GP’s engagement in detecting and managing abuse of alcohol, illegal drugs, hypnotics and tranquilizers in the Belgian adult population
Ketterer, Frédéric ; ; et al
in European Journal of General Practice (2013, September), 19(3), 162-184
Background General practitioners (GPs) Occupational physicians (OPs) can play an important role in detecting and managing substance abuse in the working population. The UP TO DATE project aims at ... [more ▼]
Background General practitioners (GPs) Occupational physicians (OPs) can play an important role in detecting and managing substance abuse in the working population. The UP TO DATE project aims at identifying the difficulties these professionals encounter in this area, and to explore ways of collaboration in providing appropriate care. Research question What are the experiences, attitudes and decision making of GPs and OPs regarding to alcohol, illegal drugs, hypnotics and tranquilizers abuse from a physician’s perspective? Method In this qualitative study, with a phenomenological perspective, 20 GPs and 16 OPs, experienced with substance abuse in daily practice, got a face to face in-depth interview. (October until December 2012). Along with the data collection process the analysis started with a constant comparison between the data and the chosen integrated model of change (De Vries), using coding techniques of grounded theory. Results GPs meet important barriers to detect misuse of all substances. To address this issue and the patient’s motivation for change, the doctor-patient relationship is crucial. The risk to disturb the relationship, and loose the patient’s trust, is a major concern. An attitude of patient-centeredness, collaboration and empowerment of the patient is needed to make any progress, to get results and to overcome as a GP the burden of those demanding encounters. Self-care is an important concern. Collaboration with specialised health providers confronted GPs with various problems: not enough services, long waiting lists, unclear methods and criteria. GPs lack an insight in the OP’s role, and experience problems to contact them. Whether the OP is a trustful health advocate for their patient is a major concern. Some OPs are perceived too linked to the employer, raising legitimate concerns about professional confidentiality. Conclusion These are preliminary results. At the conference, a comprehensive overview on the qualitative analysis will be given. [less ▲]Detailed reference viewed: 52 (19 ULg)
De la prévention des risques professionnels au développement de la santé dans les organisations
Conference (2013, August 29)Detailed reference viewed: 19 (4 ULg)
Les critères diagnostiques de l’épuisement professionnel en vue d’un dépistage réalisé par des professionnels de la santé
DE CIA, Julie ; ; et al
in Zawieja, Philippe; Guarnieri, Frank (Eds.) Epuisement Professionnel : approches innovantes et pluridisciplinaires (2013)Detailed reference viewed: 138 (40 ULg)
Validation des propositions issues du projet sur l'amélioration de la collaboration entre le médecin généraliste et les médecins conseils et les médecins du travail pour une meilleure prise en charge des pathologies d'origine professionnelle
Mairiaux, Philippe ; Govers, Patrick ; Schippers, Nathalie et al
Report (2013)Detailed reference viewed: 17 (6 ULg)
Bien-Etre au travail et santé mentale - enquête parmi les travailleurs de la Confédération luxembourgeoise du Commerce
Mairiaux, Philippe ; Schippers, Nathalie ; Donneau, Anne-Françoise
Conference given outside the academic context (2013)Detailed reference viewed: 27 (4 ULg)
Introduction to Symposium on Socio-political Challenges in Work Disability Prevention
; ; Mairiaux, Philippe
Conference (2013, June 12)Detailed reference viewed: 6 (1 ULg)
Three cases of structural and procedural barriers to return to work in the Belgian health system.
Conference (2013, June 12)
Three cases of structural and procedural barriers to RTW in the Belgian health system • Access to “part-time return to work”: past (before 2013) and present procedures; which improvements are brought by ... [more ▼]
Three cases of structural and procedural barriers to RTW in the Belgian health system • Access to “part-time return to work”: past (before 2013) and present procedures; which improvements are brought by the regulation change effective in April 2013? • “Pre-return to work visit” by the occupational physician: theoretical advantages of this visit introduced in the labour law in 2004; why is it poorly implemented? what are the actual barriers to access it? what changes should be brought to lower the access threshold? • How to implement in the Belgian system a procedure of therapeutic RTW like the Quebec RTT system (a period of trial RTW without productivity requirements and with no costs to the employer)? Exercise case to be solved by the WDP trainees. Reference: Mairiaux et al. National study report on return to work after a long sickness absence (in Dutch): http://www.werk.belgie.be/moduleDefault.aspx?id=37079 [less ▲]Detailed reference viewed: 8 (2 ULg)
La santé des indépendants : qui s'en préoccupe vraiment ? "L'enquête et ses principaux résultats"
Speech (2013)Detailed reference viewed: 7 (1 ULg)
Work ability assessment in a worker population : comparison and determinants of Work Ability index and Work Ability score
; ; et al
in BMC Public Health (2013), 13
Background Public authorities in European countries are paying increasing attention to the promotion of work ability throughout working life and the best method to monitor work ability in populations of ... [more ▼]
Background Public authorities in European countries are paying increasing attention to the promotion of work ability throughout working life and the best method to monitor work ability in populations of workers is becoming a significant question. The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI), a 7-item questionnaire, with another one based on the use of WAI’s first item, which consists in the worker’s self-assessment of his/her current work ability level as opposed to his/her lifetime best, this single question being termed “Work Ability score” (WAS). Methods Using a database created by an occupational health service, the study intends to answer the following questions: could the assessment of work ability be based on a single-item measure and which are the variables significantly associated with self-reported work ability among those systematically recorded by the occupational physician during health examinations? A logistic regression model was used in order to estimate the probability of observing “poor” or “moderate” WAI levels depending on age, gender, body mass index, smoking status, position held, firm size and diseases reported by the worker in a population of workers aged 40 to 65 and examined between January 2006 and June 2010 (n=12389). Results The convergent validity between WAS and WAI was statistically significant (rs=0.63). In the multivariable model, age (p<0.001), reported diseases (OR=1.13, 95%CI [1.11-1.15]) and holding a position mostly characterized by physical activity (OR=1.67, 95%CI [1.49-1.87]) increased the probability of reporting moderate or poor work ability. A work position characterized by the predominance of mental activity (OR=0.71, 95%CI [0.61-0.84]) had a favourable impact on work ability. These relations were observed regardless of the work ability measurement tool used. Conclusion The convergent validity and the similarity in results between WAI and WAS observed in a large population of employed workers should thus foster the use of WAS for systematic screening of work ability. Ageing, overweight, decline in health status, holding a mostly physical job and working in a large-sized firm increase the risk of presenting moderate or poor work ability. [less ▲]Detailed reference viewed: 32 (5 ULg)
Retour au travail après une absence de longue durée : quels enjeux pour l'ergonomie ?
Conference (2013, March 26)Detailed reference viewed: 14 (1 ULg)
Trois cas cliniques d'atteinte de la coiffe des rotateurs : interaction entre l'activité professionnelle et la taille du patient.
Pirenne, Danièle ; Mairiaux, Philippe
in Presse Médicale (2013), 42(10), 1418-1420Detailed reference viewed: 19 (5 ULg)
Recherche sur le burn-out en Belgique
Hansez, Isabelle ; DE CIA, Julie ; Angenot, Arnaud et al
Le burn-out représente un réel problème avec des conséquences lourdes pour la santé des travailleurs, les entreprises et la société. C’est pourquoi le Service Public Fédéral Emploi, Travail et ... [more ▼]
Le burn-out représente un réel problème avec des conséquences lourdes pour la santé des travailleurs, les entreprises et la société. C’est pourquoi le Service Public Fédéral Emploi, Travail et Concertation sociale ainsi que le Fonds social européen ont décidé de soutenir un programme de recherche sur le burn-out (l’épuisement professionnel) en Belgique. La méthodologie du projet se déclinait en deux objectifs : - mettre au point un outil de détection précoce du burn-out permettant d’en détecter les signes avant-coureurs ; - mettre en évidence des pistes de recommandation pour la prévention primaire, secondaire et tertiaire : répertorier les mesures de prévention existantes (‘bonnes pratiques’) pour pouvoir agir sur l’organisation du travail et éviter le burn-out et enfin, fournir des conseils pour le retour au travail d’une personne qui a eu une incapacité de travail en raison d’un burn-out. Ce travail s’appuyait bien évidemment sur la précédente recherche commanditée par le SPF Emploi en 2009-2010 mais aussi sur d’autres travaux, tels que la recherche sur la prévention et la prise en charge du burn-out chez les médecins généralistes (KCE, 2011). [less ▲]Detailed reference viewed: 82 (11 ULg)
Etude rétrospective de 438 salariés diabétiques dans un service interentreprises luxembourgeois de santé au travail - Enquête sur la relation entre la maladie diabétique et la survenue d'une décision d'inaptitude, d'un arrêt maladie prolongé ou d'un accident de travail.
; Mairiaux, Philippe ;
in Archives des Maladies Professionnelles et de l'Environnement (2013), 74(4), 352-358
A retrospective study was carried out from October 2004 until September 2006 in a Luxembourger occupational health service. The purposes of the medical checks performed during this period of time were ... [more ▼]
A retrospective study was carried out from October 2004 until September 2006 in a Luxembourger occupational health service. The purposes of the medical checks performed during this period of time were analysed as well as the related decision of occupational health practitioners. A total of 28244 persons attended the medical checks thereof 438 had diabetes (diabetes mellitus type 1 and type 2). The risk of being declared unfit for a job was compared in workers populations with and without diabetes. The probabilities to consult an occupational practitioner after a long-time sick leave (more than 6 weeks long) or after an accident at work were also compared in both workers populations. The Woolf’s method was used to adjust all odds ratios for age and sex. The proportions of persons with diabetes appear similar to those found by age in the general population, however the risk of being declared unfit for a job was significantly higher for persons with diabetic than for non-diabetic persons (OR=3.14 ; 95% CI [2.30 - 4.28]). In 84% cases, diabetes wasn’t the only cause of unfitness (comorbidities, vascular complications…). Diabetes represented a higher risk of a long time sick leave (OR=1.99 ; 95% CI [1.44 - 2.77]), but it didn’t lead to an significant risk of accident at work (OR=1.92 ; 95% CI [0.94 - 2.26]). Our results suggest that several employees with diabetes seemed to be restricted from certain jobs or couldn’t maintain their jobs. Most often, the occupational practitioners decisions were not solely justified by the diabetes but by the coexistence of complications or comorbidities. This last argument, associated with an increased risk to be on sick leave for a long period, stresses the importance of the preventive actions in diabetes. However, the prejudice of a higher risk of occupational accidents due to diabetics seems unfounded. [less ▲]Detailed reference viewed: 28 (6 ULg)
A review of guidelines for collaboration in substance misuse management
; ; Vanmeerbeek, Marc et al
in Occupational Medicine (2013), 63(6), 445-447
Background: Substance abuse among the working population results in increasing economic costs. General practitioners (GP) and occupational physicians (OP) can play a central role in detecting and managing ... [more ▼]
Background: Substance abuse among the working population results in increasing economic costs. General practitioners (GP) and occupational physicians (OP) can play a central role in detecting and managing substance abuse in the working population. Their collaboration could be critical in coordinating care, in facilitating rehabilitation and in reducing sick leave. Aims: To search in guidelines for evidence on collaboration between GPs and OPs in substance abuse detection and management in the working population. Methods: International guidelines regarding collaborative care for alcohol abuse, illicit drug use and hypnotics and tranquilizers were identified by a systematic search in the Guidelines International Network (GIN) and US National Guidelines Clearinghouse (NGC) databases. Results: In total 20 guidelines were considered of sufficient methodological quality, based on criteria of the Appraisal of Guidelines for Research and Education (AGREE) II instrument. Only two guidelines reported on the OP’s role in screening and intervention for alcohol abuse. Conclusion: There is a lack of evidence on the OP’s role and on collaboration between GPs and OPs. We recommend studying their respective roles in substance abuse management, the effectiveness of workplace interventions, pros and cons of collaboration as well as the best way to achieve this if recommended. [less ▲]Detailed reference viewed: 51 (9 ULg)
Retour au travail après une absence de longue durée : Comment dynamiser le dispositif légal existant ?
in DAVAGLE, MICHEL (Ed.) Le maintien au travail de travailleurs devenus partiellement inaptes (2013)Detailed reference viewed: 41 (7 ULg)
Retour au travail après une absence de longue durée : le défi du transfert de l'évidence scientifique au système de santé belge
Conference (2012, December 03)Detailed reference viewed: 17 (1 ULg)
Audit de la Santé au Travail au Grand Duché du Luxembourg
Mairiaux, Philippe ; Levêque, Audrey ; Pichault, François
Report (2012)Detailed reference viewed: 45 (2 ULg)
Quels patients risquent de ne pas reprendre le travail ?
Conference (2012, November 17)Detailed reference viewed: 27 (2 ULg)