Hara Karen Walseth, Borchgrevink Petter Christian, Jacobsen Henrik Børsting, Fimland Marius Steiro, Rise Marit By, Gismervik Sigmund, Woodhouse Astrid
a Department of Public Health and Nursing, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway.
b Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences , Norwegian University of Science and Technology , Trondheim , Norway.
Disabil Rehabil. 2018 Oct;40(21):2516-2526. doi: 10.1080/09638288.2017.1339298. Epub 2017 Jun 29.
The aim was to investigate the feasibility of introducing a novel transdiagnostic occupational rehabilitation program delivered in groups mixing participants with chronic pain, chronic fatigue and common mental disorders.
Observational data on group climate and individual participation were triangulated with qualitative data from focus group interviews on the participants' experiences with transdiagnostic groups.
The study included 222 participants receiving a temporary work disability benefit. Self-reported chronic pain (75%), chronic fatigue (79%), and mental distress (62%) were prevalent and the majority reported overlapping conditions (78%). Program completion among participants was high (96%). Those completing participated actively (95%) in the program. Overall group climate was stable with moderately high engagement. Participants with clinically confirmed mental disorders (22%) showed similar outcomes. Self-reported problems with "working in a group" prior to rehabilitation were not associated with how participants experienced group climate. Qualitative data supported the findings of positive participant experiences with transdiagnostic group settings.
Transdiagnostic groups showed high participation rates, moderately high group engagement across symptom profiles and positive participant experiences. Implementing transdiagnostic occupational rehabilitation in groups mixing participants with chronic pain, chronic fatigue and common mental disorders was feasible and acceptable to participants. Implications for rehabilitation Most research has been done on disorder-specific occupational rehabilitation programs, but emerging evidence supports a more generic approach. Transdiagnostic therapies, such as Acceptance and Commitment Therapy (ACT), have shown promising results for both somatic and mental disorders. The feasibility of implementing transdiagnostic rehabilitation groups, their acceptability to participants and the demand for such groups has not been established. This study indicates that it is feasible to introduce a novel transdiagnostic group-based occupational rehabilitation program for mixed groups of sick-listed participants with chronic pain, chronic fatigue and/or common mental disorders.
本研究旨在探讨引入一种新型跨诊断职业康复计划的可行性，该计划以小组形式开展，参与者包括慢性疼痛、慢性疲劳和常见精神障碍患者。
关于小组氛围和个体参与情况的观察数据，与来自焦点小组访谈的定性数据进行了三角互证，焦点小组访谈内容为参与者对跨诊断小组的体验。
该研究纳入了222名领取临时工作残疾福利的参与者。自我报告的慢性疼痛（75%）、慢性疲劳（79%）和精神困扰（62%）普遍存在，大多数人报告存在多种重叠情况（78%）。参与者的项目完成率很高（96%）。完成项目的参与者积极参与度高（95%）。总体小组氛围稳定，参与度适中偏高。临床确诊患有精神障碍的参与者（22%）表现出相似的结果。康复前自我报告的“小组工作”问题与参与者对小组氛围的体验无关。定性数据支持了参与者对跨诊断小组环境有积极体验的研究结果。
跨诊断小组显示出高参与率、不同症状类型的适度高小组参与度以及参与者的积极体验。在将慢性疼痛、慢性疲劳和常见精神障碍患者混合在一起的小组中实施跨诊断职业康复是可行的，且为参与者所接受。康复启示 大多数研究是针对特定疾病的职业康复计划进行的，但新出现的证据支持采用更通用的方法。跨诊断疗法，如接受与承诺疗法（ACT），已显示出对躯体和精神障碍均有良好效果。实施跨诊断康复小组的可行性、参与者对其的接受度以及对此类小组的需求尚未得到证实。本研究表明，为患有慢性疼痛、慢性疲劳和/或常见精神障碍的病假参与者混合群体引入一种新型的基于跨诊断小组的职业康复计划是可行的。
