Coutu Marie-France, Légaré France, Stacey Dawn, Durand Marie-José, Corbière Marc, Bainbridge Lesley, Labrecque Marie-Elise
Hôpital CharlesLeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, Longueuil, Canada.
Centre Hospitalier Universitaire de Québec Research Center, Hospital St-François d'Assise, Québec, Canada.
Patient Educ Couns. 2015 Jul;98(7):864-70. doi: 10.1016/j.pec.2015.03.015. Epub 2015 Mar 23.
In a work rehabilitation context, we assessed occupational therapists' (OTs) shared decision-making (SDM) behaviors with individuals having persistent pain and explored factors influencing SDM behaviors.
A cross-sectional study that used audio-recordings of work rehabilitation consultations between OTs trained in SDM and a convenient sample of patients. Eligible patients were: off work for ≥12 weeks due to persistent pain associated with a musculoskeletal disorder, starting a work rehabilitation program, and French speaking. Transcripts were analyzed using the Observing Patient Involvement in Shared Decision Making (OPTION) instrument and assessed patients' decisional conflict and socioeconomic status.
Of 15 OTs trained in SDM, 11 (90% female), provided audiotaped SDM meetings with 37 patients (40.5% female; aged 18-62 years). Their average OPTION score was 53.94 out of 100 (SD=9.68; range 35.42-70.83), indicating basic skills. Significant factors associated with OPTION scores (R (2)adjusted=21.7%) were the interview length (p=0.008) and level of patient education (p=0.038).
Basic SDM behaviors were integrated in the practice of OTs trained in SDM.
Evaluating SDM behaviors is a step toward providing OTs with performance feedback toward achieving client-centered care.
在工作康复背景下，我们评估了职业治疗师（OT）与患有持续性疼痛的个体的共同决策（SDM）行为，并探讨了影响SDM行为的因素。
一项横断面研究，使用了接受过SDM培训的职业治疗师与方便抽样的患者之间工作康复咨询的录音。符合条件的患者为：因肌肉骨骼疾病相关的持续性疼痛而缺勤≥12周，开始工作康复计划，且说法语。使用“观察患者参与共同决策”（OPTION）工具对转录本进行分析，并评估患者的决策冲突和社会经济状况。
在15名接受过SDM培训的职业治疗师中，11名（90%为女性）提供了与37名患者（40.5%为女性；年龄18 - 62岁）的SDM会议录音。他们的平均OPTION评分为100分中的53.94分（标准差=9.68；范围35.42 - 70.83），表明具备基本技能。与OPTION评分相关的显著因素（调整后的R(2)=21.7%）为访谈时长（p = 0.008）和患者教育水平（p = 0.038）。
接受过SDM培训的职业治疗师的实践中融入了基本的SDM行为。
评估SDM行为是朝着为职业治疗师提供绩效反馈以实现以客户为中心的护理迈出的一步。
