Innes Ev, Straker Leon
School of Occupation & Leisure Sciences, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia.
Work. 2002;19(2):149-65.
The attributes of work-related assessments have been found to differ between types of assessment. This suggests that there may also be strategies that are more appropriately used with some assessments than with others.
The aims of this study were to determine: the reported frequency with which strategies were actually and ideally used when conducting each of three types of work-related assessment (workplace assessment (WPA); functional capacity evaluation (job) (FCEJ); functional capacity evaluation (no job) (FCENJ)); if there were differences between the strategies used with each type of work-related assessment; and the barriers, if any, that existed to achieving ideal practice when conducting work-related assessments.
A questionnaire was sent to all accredited occupational or vocational rehabilitation providers in Australia, targeting occupational therapists and physiotherapists who conducted work-related assessments. The response rate was 25.3%, and 132 questionnaires were analysed.
MANOVAs revealed there were significant differences between the 3 forms of work-related assessments for the strategies actually used F 78,40=3.47; p<0.001) and ideally used (F 78,24 =2.36; p=0.010). For both actually and ideally used strategies there was a core of strategies with no significant difference and shared by all forms of assessment. Several patterns of difference emerged. The largest group was where WPAs were different from both forms of FCE. A smaller group of strategies showed a difference between FCENJs and both WPAs and FCEJs. There were also some strategies that were different for all forms of assessment. Reliability analysis revealed 7 constructs which reflected the process of conducting work-related assessments. The major barrier to achieving ideal practice was time/cost.
This study demonstrated that there were significant differences between 3 forms of work-related assessments (WPAs, FCEJs & FCENJs) for the reported actual and ideal use of strategies. These strategies were associated with more qualitative or quantitative forms of assessment. This appeared to represent a continuum of work-related assessments that ranged from WPAs demonstrating strategies most associated with qualitative approaches to FCENJs demonstrating strategies most associated with quantitative approaches, with FCEJs between the two. By using strategies appropriate to each type of assessment, clinicians will be able to enhance the excellence of their practice.
已发现与工作相关的评估属性在不同类型的评估之间存在差异。这表明可能也存在一些策略,某些评估使用起来比其他评估更合适。
本研究的目的是确定:在进行三种与工作相关的评估(工作场所评估(WPA);功能性能力评估(有工作)(FCEJ);功能性能力评估(无工作)(FCENJ))时,实际和理想使用策略的报告频率;每种与工作相关的评估所使用的策略之间是否存在差异;以及在进行与工作相关的评估时,实现理想实践存在哪些障碍(如有)。
向澳大利亚所有经认可的职业或职业康复服务提供者发送了一份问卷,目标是进行与工作相关评估的职业治疗师和物理治疗师。回复率为25.3%,共分析了132份问卷。
多变量方差分析显示,在实际使用的策略(F(78,40)=3.47;p<0.001)和理想使用的策略(F(78,24)=2.36;p=0.010)方面,三种与工作相关的评估形式之间存在显著差异。对于实际和理想使用的策略,都有一组核心策略没有显著差异且为所有评估形式所共有。出现了几种差异模式。最大的一组是WPA与两种形式的FCE不同。一小部分策略显示FCENJ与WPA和FCEJ都存在差异。也有一些策略在所有评估形式中都不同。可靠性分析揭示了7个反映进行与工作相关评估过程的结构。实现理想实践的主要障碍是时间/成本。
本研究表明,在报告的策略实际和理想使用方面,三种与工作相关的评估形式(WPA、FCEJ和FCENJ)之间存在显著差异。这些策略与更定性或定量的评估形式相关。这似乎代表了一个与工作相关的评估连续体,从最与定性方法相关的策略的WPA到最与定量方法相关的策略的FCENJ,FCEJ介于两者之间。通过使用适合每种评估类型的策略,临床医生将能够提高他们的实践水平。