Occupational physicians’ perceived barriers and suggested solutions to improve adherence to a guideline on mental health problems: analysis of a peer group training

Abstract

BackgroundDespite the impact of mental health problems on sickness absence, only few occupational health guidelines addressing these problems are available. Moreover, adherence has found to be suboptimal. To improve adherence to the Dutch guideline on mental health problems a training was developed for Dutch occupational physicians (OPs) focusing on identifying barriers and addressing them. The aim of this study was to provide an overview of the barriers that OPs perceived in adhering to the Dutch guideline on mental health problems as well as their solutions to overcome them.MethodsA qualitative study was conducted using data from the peer group training. Thirty-two (6 groups of 4 to 6) OPs received a multiple-session interactive training over the course of a year, focusing on identifying and addressing barriers, using a Plan-Do-Check-Act approach. Sessions were audio-taped and transcribed verbatim. Thematic content analysis was performed by two researchers with a selection of 50 % (21 out of 42) of the transcripts to identify the perceived barriers and the suggested solutions, using AtlasTi 7.0.ResultsKnowledge-related barriers were perceived regarding the content of all parts of the guideline. Commonly perceived attitude-related barriers were a lack of self-efficacy to perform certain guideline recommendations and difficulties with changing habits and routines. External barriers that were commonly perceived were work-contextual barriers, such as a lack of time/work pressure, tight contracts between occupational health services (OHSs) and employers, and conflicting policy of and a lack of collaboration with other parties (e.g. employer, other healthcare providers). The most often tested solutions by OPs during the training were sharing information, experiences, tips and tricks and referring to existing tools, or developing new tools to facilitate guideline usage.ConclusionsDutch OPs perceive a range of knowledge-related, attitude-related and external barriers in adhering to the guideline on mental health problems. The tested solutions during the training particularly seemed to focus on knowledge and attitude-related barriers. To optimally implement this or similar mental health guidelines, it may be important to complement guideline training and education of individual or groups of OPs, with interventions that address external barriers such as changing tight contracts, or improving communication and collaboration with other parties.

“Acquired brain injury and return to work”: the feasibility of a training program for insurance physicians

“…reported in other studies [13,15,17,18] and should be addressed when implementing the program more broadly. With regard to "lack of time," for example, the short duration of the training program makes it feasible; a relatively limited amount of time is required to attend the training program.…”

“…Although adherence to guidelines allows for evidence-based best practice and has been shown to improve quality of care [13,14], implementing new guidelines is still challenging [15,16]. Numerous studies have revealed barriers at the organizational, patient or professional level, such as lack of knowledge on the part of individual healthcare physicians [13,15,17,18]. A range of approaches can be taken to address these knowledge gaps, such as educational interventions [13,19,20].…”

Welke barrières ervaren bedrijfsartsen bij het gebruik van de richtlijn Psychische problemen?

“…Vervolgens werden deze letterlijk uitgeschreven en door twee onderzoekers met behulp van het kwalita tieve softwareprogramma Atlas.ti geanalyseerd. 10 Er werd gekozen om in eerste instantie 50% van de transcripten kwalitatief te analyseren en vervolgens na te gaan of er geen nieuwe inzichten meer werden bereikt (ofwel of er datasaturatie was bereikt, in termen van kwalitatief onderzoek). Dit bleek inderdaad het geval; de overlap in barrières en oplossingen was groot.…”

“…Meer gede tailleerde informatie over de analyses is te vinden in het Engelstalige artikel. 10 Resultaten De 31 bedrijfsartsen volgden alle acht bijeenkomsten van de training. Zes bedrijfsartsen konden één keer niet aanwezig zijn en haalden deze bijeenkomst in een andere trainingsgroep in.…”

Perspectives of mental healthcare providers on pathways to improved employment for persons with mental disorders in two lower middle-income countries

“…Their provision of care and support is pivotal to recovery and the ability to work [9,11]. In the work environment, occupational health physicians and therapists also contribute to workers' health and wellbeing by providing advice on mental health care and promotion [12][13][14][15]. A study using the Delphi method by Dekkers-Sánchez and colleagues suggest that occupational physicians and rehabilitations physicians have relevant role in work retention and return to work of employees [11].…”