between the biopsychosocial model and long-term sick-leave.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
In a prospective descriptive laboratory study, 25 Helping Hand(™) (HH) (10 without and 15 with reminder system) and 50 Medication Event Monitoring Systems (MEMS) (25 with 18-month and 25 with 2-year ...battery life) were manipulated twice daily following a predefined protocol during 3 consecutive weeks. Accuracy was determined using the fixed manipulation scheme as the reference. Perfect functioning (i.e., total absence of missing registrations and/or overregistrations) was observed in 70% of the HH without, 87% of the HH with reminder, 20% MEMS with 18 months, and 100% with 2-year battery life respectively.
Burnout is a work-related mental health problem that often causes long-term sickness absence. Return-to-work (RTW) interventions for burned-out sick-listed employees aim to prevent long-term work ...disability. This systematic review addresses two questions: (1) Which interventions for burned-out sick-listed employees have been studied?; (2) What is the effect of these interventions on RTW?We performed a systematic literature review and searched PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL and Web of Science from 1 January 2000 to 31 December 2022. We searched for articles of interventions for burned-out sick-listed employees. We conducted the review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Outcome was RTW.We identified 2160 articles after removal of all duplicates. Eight studies met inclusion criteria. RTW outcomes were number of sick-leave days, sick-leave rates, median period of RTW and worked hours per week. Five studies described person-directed interventions, one described a workplace-directed intervention, one described a combination of both intervention types and one study described all three types of intervention. Only the workplace-directed intervention showed a significant improvement in RTW compared with the comparator group: at 18-month follow-up, 89% of the intervention group had returned to work compared with 73% of the comparator group.Only a limited number of studies have explored interventions specifically focused on burned-out sick-listed employees and the effect on RTW. Due to heterogeneity and moderate to high risk of bias of these studies, no firm conclusions can be drawn on the described interventions and their effect on RTW.The study was registered with the International prospective register of systematic reviews (PROSPERO, registration number: CRD42018089155).
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