539 Shared decision making in a preventive consultation on pregnancy and work, an experimental vignette study among occupational physicians

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Abstract

Introduction

In Occupational Health (OH), the application of shared decision making (SDM) is not very well developed. As high level evidence on effectiveness of many OH interventions is scarce and often different options for OH interventions are available, preference-sensitive decisions in OH are prevalent. We studied a theoretical preference-sensitive decision in a preventive consultation by an occupational physician (OP): prevention of preterm birth in nurses exposed to physically demanding work during pregnancy. The aim was to investigate whether a more closed recommendation in one guideline (‘if a work-related risk factor exists, action should be taken’) versus a more open formulated recommendation (‘no mandatory intervention but if distress is experienced, the worker should be advised to discuss it with her employer’) in another guideline on pregnancy and work lead to differences in attitude of the OP to SDM in this case, in risk perception by the OP, and in self-efficacy to deliberate with the worker about this topic.

Methods

OPs working in the health care sector were invited to participate in an online survey. We constructed vignettes about a voluntary preventive consultation by a nurse with her OP with two different recommendations on exposure to heavy physical work during pregnancy and two different case scenario’s. The main issue for this consultation is if the nurse can continue her work during pregnancy in a regular way or that she should be advised to reduce or adapt her tasks. Within-subject differences in attitudes, perception and self-efficacy, comparing the four experimental settings, were tested with paired sample t-tests.

Result

The online questionnaire was completed by 25 OPs (16 women and 9 men). As analysis is ongoing, the results of this experiment will be presented.

Discussion

More attention for SDM in OH is needed. Experimental studies like this one may give clues to the use of SDM in the field of OH.

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