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预防肌肉骨骼疾病导致的工作残疾:实施证据面临的挑战。

Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence.

作者信息

Loisel Patrick, Buchbinder Rachelle, Hazard Rowland, Keller Robert, Scheel Inger, van Tulder Maurits, Webster Barbara

机构信息

Disability Prevention Research and Training Center, Université de Sherbrooke, 1111 St-Charles West, Suite 101, Longueuil, J4K 5G4, Québec, Canada.

出版信息

J Occup Rehabil. 2005 Dec;15(4):507-24. doi: 10.1007/s10926-005-8031-2.

Abstract

BACKGROUND

The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. One reason for limited dissemination of evidence is the complexity of the problem, as it is subject to multiple legal, administrative, social, political, and cultural challenges.

PURPOSE AND METHODS

A literature review and collection of experts' opinion is presented, on the current evidence for work disability prevention, and barriers to evidence implementation. Recommendations are presented for enhancing implementation of research results.

CONCLUSION

The current evidence regarding work disability prevention shows that some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. Future studies should involve all relevant stakeholders and aim at developing new strategies that are effective, efficient, and have a potential for successful implementation. These studies should be based upon a clearer conceptualization of the broader context and inter-relationships that determine return to work outcomes.

摘要

背景

让残疾工人重返工作岗位的过程面临诸多挑战。尽管有越来越多关于工作残疾预防的证据,但很少有人采用这些证据。证据传播有限的一个原因是问题的复杂性,因为它受到多种法律、行政、社会、政治和文化挑战的影响。

目的和方法

本文对工作残疾预防的现有证据以及证据实施的障碍进行了文献综述并收集了专家意见。针对加强研究结果的实施提出了建议。

结论

目前关于工作残疾预防的证据表明,一些临床干预措施(建议重返调整后的工作岗位和分级活动计划)以及一些非临床干预措施(在服务和政策/社区层面而非实践层面)在减少旷工方面是有效的。在工作残疾领域实施证据是一项重大挑战,因为干预建议往往不精确且尚未实际可立即应用,存在许多障碍,并且涉及许多利益相关者。未来的研究应让所有相关利益者参与,并旨在制定有效、高效且有成功实施潜力的新策略。这些研究应基于对决定重返工作结果的更广泛背景和相互关系的更清晰概念化。

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