Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada.
J Occup Rehabil. 2013 Mar;23(1):82-92. doi: 10.1007/s10926-012-9387-8.
Studies from different fields documenting the differences between clinicians' and workers' representations have not elucidated where the differences exist or how they can be resolved.
To define and describe scenarios depicting the differences between clinical judgment, workers' representations about their disability and clinicians' interpretations of these representations.
A multiple case-study design was used. Semi-structured prospective interviews were conducted at four points in time, with five clinicians managing 12 cases of workers having persistent pain and participating in an evidence-based work rehabilitation program.
Four scenarios depicting differences in representations were found, but not all the differences necessarily had a negative impact on the program outcomes. For the clinicians, clear identification of the problem was important to allow for the use of concrete, pragmatic strategies. For the workers, congruence between the proposed strategy and their representations was crucial.
During rehabilitation, the objectives must be acceptable to both parties or the proposed strategy must, at least, make sense to the patient.
不同领域的研究记录了临床医生和工作人员的表述之间的差异，但并未阐明这些差异存在的位置或如何解决这些差异。
定义和描述描绘临床判断、工作人员对其残疾的表述以及临床医生对这些表述的解释之间差异的场景。
采用多案例研究设计。对 5 名管理 12 名持续疼痛的工人案例并参与基于证据的工作康复计划的临床医生进行了四次时间点的半结构化前瞻性访谈。
发现了四个描述表述差异的场景，但并非所有差异都必然对计划结果产生负面影响。对于临床医生来说，明确识别问题对于使用具体、务实的策略很重要。对于工人来说，所提出的策略与他们的表述之间的一致性至关重要。
在康复过程中，目标必须得到双方的认可，或者所提出的策略至少必须对患者有意义。
