Saliba M-L, Arnaud S, Souville M, Viau A, François G, Verger P
ORS PACA, observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
Rev Epidemiol Sante Publique. 2013 Apr;61(2):172-9. doi: 10.1016/j.respe.2012.09.003. Epub 2013 Mar 7.
Continued employment of people with health problems that reduce their ability to work is a major social issue. The French measures to optimize job retention are characterized by a multiplicity of participants, and their efficacy depends largely on the capacity of these different participants to work together. The objective of this study was to document the perceived role, attitudes and practices of participants involved in these job retention measures and of general practitioners, as well as their difficulties in this domain.
In 2009, 15 semi-directive interviews were conducted in the region of Provence-Alpes-Côte d'Azur (PACA) of occupational physicians, general practitioners, and other participants involved in the occupational reclassification of workers no longer completely fit for their job. The data collected were analyzed from a thematic perspective.
The different groups of professionals questioned agreed on the primacy of the role of the occupational physician, on the importance of early consideration of each worker's case, and on the need to work together as partners to optimize the prospects of job retention. This study nonetheless showed numerous communication difficulties between the various professionals: although informal exchanges have developed over time, the efficacy of the system seems to be limited by a lack of clarity about the role of each institution, divergences of opinions on some key points including the role of the physicians caring for the patient, and, more largely, lack of information about the tools for job retention.
The distribution of homogeneous knowledge, the development of multidisciplinary collaborative practices and the pooling of the lessons of experience between the different groups of participants are essential for the success of job retention procedures.
健康问题导致工作能力下降的人群继续就业是一个重大社会问题。法国优化工作保留的措施具有参与者众多的特点，其成效在很大程度上取决于这些不同参与者协同工作的能力。本研究的目的是记录参与这些工作保留措施的参与者以及全科医生所感知到的角色、态度和做法，以及他们在这一领域所面临的困难。
2009年，在普罗旺斯-阿尔卑斯-蓝色海岸大区（PACA）对职业医生、全科医生以及参与对不再完全适合其工作的工人进行职业重新分类的其他参与者进行了15次半指导性访谈。从主题角度对收集到的数据进行了分析。
接受询问的不同专业群体一致认为职业医生的角色至关重要，尽早考虑每个工人的情况很重要，以及需要作为合作伙伴共同努力以优化工作保留的前景。然而，本研究表明不同专业人员之间存在诸多沟通困难：尽管随着时间推移形成了非正式交流，但该系统的成效似乎受到各机构角色不明确、在一些关键点上存在意见分歧（包括照顾患者的医生的角色）以及更广泛地缺乏关于工作保留工具的信息的限制。
均匀知识的传播、多学科协作实践的发展以及不同参与者群体之间经验教训的汇集对于工作保留程序的成功至关重要。
