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多学科护理方案对妇科手术后患者康复和重返工作的效果:一项随机对照试验的设计。

Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial.

机构信息

Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

BMC Health Serv Res. 2012 Feb 1;12:29. doi: 10.1186/1472-6963-12-29.

Abstract

BACKGROUND

Return to work after gynaecological surgery takes much longer than expected, irrespective of the level of invasiveness. In order to empower patients in recovery and return to work, a multidisciplinary care program consisting of an e-health intervention and integrated care management including participatory workplace intervention was developed.

METHODS/DESIGN: We designed a randomized controlled trial to assess the effect of the multidisciplinary care program on full sustainable return to work in patients after gynaecological surgery, compared to usual clinical care. Two hundred twelve women (18-65 years old) undergoing hysterectomy and/or laparoscopic adnexal surgery on benign indication in one of the 7 participating (university) hospitals in the Netherlands are expected to take part in this study at baseline. The primary outcome measure is sick leave duration until full sustainable return to work and is measured by a monthly calendar of sickness absence during 26 weeks after surgery. Secondary outcome measures are the effect of the care program on general recovery, quality of life, pain intensity and complications, and are assessed using questionnaires at baseline, 2, 6, 12 and 26 weeks after surgery.

DISCUSSION

The discrepancy between expected physical recovery and actual return to work after gynaecological surgery contributes to the relevance of this study. There is strong evidence that long periods of sick leave can result in work disability, poorer general health and increased risk of mental health problems. We expect that this multidisciplinary care program will improve peri-operative care, contribute to a faster return to work of patients after gynaecological surgery and, as a consequence, will reduce societal costs considerably.

TRIAL REGISTRATION

Netherlands Trial Register (NTR): NTR2087.

摘要

背景

妇科手术后的恢复时间比预期的要长得多,无论手术的侵入性如何。为了使患者在康复和重返工作岗位时获得更多的自主权,我们开发了一种多学科护理计划,该计划包括电子健康干预措施和综合护理管理,其中包括参与式工作场所干预。

方法/设计:我们设计了一项随机对照试验,以评估多学科护理计划对妇科手术后患者完全可持续重返工作岗位的影响,与常规临床护理相比。预计将有 212 名年龄在 18-65 岁之间的女性(18-65 岁)参与本研究,她们因良性指征在荷兰的 7 家参与(大学)医院中的一家接受子宫切除术和/或腹腔镜附件手术。主要结局指标是手术 26 周内病假直至完全可持续返回工作岗位的持续时间,并通过手术 26 周内每月的病假日历来衡量。次要结局指标是护理计划对一般恢复、生活质量、疼痛强度和并发症的影响,通过基线、术后 2、6、12 和 26 周的问卷调查来评估。

讨论

妇科手术后预期的身体恢复与实际重返工作岗位之间的差距是这项研究的相关性所在。有强有力的证据表明,长时间的病假会导致工作残疾、整体健康状况恶化和心理健康问题的风险增加。我们预计,这种多学科护理计划将改善围手术期护理,促进妇科手术后患者更快地重返工作岗位,并因此大大降低社会成本。

试验注册

荷兰试验注册(NTR):NTR2087。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7f2/3355012/1fc346c2c742/1472-6963-12-29-1.jpg

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