[Structure of Relationships Formed by Occupational Health Nurses for Co-operating with Managers to Support Workers with Mental Health Concerns].

OBJECTIVE: Occupational health staff and managers play important roles in supporting workers with mental health concerns and mutual co-operation among them is a necessary element. However, when co-operating with other professionals, several problems arise that often make such co-operation a challenge. Effective mutual actions are needed to promote such co-operation, and relationships must be formed for this purpose. Therefore, in this study, we aimed to clarify how occupational health nurses form relationships for facilitating co-operation with managers to provide support to workers with mental health concerns. METHODS: Data were collected using semi-structured interviews with 11 occupational health nurses who provide individualized mental health support and who have at least 5 years of experience as occupational health nurses. Analysis of the recorded interviews was performed using a qualitative statistical method (KJ method). RESULTS: Six elements that constitute the formation of relationships were identified. When occupational health nurses form relationships for facilitating co-operation with a manager to provide support to workers, they "form relationships through strategic communication" with them and when co-operation is required, they form a relationship by "acting in a manner that suits the manager," such as his/her character and the situation. To support this relationship, occupational health nurses "provide mental support to the manager" by listening to his/her anxiety or real intention about supporting the subordinate with mental health concerns and provide relief while understanding their burdens during the co-operation. Occupational health nurses even "provide support to the manager in their activities," which assessed the situation at the workplace as the specialist and advised the manager to understand how to concern to the subordinate specifically. In addition, they "indirectly support the manager" which included coordinating with the concerned persons so as to not excessively burden the manager. Such support promoted the "creation of systems for clear roles" of managers in supporting the subordinate with mental health concerns. DISCUSSIONS: Relationships that occupational health nurses form with their managers were the structure which formed emotional human relationships from the front or back necessity of co-operation causes and developing confidence in relationships with the foundation of emotional human relationships.

Competencies required for occupational health nurses.

OBJECTIVES: For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. METHODS: Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. RESULTS: Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. CONCLUSION: Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer.

The structure of occupational health nurses' support for return-to-work to workers with depression.

OBJECTIVES: The present study aimed to explore the structure of occupational health nurses' support for return-to-work to workers with depression. METHODS: Semi-structured interviews were conducted with 10 occupational health nurses who support workers returning to work. Data were analyzed using the Modified Grounded Theory Approach. RESULTS: The qualitatively analyzed data was grouped into 9 categories. The support for return-to-work was divided into 3 periods: (1) the first priority for recovery, (2) preparation for return-to-work, and (3) adaptation to work. There were indirect supports to workers such as "environmental arrangement for medical treatment," "connection," and "support form parties concerned about workers," and direct supports such as "readiness for medical treatment," "overcoming social and psychological problems," and "working life independence. " Direct support was facilitated by "construction of the relationship. " The occupational health nurses' philosophy was to support "profitable return-to-work for both the worker and the employer. " These processes were "support of confidence recovery process " to regain confidence lost through absence from work because of depression and to accomplish a smooth return-to-work. DISCUSSION: There were problems in each period corresponding to the return-to-work conditions, and occupational health nurses supported the employees in overcoming each problem. Moreover, it was said that cooperation with the parties concerned in the office would greatly influence the success or failure in the return-to-work support, and it was thought that direct supports and indirect supports to employees with respect to adjustment with the parties concerned in the office were necessary. CONCLUSIONS: The structure of occupational health nurses' supports was to support the confidence recovery process of workers by indirect and direct support at each period of return-to-work.