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Table 4 Treatment satisfaction questionnaire OP

From: Design of a randomized controlled trial on the effects of Counseling of mental health problems by Occupational Physicians on return to work: the CO-OP-study

  Process evaluation of the treatment by the OP
1 Which was the effect of the treatment given by the OHS on the employee,
a) related to recovery?*
b) related to return to work?*
2 Was the employee cooperative regarding the treatment?
  a) No, not cooperative; b) Cooperative, but passive; c) Cooperative and active; d) No idea
3 Was the employer cooperative regarding the treatment?
  a) No, not cooperative; b) Cooperative, but passive; c) Cooperative and active; d) No idea
4 What was the influence of the following factors on return to work of the employee?*
a) Degree of physical work load
b) Degree of mental work load
c) Degree of physical work ability of the employee
d) Degree of mental work ability of the employee
e) Support by supervisor
f) Support by colleagues
g) Support by employer
h) Work motivation of the employee
i) Job control of the employee
j) Relationships at work between employee and employer
k) Duration of curative treatment
l) Advices of the curative sector
m) Waiting lists in the curative sector
n) Inadequate sickness behaviour of the employee
o) Psychosocial situation of the employee
p) Financial situation of the employee
q) Home situation of the employee (including care tasks)
r) Remaining, not work-related, factors
s) Practical (including organizational) options to work accommodations
t) Financial circumstances employer
u) Other factor, namely...
5 To what extent are you satisfied by the treatment of the OHS, related to
a) Treatment effectiveness?**
b) Treatment process?**
* Response range: 1. obstructive ; 2. no effect or influence ; 3. supportive
** 7-point Likert scale from 0 (totally dissatisfied) to 6 (totally satisfied)
  To increase the readability of this article we have translated the questionnaire from Dutch to English. In the study the Dutch version was used.