Presentation M P33

M P33 (Poster Presentation):
Job restrictions for healthcare workers: Consequences from the managers' viewpoint

Presented by: Jean-Baptiste Fassier

Authors

Fassier JB1,2,3, Grataloup M1, Bergeret A1,2, Irma Study Group

  1. UMRESTTE, Université Claude Bernard Lyon 1, Lyon, France
  2. Hospices Civils de Lyon, Occupational health and medicine department, Lyon, France
  3. CAPRIT, Ecole de réadaptation, Université de Sherbrooke, Qc, Canada

Abstract

Background

Healthcare workers in France undergo periodic medical examinations by occupational physicians (OPs). Fitness for work is evaluated by OPs on the basis of the medical condition of the worker and the job requirements. In the case of workers diagnosed with musculoskeletal disorders (back pain, upper limb), job restrictions to manual handling of loads and/or repetitive movements are commonly granted in order to protect workers’ health. However, such restrictions are likely to have negative consequences on colleagues and managers. Furthermore, OPs professional practices have been reported to vary from one OP to another. The aim of this study was to describe the consequences of job restrictions for healthcare workers with musculoskeletal disorders, from the managers' viewpoint.

Methods

Qualitative methods applied to health services research were used. The study was conducted in a large university hospitals consortium in the Rhône-Alpes region of France (23,000 workers; 12 OPs). Study participants were clinical managers (nurses) having one (or more) worker with job restrictions to manual handling of loads and/or repetitive movements. Managers were identified by the OPs and gave their informed consent to participate in a focus group with other managers. Six focus groups were conducted in three different hospitals. A discussion guide was prepared with the following themes: experience of job restrictions as a manager, relations with the OP, relations with other actors (administration, etc.), relations with the worker having restrictions, relations with fellow workers. Focus groups were conducted by two persons, audiotaped and transcribed verbatim. Thematic qualitative content analyses were conducted with MAXQDA software v11. Coding proceeded both deductively from the categories of the discussion guide, and inductively in order to account for all the data collected.

Results

It was possible to identify in the managers’ discourse what are positive or negative outcomes, as a result of job restrictions. Factors associated with both positive and negative outcomes were identified. The consequences of job restrictions were shaped in the interactions between the worker, the manager, the co-workers and the OP. The quality of the interactions was highly variable and paramount to ensure positive outcomes associated with job restrictions.

Conclusions

Job restrictions are far more than a simple prescription from the OP or an entitlement for the worker. They are a complex social process which outcomes rely on the quality of interactions between the actors. As such, some quality indicators could be proposed to ease the process and evaluate collaboration practices of both OPs, managers and workers with job restrictions.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: Workplace