Okawara Makoto, Kajiki Shigeyuki, Kusumoto Akira, Fujino Yoshihisa, Shinkai Takahiro, Morimoto Hideki, Hino Yoshiyuki, Yamashita Satoshi, Hattori Michihiro, Mori Koji
Occupational Health Training Center, University of Occupational and Environmental Health.
Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health.
Sangyo Eiseigaku Zasshi. 2018 Feb 1;60(1):1-14. doi: 10.1539/sangyoeisei.17-009-E. Epub 2017 Oct 24.
There is little specific information concerning the method and the efficacy of sharing information between occupational health physicians and psychiatrists regarding the employment status and medical history of their patients with mental illnesses. To promote cooperation between occupational health physicians and psychiatrists, we examined the points necessary to be included on medical information request forms exchanged between them.
We conducted focused group discussion (FGD) to identify the points that need to be described on the request form and the concerns in cooperation between occupational health physicians and psychiatrists. We conducted FGDs twice, with two different groups of nine psychiatrists participating in each round. We extracted and organized FGD results and determined the necessary request form points. Next, we assumed two different cases of workers with mental illnesses and created three request form templates with differing item descriptions and lengths. We also conducted a questionnaire survey among clinical psychiatrists to determine their impression of the templates. We performed logistic regression analysis on the obtained results.
On the basis of the FGD results we extracted the situation in the workplace, clarification of points to be confirmed, representation of the occupational health physician's position, and handling of information provided by the doctor as points required for the request form. On the basis of these results and the opinions of occupational health specialists, we created a new request form using these points. Additionally, the results from the questionnaire survey about the prescribed items revealed the proportion of favorable answers regarding sufficient information written on the request form and a feeling of security for information provision increased (p < 0.01). Conversely, the proportion of favorable responses for readability decreased.
Psychiatrists are concerned about the possibility that their patient may be at a disadvantageous situation by providing their personal medical information and believe the clinical information required by the occupational health physicians is unclear. This suggests that there are factors impeding the cooperation between the occupational health physicians and psychiatrists. When an occupational health physician writes a request form, cooperation with psychiatrists may be promoted by enriching the request form contents and by including the representation of the occupational health physician's position and the intended purpose of the provided information by paying attention to the volume of sentences.
关于职业健康医生与精神科医生就患有精神疾病患者的就业状况和病史共享信息的方法及效果，具体信息较少。为促进职业健康医生与精神科医生之间的合作，我们研究了他们之间交换的医疗信息申请表中应包含的必要要点。
我们进行了焦点小组讨论（FGD），以确定申请表上需要描述的要点以及职业健康医生与精神科医生合作中的关注点。我们进行了两次FGD，每组有九名不同的精神科医生参与每一轮讨论。我们提取并整理了FGD结果，确定了申请表的必要要点。接下来，我们假设了两种不同的患有精神疾病的工人案例，并创建了三个项目描述和长度不同的申请表模板。我们还对临床精神科医生进行了问卷调查，以确定他们对这些模板的印象。我们对所得结果进行了逻辑回归分析。
根据FGD结果，我们提取了工作场所情况、需确认要点的说明、职业健康医生立场的表述以及对医生提供信息的处理作为申请表所需要点。基于这些结果和职业健康专家的意见，我们使用这些要点创建了一份新的申请表。此外，关于规定项目的问卷调查结果显示，对申请表上所写信息充分性的肯定回答比例以及提供信息时的安全感有所增加（p < 0.01）。相反，可读性方面的肯定回答比例下降。
精神科医生担心患者提供个人医疗信息可能使其处于不利地位，并且认为职业健康医生所需的临床信息不明确。这表明存在阻碍职业健康医生与精神科医生合作的因素。职业健康医生在撰写申请表时，通过丰富申请表内容、包括职业健康医生立场的表述以及注意语句篇幅来明确所提供信息的目的，可能会促进与精神科医生的合作。
