Stenberg Gunilla, Pietilä Holmner Elisabeth, Stålnacke Britt-Marie, Enthoven Paul
a Department of Community Medicine and Rehabilitation, Division of Physiotherapy , Umeå University , Umeå , Sweden ;
b Department of Community Medicine and Rehabilitation, Division of Rehabilitation Medicine , Umeå University , Umeå , Sweden ;
Disabil Rehabil. 2016 Oct;38(21):2085-94. doi: 10.3109/09638288.2015.1114156. Epub 2016 Jan 5.
Exploring healthcare professional experiences of Multimodal rehabilitation (MMR) in primary care.
Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their work with MMR in primary care. Interviews covered experiences of assessing patients and work with patients in the programme. Transcribed interviews were analysed by qualitative content analysis.
The analysis resulted in four categories: select patients for success; a multilevel challenge; ethical dilemmas and considering what is a good result. MMR work was experienced as useful and efficient, but also challenging because of patient complexity. Preconceptions about who is a suitable patient for MMR influenced the selection of patients (e.g. gender, different culture). Interviewees were conflicted about not to being able to offer MMR to patients who were not going to return to work. They thought that there were more factors to evaluate MMR than by the proportion that return to work.
Healthcare professionals perceive MMR as a helpful method for treating chronic pain patients. At the same time, they thought that only including patients who would return to work conflicted with their ethical views on equal healthcare for all patients. Preconceptions can influence selection for, and work with, MMR. Implications for rehabilitation Multimodal pain rehabilitation in primary healthcare is challenging because of the complexity of the patients. Healthcare professionals must deal with conflicting emotions in regard to different commitments from healthcare legislation and the goals of multimodal rehabilitation. Healthcare professionals should be aware that stereotypes regarding gender and immigrants can lead to bias when selecting patients for multimodal rehabilitation.
探索医疗保健专业人员在初级保健中开展多模式康复（MMR）的经验。
对14名医疗保健专业人员（11名女性，3名男性）进行了单独访谈，了解他们在初级保健中开展MMR工作的情况。访谈涵盖了评估患者的经验以及在该项目中与患者合作的情况。对转录后的访谈内容进行了定性内容分析。
分析得出四个类别：挑选成功的患者；多层次挑战；伦理困境以及考量何为良好结果。MMR工作被认为是有用且高效的，但由于患者情况复杂也具有挑战性。对谁是适合MMR的患者的先入之见影响了患者的选择（例如性别、不同文化背景）。受访者对于无法为不会重返工作岗位的患者提供MMR存在矛盾心理。他们认为评估MMR需要考量的因素比重返工作岗位的比例更多。
医疗保健专业人员将MMR视为治疗慢性疼痛患者的一种有益方法。与此同时，他们认为仅纳入会重返工作岗位的患者与他们对所有患者平等医疗保健的伦理观点相冲突。先入之见会影响MMR的患者选择及相关工作。对康复的启示 由于患者情况复杂，初级医疗保健中的多模式疼痛康复具有挑战性。医疗保健专业人员必须应对因医疗保健立法的不同要求与多模式康复目标之间的冲突而产生的矛盾情绪。医疗保健专业人员应意识到，在为多模式康复选择患者时，关于性别和移民的刻板印象可能导致偏见。
