SANGYO EISEIGAKU ZASSHI
Online ISSN : 1349-533X
Print ISSN : 1341-0725
ISSN-L : 1341-0725
Volume 54, Issue 6
Displaying 1-3 of 3 articles from this issue
Original
  • Yoshihisa FUJINO, Naoki TAKAHASHI, Tomoko YOKOGAWA, Kotaro KAYASHIMA, ...
    2012 Volume 54 Issue 6 Pages 267-275
    Published: December 20, 2012
    Released on J-STAGE: December 12, 2012
    Advance online publication: September 21, 2012
    JOURNAL FREE ACCESS FULL-TEXT HTML
    Supplementary material
    Objectives: No consistent procedure has been established for advice given by occupational physicians concerning scope of disease, criteria of diagnosis and laboratory data, and basis of judgment. The aim of this study was to identify practice-based contexts of occupational physician’s advice. Methods: We interviewed 6 occupational physicians, and held focus group discussions (FGD) involving 19 occupational physicians, academic researchers, and clinical doctors. Scripts of the interview and FGD were coded to identify the contexts of occupational physician’s advice. Additionally, to assure the generalizability of the proposed contexts of occupational physician’s advice, we also conducted a survey to collect cases of advice, for which the fitness of the proposed contexts was confirmed. Results: Four contexts of occupational physician’s advice were identified from interviews and FGD, and an additional context was detected through the occupational physician’s survey, namely Type 1, work potentially affects a worker’s health; Type 2, risk management and prevention of accidents relating to disease; Type 3, recommendation to visit a doctor (referral); Type 4, communication to the head of the department/supervisor; and Type 5, fit for work with appropriate adjustment of work environment and/or conditions. All 48 cases collected could be classified into one or more of these five contexts. Discussion: This study clarified that several contexts exist for occupational physician’s advice in practice. The five proposed contexts reveal different responsibilities and judgments between occupational physician, worker, and employer. Understanding the contexts of occupational physician’s advice is important for enhancing consensus-building between stakeholders.
Field Study
  • Katsuyuki NAMBA
    2012 Volume 54 Issue 6 Pages 276-285
    Published: December 20, 2012
    Released on J-STAGE: December 12, 2012
    Advance online publication: September 21, 2012
    JOURNAL FREE ACCESS FULL-TEXT HTML
    Supplementary material
    Objective: We evaluated the relapse-free job retention rate and cost-effectiveness of return-to-work (RTW) programs for workers with mental illness. Method: We retrospectively evaluated a group of 196 employees of a pharmaceutical company in Japan who had taken sick leave because of mental illness. We found that the old RTW program led to 142 employees returning to work and the new RTW program resulted in 54 employees returning to work. In the new program, we introduced the following improvements: evaluation of recovery and readiness to return to work by using the “Daily Activity Record Sheet”; planning for RTW with reasonable steps in 6 months; monthly interviews with an occupational health physician, to keep in touch with workers in the RTW process; and arranging a “Return-to-Work Coordination Meeting” with occupational health specialists, to make reasonable adjustments to a return-to-work plan. Results: The median duration of sick leave was 60 days longer in the new program. The relapse-free job retention rate within 1 year was 54.2% in the old program and was increased to 91.6% in the new program. The old and new programs cost 65,945 yen and 300,898 yen, respectively. The benefits of the old and new programs were 6,226,192 yen and 8,418,514 yen, respectively. The return on investment (ROI) was 933%. Conclusion: The new RTW program is effective at improving the relapse-free job retention rate of workers with mental illness.
  • Naoki KOBAYASHI, Shin-ichiro SASAHARA, Yusuke TOMOTSUNE, Sho-taro DOKI ...
    2012 Volume 54 Issue 6 Pages 286-293
    Published: December 20, 2012
    Released on J-STAGE: December 12, 2012
    Advance online publication: September 21, 2012
    JOURNAL FREE ACCESS FULL-TEXT HTML
    Objectives: This study examined the relationships among the support system for return to work, work rules about sick leave, and incidence of sick leave due to mental health failure. Methods: A questionnaire was distributed to 150 workplaces with a history of use of the occupational health promotion center of a certain prefecture. The questionnaire asked about the number and duration of sick leaves due to mental health failure, the support system for return to work, and work rules about sick leave. Results: A significant correlation between the number of permanent staff and maximum period of sick leave was found (r=0.489, p<0.001), as well as a significant correlation between the number of permanent staff and the period of monetary compensation during sick leave (r=0.315, p=0.031). In addition, in 9 workplaces with more than 1,000 permanent staff, a significant correlation between the period of monetary compensation period during sick leave and incidence of sick leave was found (r=0.670, p=0.048), as well as a significant correlation between the period of monetary compensation during sick leave and the average length of sick leave (r=0.866, p<0.001). Conclusions: The results of this study suggest the possibility that monetary compensation is associated with the duration of sick leave due to mental health failure. Hereafter, to construct a support system for mental health, consideration of the effect of monetary compensation appears to be required.
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