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保险医师在抑郁障碍工作能力评估中使用检查表的促进因素和障碍。

Facilitators and Barriers in the Use of a Checklist by Insurance Physicians during Work Ability Assessments in Depressive Disorder.

机构信息

Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Saf Health Work. 2011 Dec;2(4):328-35. doi: 10.5491/SHAW.2011.2.4.328. Epub 2011 Dec 5.

Abstract

OBJECTIVES

Depressive disorder (DD) is a complex disease, and the assessment of work ability in patients with DD is also complicated. The checklist depression (CDp) has recently been developed to support such work ability assessments and has been recommended for implementation in insurance medicine, starting with an analysis of the organisational and social contexts. The aim of this study was to identify the potential facilitators and barriers in the use of the CDp by insurance physicians (IPs) during work ability assessments of employees on sick leave due to DD.

METHODS

A qualitative research was conducted based on semi-structured interviews. The participants were IPs with at least one year of work experience in performing work ability assessments. The interviews were audiotaped, transcribed and analysed qualitatively.

RESULTS

Ten IPs (7 males, 3 females; mean 53 years) were interviewed. Important facilitators, which emerged for use of the CDp, were an oral introduction for colleagues and staff, support from management, valuing the increased transparency in work ability assessments with using the CDp, having adequate time for assessments as well as modification of the appearance (colour, plasticised form) and content (clarifying aspects of the examples) of the assessment tool. The fear of the loss of autonomy, lack of added value of the CDp, high workload, inadequate instructions and lack of time were mentioned as barriers.

CONCLUSION

Adequate introduction to the use of CDp and the fear of the loss of autonomy of IPs need special attention in planning its implementation.

摘要

目的

抑郁障碍(DD)是一种复杂的疾病,评估 DD 患者的工作能力也很复杂。清单型抑郁评估量表(CDp)最近被开发出来,以支持这种工作能力评估,并已被推荐在保险医学中实施,首先要对组织和社会背景进行分析。本研究的目的是确定在对因 DD 休病假的员工进行工作能力评估时,保险医师(IP)使用 CDp 的潜在促进因素和障碍。

方法

本研究基于半结构式访谈进行了定性研究。参与者为具有至少一年进行工作能力评估工作经验的 IP。对访谈进行了录音、转录和定性分析。

结果

共对 10 名 IP(7 名男性,3 名女性;平均年龄 53 岁)进行了访谈。在使用 CDp 时,出现了一些重要的促进因素,包括向同事和员工进行口头介绍、管理层的支持、重视使用 CDp 提高工作能力评估的透明度、有足够的评估时间以及对评估工具的外观(颜色、塑料形式)和内容(澄清示例的各个方面)进行修改。提到的障碍包括对自主权丧失的恐惧、CDp 没有附加值、工作量大、说明不足以及缺乏时间。

结论

在规划实施 CDp 时,需要特别注意对 IP 使用 CDp 的充分介绍和对自主权丧失的恐惧。

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