title: Development and qualitative evaluation of an adapted return to work guideline for the sick-listed unemployed and temporary agency workers with minor psychological problems.
abstract: BACKGROUND
  Among the working population, unemployed and temporary agency workers with psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. There is a need for the development of a new protocol for this group, because the existing return to work (RTW) interventions, including practice guidelines, do not address the situation when there is no workplace to return to. The purpose of this study was to (1) describe the adaptations needed in the practice guideline for employed workers to enable its use by insurance physicians (IPs) for counselling of sick-listed unemployed and temporary agency workers with minor psychological problems; and (2) evaluate the experiences of IPs when using the new guidance document for minor psychological problems (MPP guidance document).
  
  
  METHODS
  The MPP guidance document for unemployed and temporary agency workers was developed through discussions with nine IPs and with the help of an expert. Semi-structured interviews with five IPs were then held to evaluate the IPs' field experience using the MPP guidance document, in terms of (a) feasibility and (b) perceived usefulness of the MPP guidance document.
  
  
  RESULTS
  The main adaptation introduced in the guideline is that interaction with the workplace, which is absent in this population, needed to be established in an alternative way, i.e., through the involvement of vocational rehabilitation agencies and labour experts. Overall, the guideline required minimal changes. In total, nineteen sick-listed workers were counselled using the MPP guidance document. The overall experience of the IPs was that the MPP guidance document was feasible and useful for the IP, while they had mixed responses on its usefulness for the sick-listed worker, in part due to the follow-up period of this study.
  
  
  CONCLUSIONS
  An existing practice guideline for employed workers was adapted for use as a guidance document for unemployed and temporary agency workers with minor psychological problems. IPs were positive about applying the MPP guidance document. The guidance document provides opportunities for RTW counselling for unemployed and temporary agency workers with minor psychological problems.
authors.affiliation: Academic Medical Center, Department: Coronel Institute of Occupational Health/Research Center for Insurance Medicine, University of Amsterdam, PO BOX 22700, Amsterdam 1100 DE, The Netherlands. s.s.audhoe@amc.uva.nl
authors.forename: Selwin S
authors.initials: SS
authors.lastname: Audhoe
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hoving
authors.forename: Karen
authors.initials: K
authors.lastname: Nieuwenhuijsen
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D000328:Adult; D004651:Employment / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000379:methods; D015203:Reproducibility of Results; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data*