Bernaers Lisa, Willems Tine Marieke, Rusu Dorina, Demoulin Christophe, Van de Velde Dominique, Braeckman Lutgart
Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ) 3B3, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ) 4K3, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
J Occup Rehabil. 2025 May 7. doi: 10.1007/s10926-025-10295-2.
Low back pain (LBP) can lead to disability and sick leave, impacting work participation and overall health. Given the complex and multifactorial nature of LBP, Belgium's Federal Agency for Occupational Risks (FEDRIS) promotes a secondary prevention strategy for LBP among workers engaged in ergonomically demanding tasks. This strategy includes multidisciplinary-based rehabilitation and an optional workplace intervention (WPI), initiated upon employer request. The WPI component consists of a half-day ergonomic risk analysis at the workplace conducted by an external occupational health service. This paper is one of two parallel qualitative studies that explored the experiences and perspectives of employees and healthcare professionals (HCPs) on the secondary prevention program. The current study focuses on the optional WPI, aiming to identify its strengths, challenges, and potential solutions.
Between April 2022 and April 2023, six multicenter semistructured focus groups were held with 15 employees (2015-2019 program participants) and 24 HCPs (including external ergonomists) recruited from 11 Belgian rehabilitation centers and hospitals. Sessions were organized as employee-only, HCP-only, or mixed groups. All the interviews were anonymized, transcribed verbatim, and analyzed inductively via thematic analysis, with validation through data triangulation, intercoder checks, and participant feedback.
The analysis reveals strengths, challenges, and solutions associated with the WPI before, during, and after implementation. Before the intervention, some HCPs recognized the WPIs' benefits, but limited awareness, employer hesitancy, practicality concerns, and job security fears presumably contributed to low application rates. The proposed solutions include proactive communication, streamlined processes, and enhanced employer engagement. During implementation, strengths included improved employee engagement and interdisciplinary collaboration, but challenges related to limited integration and timing affected effectiveness. Early ergonomic assessments and better communication are suggested. After the intervention, inconsistent feedback hindered sustainability, highlighting the need for systematic follow-up and stronger organizational commitment.
The WPI provides some tangible benefits for sustainable return to work in Belgium's secondary prevention strategy for LBP, yet a few gaps remain. Low employer awareness, application hesitancy, and inconsistent follow-up hinder effective implementation. Equally, interdisciplinary collaboration and proactive ergonomic assessments are considered strengths of the WPI. Involving all key stakeholders emerges as critical for addressing practical concerns and ensuring ongoing support. Future refinements should prioritize streamlined processes, early-stage interventions, and consistent feedback.
腰痛（LBP）会导致残疾和病假，影响工作参与度和整体健康。鉴于腰痛的复杂性和多因素性质，比利时联邦职业风险机构（FEDRIS）在从事高工效学要求任务的工人中推广腰痛二级预防策略。该策略包括基于多学科的康复以及应雇主要求启动的可选工作场所干预（WPI）。WPI部分包括由外部职业健康服务机构在工作场所进行为期半天的工效学风险分析。本文是两项平行定性研究之一，探讨了员工和医疗保健专业人员（HCP）对二级预防计划的体验和看法。当前研究聚焦于可选的WPI，旨在确定其优势、挑战及潜在解决方案。
在2022年4月至2023年4月期间，与从11家比利时康复中心和医院招募的15名员工（2015 - 2019年项目参与者）和24名HCP（包括外部工效学家）举行了6次多中心半结构化焦点小组会议。会议分为仅员工组、仅HCP组或混合组。所有访谈均匿名，逐字转录，并通过主题分析进行归纳分析，通过数据三角互证、编码员间核对和参与者反馈进行验证。
分析揭示了WPI在实施前、实施期间和实施后相关的优势、挑战和解决方案。在干预前，一些HCP认识到WPI的益处，但意识有限、雇主犹豫、实用性担忧以及对工作安全的恐惧可能导致了低申请率。提出的解决方案包括积极沟通、简化流程和增强雇主参与度。在实施期间，优势包括员工参与度提高和跨学科协作，但与整合有限和时间安排相关的挑战影响了有效性。建议进行早期工效学评估和更好的沟通。在干预后，不一致的反馈阻碍了可持续性，凸显了系统跟进和更强组织承诺的必要性。
WPI在比利时腰痛二级预防策略中为可持续重返工作提供了一些切实的益处，但仍存在一些差距。雇主意识淡薄、申请犹豫和跟进不一致阻碍了有效实施。同样，跨学科协作和积极的工效学评估被视为WPI的优势。让所有关键利益相关者参与对于解决实际问题和确保持续支持至关重要。未来的改进应优先考虑简化流程、早期干预和一致的反馈。
