Care and Public Health Research Institute, Department of Social Medicine, Maastricht University, Maastricht, The Netherlands.
J Occup Rehabil. 2011 Jun;21(2):179-89. doi: 10.1007/s10926-010-9267-z.
INTRODUCTION Workplace disability prevention is important, but stakeholders can differ in their appreciation of such interventions. We present a responsive evaluation of a workplace disability prevention intervention in a Canadian healthcare organization. Three groups of stakeholders were included: designers of the intervention, deliverers, and workers. The aim was to examine the appreciation of this intervention by analyzing the discrepancies with respect to what these various stakeholders see as the causes of work disability, what the intervention should aim at to address this problem, and to what extent the intervention works in practice. METHODS A qualitative research method was used, including data-triangulation: (a) documentary materials; (b) semi-structured interviews with the deliverers and workers (n = 14); (c) participatory observations of group meetings (n = 6); (d) member-checking meetings (n = 3); (e) focus-group meetings (n = 2). A grounded theory approach, including some ethnographic methodology, was used for the data-analysis. RESULTS Stakeholders' perceptions of causes for work disability differ, as do preferred strategies for prevention. Designers proposed work-directed measures to change the workplace and work organizations, and individual-directed measures to change workers' behaviour. Deliverers targeted individual-directed measures, however, workers were mostly seeking work-directed measures. To assess how the intervention was working, designers sought a wide range of outcome measures. Deliverers focused on measurable outcomes targeted at reducing work time-loss. Workers perceived that this intervention offered short-term benefits yet fell short in ensuring sustainable return-to-work. CONCLUSION This study provides understanding of where discrepancies between stakeholders' perceptions about interventions come from. Our findings have implications for workplace disability prevention intervention development, implementation and evaluation criteria.
工作场所的残疾预防很重要,但利益相关者对这些干预措施的重视程度可能存在差异。我们对加拿大医疗保健组织中的一项工作场所残疾预防干预措施进行了响应式评估。纳入了三组利益相关者:干预措施的设计者、执行者和工人。目的是通过分析这些不同利益相关者对工作残疾原因的看法、干预措施应针对解决该问题的目标以及干预措施在实践中的效果程度之间的差异,来评估这种干预措施的意义。
采用定性研究方法,包括数据三角剖分:(a)文件材料;(b)与执行者和工人(n=14)进行半结构化访谈;(c)参与小组会议的观察(n=6);(d)成员核对会议(n=3);(e)焦点小组会议(n=2)。采用扎根理论方法,包括一些民族学方法,对数据进行分析。
利益相关者对工作残疾原因的看法不同,预防的首选策略也不同。设计者提出了以工作为导向的措施来改变工作场所和工作组织,以及以个人为导向的措施来改变工人的行为。然而,执行者的目标是个人导向的措施,而工人则大多寻求以工作为导向的措施。为了评估干预措施的效果,设计者寻求了广泛的结果测量方法。执行者侧重于可衡量的结果,旨在减少工作时间损失。工人认为这种干预措施带来了短期利益,但在确保可持续重返工作岗位方面做得不够。
本研究提供了对利益相关者对干预措施的看法差异的理解。我们的研究结果对工作场所残疾预防干预措施的制定、实施和评估标准具有启示意义。