Therapists' experiences and needs with regard to providing work-focused care: a focus group study.

BACKGROUND: Musculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person's ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists' experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors. METHODS: An exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the groups were audio recorded. Data were analysed using inductive thematic analysis. RESULTS: Sixteen therapists (mean age 44 years, range 25-59) participated in this study. Participants were aware of the importance of taking occupational factors into account. Whether they address occupational factors is largely dependent on the patient's request for help. However, ETs and OTs consider it normal to ask about occupational factors during the diagnostic process, while PTs often address this in later consultations. Almost all participants were unaware of the existence of PTs, OTs or ETs who are specialised in occupational health. Moreover, almost all participants struggled with when to refer a patient to other (occupational) healthcare professionals. This study identified several needs of therapists. These included knowledge about laws and legislation and skills for identifying and addressing work-related or work-relevant complaints. CONCLUSIONS: Participants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.

Workplace health in the public health perspective: policy requirements and performance indicators for Good Practice in Health, Environment, Safety and Social Management in Enterprises (GP HESSME)

The enterprises are an essential element of the national public health system. The employers, but also employees, make at work a huge number of decisions which have an influence on the quality of living and working environment, work organization and work cultures as well as on use of natural resources and ambient environment. These decisions have an impact on their own health as well as on that of their families, neighbours and customers. Good practice in workplace health is a process of continuous improvement of health, environment, safety and social performance involving partners inside and outside of an enterprise. Good practice in health, environment, safety and social management in the enterprises (GP HESSME) aims at empowering employers and employees to increase control over their own health and their family's health considering environmental, lifestyle, occupational and social health determinants. It also supports maintenance of work ability and employability by continuous vocational education and training. This document describes the main objectives, work areas and benefits of GP HESSME and history of development of this cross-sectoral and multidisciplinary approach. The main steps for introducing GP HESSME are presented, followed by the cross-sectoral policy requirements at municipal, provincial and national level. The roles of national local authorities, employers and employees and enterprises' networking are highlighted. The sets of input, process, output and outcome indicators are proposed for monitoring and to link workplace health activities with public health performance