Department of Psychology, University of Bologna, 40127 Bologna, Italy.
Department of Psychiatry, Bologna University Hospital Authority St. Orsola-Malpighi Polyclinic IRCCS, 40138 Bologna, Italy.
Int J Environ Res Public Health. 2022 Jul 26;19(15):9098. doi: 10.3390/ijerph19159098.
This retrospective observational study investigated hospital staff requests for job fitness visits, addressed to occupational medicine. Specific objectives were to analyze: (1) health workers’ requests, sociodemographic characteristics, psychiatric diagnoses, assigned doctor’s fit notes, and (orthopedic, psychiatric) limitations; (2) associations between psychiatric diagnoses, sociodemographic (sex, age), and work-related (job, department) characteristics; (3) associations between the same psychiatric diagnoses/orthopedic limitations, fit notes, and/or psychiatric limitations. Data of St. Orsola-Malpighi Polyclinic health workers (N = 149; F = 73.8%; mean age = 48 ± 9.6 years), visited by both the occupational medicine physician and psychiatrist (January 2016−May 2019), were analyzed. 83.2% of the sample presented with at least one psychiatric diagnosis, including mood (47%), anxiety (13.4%), and anxious-depressive (10.7%) disorders. Significant differences between psychiatric diagnoses according to sex and fit notes (both p < 0.01) have been found, whereas no significant associations based on age and work-related characteristics have been observed. Analysis of frequencies of participants with the same psychiatric diagnosis (orthopedic limitation being equal), according to doctor’s fit notes and psychiatric work limitations, showed a high heterogeneity of assignments. The current occupational medicine procedure for fit notes/job limitations assignments does not allow taking into consideration clinical factors possibly associated with more specific assignments. To standardize the procedure and translate the psychiatrist’s clinical judgment into practice, further studies to test the usefulness of clinimetrics, which might represent a reliable approach in considering different fit notes and job limitations, are needed.
这项回顾性观察研究调查了医院工作人员向职业医学提出的工作适应性检查请求。具体目标是分析：（1）卫生工作者的请求、社会人口统计学特征、精神科诊断、指定医生的适应报告和（骨科、精神科）限制；（2）精神科诊断、社会人口统计学（性别、年龄）和与工作相关的（工作、部门）特征之间的关联；（3）同一精神科诊断/骨科限制、适应报告和/或精神科限制之间的关联。分析了圣奥尔索拉-马尔皮吉综合医院卫生工作者（N = 149；F = 73.8%；平均年龄为 48 ± 9.6 岁）的数据，这些工作者在 2016 年 1 月至 2019 年 5 月期间同时接受了职业医学医生和精神科医生的检查。83.2%的样本至少有一个精神科诊断，包括情绪（47%）、焦虑（13.4%）和焦虑抑郁（10.7%）障碍。根据性别和适应报告（均 p < 0.01）发现了精神科诊断之间的显著差异，而根据年龄和与工作相关的特征则没有观察到显著关联。根据医生的适应报告和精神科工作限制，分析具有相同精神科诊断（骨科限制相同）的参与者的频率，显示出分配的高度异质性。目前的职业医学适应报告/工作限制分配程序不允许考虑可能与更具体分配相关的临床因素。为了使该程序标准化并将精神科医生的临床判断转化为实践，需要进一步研究以测试临床计量学的有用性，这可能是考虑不同适应报告和工作限制的可靠方法。
