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综合护理干预对类风湿关节炎患者主管支持及工作功能的有效性

Effectiveness of an integrated care intervention on supervisor support and work functioning of workers with rheumatoid arthritis.

作者信息

van Vilsteren Myrthe, Boot Cécile R L, Twisk Jos W R, van Schaardenburg Dirkjan, Steenbeek Romy, Voskuyl Alexandre E, Anema Johannes R

机构信息

a Department of Public and Occupational Health , EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.

b Body@Work, Research Center on Physical Activity, Work, and Health, TNO-VU University Medical Center , Amsterdam , The Netherlands.

出版信息

Disabil Rehabil. 2017 Feb;39(4):354-362. doi: 10.3109/09638288.2016.1145257. Epub 2016 Apr 21.

Abstract

PURPOSE

In this manuscript, we evaluated the effectiveness of an intervention programme consisting of integrated care and a participatory workplace intervention on supervisor support, work instability and at-work productivity after 6 months of follow-up among workers with rheumatoid arthritis (RA).

METHODS

We conducted a randomized controlled trial; we compared the intervention programme to usual care. Eligible patients were diagnosed with RA, had a paid job (> 8 h per week) and who experienced, at least, minor difficulties in work functioning. Supervisor support was measured with a subscale of the Job Content Questionnaire, work instability with the Work Instability Scale for RA, and at-work productivity with the Work Limitations Questionnaire. Data were analyzed using linear regression analyses.

RESULTS

A beneficial effect of the intervention programme was found on supervisor support among 150 patients. Analyses revealed no effects on work instability and at-work productivity.

CONCLUSION

We found a small positive effect of the intervention on supervisor support, but did not find any effects on work instability and at-work productivity loss. Future research should establish whether this significant but small increase in supervisor support leads to improved work functioning in the long run. This study shows clinicians that patients with RA are in need of efforts to support them in their work functioning. Implications for Rehabilitation Rheumatoid arthritis (RA) is a chronic inflammatory disease with a severe impact on work functioning, even when a patient is still working. It is important to involve the workplace when an intervention is put in place to support RA patients in their work participation. Supervisor support influences health outcomes of workers, and it is possible to improve supervisor support by an intervention which involves the workplace and supervisor.

摘要

目的

在本论文中,我们评估了一项干预计划的效果,该计划包括综合护理和参与式工作场所干预,针对类风湿性关节炎(RA)患者随访6个月后的主管支持、工作不稳定性和工作时生产力。

方法

我们进行了一项随机对照试验;将干预计划与常规护理进行比较。符合条件的患者被诊断为患有RA,有带薪工作(每周>8小时),并且在工作功能方面至少经历过轻微困难。主管支持通过工作内容问卷的一个子量表进行测量,工作不稳定性通过RA工作不稳定性量表进行测量,工作时生产力通过工作限制问卷进行测量。数据使用线性回归分析进行分析。

结果

在150名患者中发现干预计划对主管支持有有益效果。分析显示对工作不稳定性和工作时生产力没有影响。

结论

我们发现干预对主管支持有小的积极影响,但对工作不稳定性和工作时生产力损失没有发现任何影响。未来的研究应该确定这种主管支持的显著但微小的增加从长远来看是否会导致工作功能的改善。这项研究向临床医生表明,RA患者需要在其工作功能方面得到支持。康复的意义类风湿性关节炎(RA)是一种慢性炎症性疾病,即使患者仍在工作,也会对工作功能产生严重影响。在实施干预以支持RA患者参与工作时,让工作场所参与进来很重要。主管支持会影响员工的健康结果,通过涉及工作场所和主管的干预有可能改善主管支持。

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