Peters Susan E, Truong Anthony P, Johnston Venerina
Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia.
Brisbane Hand and Upper Limb Research Institute, Brisbane, QLD, Australia.
Work. 2018;59(3):401-412. doi: 10.3233/WOR-182692.
Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case.
Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences.
621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%).
Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.
参与重返工作岗位（RTW）过程的利益相关者具有不同的角色和资质。
探讨澳大利亚利益相关者对上肢疾病且有复杂工伤赔偿案例的工人重返工作岗位的障碍及策略的看法。
使用一个病例 vignette，要求利益相关者确定障碍并推荐促进重返工作岗位的策略。对开放式回答进行内容分析。使用生物心理社会模型将回答分类为重返工作岗位的障碍和策略。进行Pearson卡方检验和方差分析以确定组间差异。
621名参与者（488名医疗保健提供者（HCPs）、62名雇主、55名保险公司人员和16名律师）确定了36个障碍（31个可改变的）：4个人口统计学障碍；8个生物学障碍；15个心理障碍和9个社会障碍。484名参与者报告了16种重返工作岗位的策略：4个生物学策略；6个心理策略和6个社会策略。“工作关系压力源”（83.4%）和“个人关系压力源”（64.7%）是最常被提及的障碍。医疗保健提供者最常提及“疼痛管理”（49.6%），而雇主、保险公司人员和律师则提及“重返工作岗位规划/合适职责计划”（40.5%；42.9%；80%）。
利益相关者认为重返工作岗位存在类似的障碍，但推荐了不同的策略。利益相关者在识别障碍方面似乎比推荐策略更精通。未来的研究应侧重于识别重返工作岗位障碍和直接干预的工具。
