Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
J Occup Rehabil. 2017 Jun;27(2):159-172. doi: 10.1007/s10926-016-9625-6.
Purpose This study aimed to perform a process evaluation of a participatory supportive return to work program for workers without a (permanent) employment contract, sick-listed due to a common mental disorder. The program consisted of a participatory approach, integrated care and direct placement in a competitive job. Our main questions were: were these components realized in practice and in accordance with the protocol? The evaluation took place alongside a randomized controlled trial. Methods The study population consisted of workers who filed a sickness benefit claim at the Dutch Social Security Agency, professionals of this agency and of vocational rehabilitation agencies. We focused on sick-listed workers and professionals who had actually participated in the intervention. Data was collected mainly by questionnaires. Results Only 36 out of 94 intervention group participants started with the program. In half of these cases application of integrated care was reported. Most other steps in the program were completed. However, fidelity to the protocol was low to reasonable. Much delay was observed in the execution of the program and only two sick-listed workers were placed in a competitive job. Still, satisfaction with the participatory approach was good. Conclusions Despite the positive evaluation of the participatory approach, the full program was executed less successfully compared to similar programs evaluated in earlier studies. This will probably affect the outcomes of our trial. Findings from this study will help to interpret these outcomes. Nevertheless, more knowledge is needed about experiences of stakeholders who participated in the program. Trial Registration NTR3563.
目的 本研究旨在对一项针对因常见精神障碍而请病假、无(永久)雇佣合同的工人的参与式支持性重返工作方案进行过程评估。该方案由参与式方法、综合护理和直接安置到竞争性工作岗位组成。我们的主要问题是:这些组成部分是否在实践中按照方案实现?评估是在一项随机对照试验的同时进行的。
方法 研究人群包括在荷兰社会保障局提出病假津贴申请的工人、该机构和职业康复机构的专业人员。我们重点关注实际参与干预的请病假工人和专业人员。数据主要通过问卷收集。
结果 94 名干预组参与者中只有 36 人开始参加该方案。在这些情况下,有一半报告了综合护理的应用。该方案的其他大部分步骤都已完成。然而,对方案的遵循程度较低至合理。在执行方案方面观察到了大量延迟,只有两名请病假的工人被安置到竞争性工作岗位。尽管如此,对参与式方法的满意度仍然很高。
结论 尽管对参与式方法的评价是积极的,但与早期研究中评估的类似方案相比,完整方案的执行成功率较低。这可能会影响我们试验的结果。本研究的结果将有助于解释这些结果。然而,需要更多关于参与该方案的利益相关者的经验的知识。
试验注册 NTR3563。