Hutting N.1, Oswald W.2, Staal J.B.3, Engels J.A.1, Nouwens E.2, Nijhuis-van der Sanden M.W.G.4, Heerkens Y.F.1
1HAN University of Applied Sciences, Research Group Occupation & Health, Nijmegen, Netherlands, 2HAN University of Applied Sciences, Physiotherapy, Nijmegen, Netherlands, 3HAN University of Applied Sciences,Faculty of Health and Social Studies, Research Group Musculoskeletal Rehabilitation, Nijmegen, Netherlands, 4Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands

Background: Work participation is an important factor in the perceived quality of life, but work and return to work are insufficiently covered in regular healthcare. In the Netherlands, more knowledge and collaboration in occupational related healthcare is needed. Many musculoskeletal patients treated by physiotherapist have work related complaints. Musculoskeletal disorders are a huge cost for society. Physiotherapists, who are often first contact healthcare practitioners, can play a major role in reducing absenteeism, presenteeism and associated costs in patients with musculoskeletal disorders. However, it seems that physiotherapist in the Netherlands do not sufficiently address work, work related factors and return to work in their treatment of patients with musculoskeletal disorders.

Purpose: The purpose of this study is to evaluate how physiotherapists in the Netherlands integrate work and work related factors in their physiotherapy practice and how this could be improved.

Methods: A qualitative study consisting of seven focus groups involving 30 participants in total (physiotherapists and occupational health physiotherapists). Based on an interview guide, participants were asked about their experiences, opinions and needs with regard to the integration of work in their physiotherapy practice (history taking, physical examination, treatment, and evaluation, working together with (other) occupational healthcare providers

Results: In general, participants found it important to address the patient’s work within physiotherapy practice. However, a major part of the participants said that work is not addressed enough in physiotherapy practice. Participants mentioned that work should be part of the history taking. It is considered important to investigate whether or not work is involved as a causal factor or recovery hindering factor. Most participants were not aware of work specific questionnaires. Participants mentioned that questionnaires and checklist could be used to evaluate the possible relationship between the patient’s complaints and work and to indicate whether a specific patient should me referred to and occupational health physiotherapist or other (occupational) health care professional. Visiting the workplace provides a lot more insight. Providing advice to patients with regard to work related factors was considered as important. Physiotherapist have limited knowledge about occupational health physiotherapy. Cooperation between physiotherapists and occupational health physiotherapist was considered as insufficient. Moreover, participants mentioned that work is not really the scope of physiotherapists, so that should be enhanced. Participants mentioned that integration of work within physiotherapy practice could be improved by integrating work in educational programs, courses (for example about laws and regulations, addressing work related factors, and workplace investigations), questionnaires, and guidelines.

Conclusion(s): Although the patient’s work is considered important, work related factors are not sufficiently addressed within physiotherapy practice in the Netherlands. Physiotherapists often lack specific knowledge about work related factors and the cooperation with occupational health physiotherapist should be improved.

Implications: The results of this qualitative study will be used in a quantitative evaluation of how physiotherapists in the Netherlands integrate work and work related factors within their physiotherapy practice. The results of this study can also be used in physiotherapy educational programs, in courses, and to improve cooperation between physiotherapists and occupational health physiotherapists.

Funding acknowledgements: This study was funded by the Scientific College Physical Therapy (WCF) of the Royal Dutch Society for Physical Therapy (KNGF).

Topic: Occupational health & ergonomics

Ethics approval: Medical ethical approval was necessary for his study (HAN UAS, number registration: ACPO 09.01/16).

All authors, affiliations and abstracts have been published as submitted.

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