80 4 CHAPTER 4 the main reasons for reporting a positive or negative disclosure experience was due to whether support was received or not by the manager (22). This indicates the importance of supervisor-worker relationships for disclosure. As research on the topic is scarce, and the decision to disclosure has major consequences for health, wellbeing and sustainable employment, it is important to further examine factors that influence disclosure. As the work- and social environment influences disclosure, it is important to not only examine the views of soldiers with MHC/SA themselves, but also to include stakeholder perspectives of soldiers without MHC/SA (20) and military mental healthcare (MMH) providers. The perspective of soldiers without MHC/SA is important, as co-workers potentially hold negative stigmatizing views (23) which could influence the disclosure decisions of others around them. Additionally, they might develop MHC/SA in the future, making it relevant to examine what would influence their disclosure decision (24). As for MMH-professionals, previous research has shown that mental health professionals play a role in how stigma affects sustainable employment (23). Moreover, MMH-professionals could play a role in providing disclosure advice to patients, making it relevant to first examine how aware they are of the barriers faced by soldiers when disclosing. In summary, the current, exploratory, study aims to identify the barriers to and facilitators for (non)-disclosure in the workplace, from multiple perspectives: soldiers with and without MHC/SA and MMH-professionals. METHOD Design Qualitative research was used, as it is a desirable method for exploratory research when the topic is complex (25). Particularly, focus groups were used as interaction among participants creates a more in-depth understanding. Due to the conversational nature of focus groups, they have the advantage to clearly show what participants think and why they think this way, as participants discuss the topic with each other (26). A qualitative descriptive design was used (27) as it provides a comprehensive summary of an event and is grounded in the general principles of naturalistic inquiry (28). As the aim of the current study was not to develop theory, but to explore barriers and facilitators for disclosure to inform future research and interventions, this design matched the aim of the study. Setting The study took place within the Dutch military and data collection took place between March and June 2019. For interpretation of the results, please find policies concerning substance (ab)use in Table 1.
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