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PubMed2005

Health promotion in occupational health.

OBJECTIVES: To describe a Swedish approach to occupational health and its implications for health promotion. METHODS: We start business with a new customer by creating a health policy for the whole company. Every year a follow-up is presented to top management where decisions are taken on what to do for the coming period. RESULTS: The result from a paper mill is presented where cost savings were five times more than expected. We have found that close follow-up and the use of personalized reminders is very useful for individuals. We have also found the importance of working more with "the softer side" i.e. looking into a person's total life situation. Management training activities are essential. This training includes for instance personality, communication and conflict handling seminars and every manager has to go through those seminars. The focus is moved from sick care to health improvement. The result is measured in long-term health for individuals. To reach that level you have to be healthy and have no absences for at least two years. CONCLUSION: The Swedish occupational health system is a unique system for creating health. With a specially trained staff including MDs, nurses, physiotherapists, psychologists, management consultants and engineers, and working from prevention to treatment, they can create a total view of both individual health and customer company wealth. Working closely together in teams and in close cooperation with customers, they can initiate great changes in both these dimensions.

Administrative Personnel↗
PubMedDate not supplied

[The concept of health in Italian occupational health legislation].

This study describes the evolution of the concept of health in Italian occupational health legislation (1900-2001). Mental health dimensions at work (such as reduction in monotony and repetitiveness, mental risks in pregnancy and so on) were introduced only recently. This can be explained with: 1) poor working conditions; 2) the delay of the occupational health community in including mental health in the concept of health; 3) the gap between scientific knowledge of risk factors for mental health and legislation aimed at prevention.

Health↗
PubMed1993

Mental health problems in occupational health care. A pilot study.

Purposes of the present study were to report prevalence data of and background factors to mental health problems in Swedish state employees attending occupational health care as compared to primary care patients. The Hopkins Symptom Check List (HSCL-25) was administered to a sample of 39 patients. For comparative reasons, 39 patients matched for sex and age were selected from a primary care sample of 388 patients. The frequency of mental health problems was 33% in occupational health care and 26% in primary care. Patients with mental health problems in both samples presented a diffuse psychosomatic clinical picture and reported a higher degree of loneliness. State employees with mental health problems reported a higher frequency of work-related problems.

Adult↗
PubMed1992

Approaching the 21st century. Congressional agenda for health care and occupational health.

1. Major health related legislative issues for occupational health nurses in the 1990s are OSH Act reform and restructure of the health care system. 2. OSHA reform issues have been consolidated into the Comprehensive Occupational Safety and Health Reform Act (S1622 and HR3160). 3. Health care reform is being addressed by many legislative initiatives and by organized nursing in Nursing's Agenda for Health Care Reform. 4. As the professional association for occupational health nurses, AAOHN serves as an advocate for the profession with the federal government.

Health Priorities↗
PubMed1994

[The French occupational health system. I. Organization of the French occupational health system].

In the first part the author discusses the fundamental principles of occupational health in France, organisational structure of company and inter-company occupational health services as well as the role and responsibilities of occupational physicians. Part II will deal with the evolution of the system. Occupational health in France deserves attention, at least, because of two reasons. Firstly, a great role of an occupational physician distinguishes it from occupational health in other European countries. Secondly, the French experience can be very useful in restructuring of the Polish occupational health system.

France↗
PubMed2006

Occupational health nursing practice in Australia: what occupational health nurses say they do and what they actually do.

This study investigated current activities of occupational health nurses (OHN) in Australia related to the applicability of and their involvement in emergent role, wellness-based practices and traditional role and illness-based practices. A questionnaire encompassing the eight Areas of Practice as articulated by the Australian College of Occupational Health Nursing (ACOHN) competency standards was used to obtain data from 93 OHNs affiliated with ACOHN. More traditional role Areas of Practice such as treatment services, health assessment and rehabilitation services were seen as more applicable to their practice and a substantial amount of time was spent on them. Managing occupational health and safety (OH&S) service' was the only emergent area that was a substantial part of the OHN's role. Less time was devoted to other emergent and pro-active areas of OHN practice, such as illness and injury prevention, health promotion, health education and research into OH&S. While less time was allocated to emergent Areas of Practice, and they were ranked more lowly they were considered to be applicable to practice. The findings of this study suggest that OHNs in Australia may not be engaging fully in all Areas of Practice that have been articulated by the ACOHN, particularly emergent role activities. Although Australian OHNs perform all the activities articulated in the ACOHN Areas of Practice, their focus is still primarily illness and injury based, and also management. While the profession is supportive of emergent role activities, there is a need to debate possibilities, undertake research into barriers and supports for emergent role activities, more clearly articulate future directions for the OHN role, and develop strategies to support OHNs as they develop their professional role.

Adult↗
PubMed1996

A graduate course in work site health promotion for occupational health practitioners.

This paper describes the rationale, teaching strategies, outcomes, and a 6-month follow-up of an academic course in work site health promotion, in which 35 occupational health practitioners participated. The one-semester course was part of the Masters in Science program in occupational health at the Tel-Aviv University Medical School. The primary goals of the study were to teach the theoretical bases of work site health promotion and their application to specific health needs, and to train better role models for employees. The primary teaching strategies were: (1) facilitation of experiential learning, by encouraging students to undergo health screening and then engage in a personal health promotion plan; (2) use of health promotion experts as guest teachers; and (3) an increase in formal knowledge through formal lectures and background reading. At the time of follow-up, most of the students were still adhering to their plans and maintaining much of their health promotion achievements. Additional outcomes included increased awareness of health risks and health promotion issues, and positions as role models in the private and professional domains. The primary barrier to adherence was low frustration tolerance, which can be regarded as the major challenge to health promotion programs and courses. It is suggested that the course format is an effective means of educating health promoters.

Adult↗
PubMed2004

Managing asthma in the workplace: an overview for occupational health nurses.

Occupational health nurses are the ideal members of the workplace team to initiate disease management programs for chronic illnesses; asthma is just one disease for which occupational health nurses can make a difference. Employees win by improving their health and quality of life, having better control of a chronic health condition, simply feeling better, and using time off for vacation rather than sick days. Employers win by having healthier employees who are absent less often and more productive at work, and who cost the company less for their health care. Occupational health nurses are the key link in this cost saving, productivity enhancing chain. Being proactive in this disease management role clearly establishes occupational health nurses' value in their organization.

Anti-Asthmatic Agents↗
PubMed1990

A conceptual model of occupational health nursing.

Occupational health nurses can practice and research in their profession better if they approach occupational health nursing with a well developed conceptual model. The Wilkinson Windmill Model is one conceptualization of occupational health nursing an occupational health nurse may use for guidance in practice, research, and education. The model consists of five primary components. This conceptual model may be a useful framework for understanding the role of the occupational health nurse in many different environments and may prove valuable as a tool for conducting research.

Humans↗
PubMed2004

[Effect of the Training Program at Occupational Health Training Center (OHTC) on the attitude of occupational health residents].

University of Occupational and Environmental Health (UOEH) conducts three courses in postgraduate education of occupational health (OH). Graduates of UOEH who have already received a basic education in OH can participate in any course and are trained to play an appropriate role as an occupational physician (OP). We operate the training program to provide practical knowledge and skills as well as to encourage interest in occupational health and to promote a further understanding of the role of the OP. In this study we evaluated changes in attitude of participants and the effectiveness of our program by an anonymous questionnaire. The subjects were all 19 participants of the 3-month program conducted between September 2003 and February 2004 as a part of the postgraduate education following several years of clinical experience. They were expected to be occupational physicians with a clinical specialty. The data were collected from questionnaires handed out at the beginning and the end of the program. The questionnaire included 8 items on the attitude toward occupational health. The subjects answered the questions according to a scale of 1 to 7. Data analysis was performed using the unpaired t-test by SPSS. The results suggested that our training program had a positive effect on trainees. Interest in occupational practice (P < 0.05) and willingness to act as a full-time occupational physician in a large company (P < 0.05) increased significantly. When considering the positive correlation between willingness to act as an OP and interest in a field that has some overlap between the speciality and occupational health, it was thought that developing a vision as an OP with respect to their career was important for training. However, in some clinical fields it may be difficult to define a relationship between the clinical speciality and occupational health. Understanding the role of an OP (P < 0.05) and self-confidence in playing an appropriate role as an OP (P < 0.05) also showed significant improvement. On the other hand, fourteen of the trainees (74%) did not have enough confidence to play a role as an OP even after completion of the program. In this study, the questionnaire we used was anonymous and did not include items concerning various attributes of the subjects. Therefore it was not possible to analyze changes of attitude at the individual level. We recognize the need to improve the program and are preparing a new version of the educational program with emphasis on understanding company organization activities and practical skills for problem solving. Opportunities to consider association between clinical speciality and occupational health are also included in this new version. We hope that the new program will further encourage trainees.

Clinical Competence↗
PubMedDate not supplied

[Health policy and occupational health: tools and methods to assure quality and appropriateness of interventions].

BACKGROUND: Although all health care organizations and professionals are encouraged to follow the explicit aim of reducing the burden of illness, accidents and disability, there is increasing pressure on health professionals to ensure that the practice be based on a quality standard and on evidence of appropriateness. OBJECTIVES AND METHODS: The paper aims to focus on both the concept and dimensions of appropriateness (a complex issue with various dimensions and definitions) and on the different research and practice models aimed at search, analysis and synthesis of the best available evidence to be applied in the decision process of health and medical practice. Literature analysis has been carried out to find available tools and methods to identify, implement and monitor the evidence of efficacy in health care systems and services. RESULTS: Most definitions of appropriateness address a number of requirements. An appropriate practice should be effective (based on sound evidence); efficient (providing that cost is considered) and consistent with the ethical principles and preferences of the relevant individual, community or society. Appropriateness is considered as the next frontier in the development of health care research: there is still limited knowledge, awareness, or research on this aspect. Health Technology Assessment consists of a multidisciplinary activity based on the systematic examination of technical performance, safety, clinical effectiveness and efficiency, including socio-economic, legal and ethical aspects. Evidence Based Medicine originates from an individual perspective and aims at using rigorous criteria to obtain the best available evidence in order to provide efficient interventions. The Clinical Practice Guidelines, based on both evidence and opinions of experts, are intended to assist clinical decisions for health professional and providers for the improvement of professional practices and system efficiency, taking into account local customers, health needs and preferences. CONCLUSIONS: Several models exist for measuring and evaluating the efficacy of health systems and health services. They can be adapted for evaluating and measuring public and occupational health practices. These tools support good practice through quality-standardized interventions aiming at the health protection of communities and individuals. These models, which are presented in a specific framework in which their outcomes and critical factors are evaluated, should be adapted to public and occupational health interventions to satisfy implicit and explicit needs of individuals and populations at risk thus assuring their quality and appropriateness.

Biomedical Technology↗
PubMed1993

Expectation and evaluation of occupational health nursing services, as perceived by occupational health nurses, employees and employers in the United Kingdom.

A structured questionnaire was used to investigate the relationship between expectation and evaluation of occupational health nursing services as perceived by providers (nurses) and receivers (employers and employees) in the United Kingdom. The response rate was 66.55% (254) from nurses, 51.32% (194) from employees and 44.97% (170) from employers. Data from 144 triads of nurse, employer and employee were used to test 13 null hypotheses, which were all rejected. The strong positive correlation between nurses', employers' and employees' expectations and evaluations indicates that, on the whole, their expectations were met. However, there were differences in the extent to which this was so and the level of expectation varied between groups. Nurses perceived themselves as not meeting their high expectations as well in non-traditional (care-supportive) as in traditional (care-orientated) services. On the whole, employers had significantly lower expectations than nurses, except in the area of care and treatment. Employees had high expectations of preventive services, but their lower evaluations indicate that these were not met. Discussion of these and other findings suggests that employers need education on the value and scope of occupational health nursing, and a model may assist nurses' conceptual understanding of it.

Adult↗
PubMedDate not supplied

[The nurse and occupational health].

Nursing and occupational health. Occupational health is the maintainance and promotion of the health of the workers in the workplace. Occupational health nursing is the application of nursing practice and public health procedures of conserving, promoting and restoring the health of individuals and groups, in their places of employment. In this paper, the main emphasis is given to the role and duties of the nurse as a member of the team, which are valid at every workplace. There are references also to the educational possibilities in occupational health nursing as a specialty and in the status of employment in Greece.

Health Promotion↗
PubMedDate not supplied

Occupational health nurses' work and expertise in Finland: occupational health nurses' perspective.

The purpose of this study was to describe Finnish occupational health nurses' (OHNs) work in terms of its contents, characteristics, necessities, meanings, development areas, changes, and expertise. The data were gathered via essays handwritten by OHNs (n = 20). Qualitative content analysis revealed that occupational health nursing practice included work with individuals, work communities, and various collaborative partners, office tasks, and other duties. Responses about OHNs' work were classified as characteristics of OHNs and of their work with advantages as well as disadvantages. The work of OHNs requires a multidisciplinary knowledge basis, professional skills, certain personal characteristics, and other features. These should be maintained and developed through continual education. The outcomes of OHNs' work were better health and healthier habits for employers, higher productivity for employers and occupational health care units, and health care savings for society. The most significant change that has occurred over the last 20 years was the move from an individual and medicine orientation toward a focus on the work community and on nursing. Expert OHNs were expected to be competent and multiskilled professionals who apply multidisciplinary knowledge in practice. This study brought out the need for further study with a focus on the client's perspective.

Attitude of Health Personnel↗