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医疗服务提供者在工伤赔偿背景下管理心理健康状况的经验。

Healthcare providers' experience with the management of mental health conditions in the context of Workers' Compensation.

作者信息

Schnitzler Lena, Kosny Agnieszka, Lifshen Marni

机构信息

Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands.

Institute for Work & Health, Toronto, ON, Canada.

出版信息

Work. 2018;59(3):449-462. doi: 10.3233/WOR-182695.

Abstract

BACKGROUND

Little is known about how healthcare providers (HCPs) in Canada manage mental health claims and the return to work (RTW) of injured workersOBJECTIVE:To examine HCPs' experience and challenges on the treatment of mental health conditions (MHCs) in the context of Workers' Compensation (WC) processes and their involvement in RTW.

METHODS

Ninety-seven interviews with HCPs (general practitioners, n = 59; allied HCPs, n = 19; specialists, n = 19) were conducted in British Columbia, Manitoba, Ontario and Newfoundland. A thematic content analysis was used to analyze interviews.

RESULTS

HCPs reported that while RTW is extolled at virtually all costs by WC boards, they did not always see it as beneficial. Most HCPs were convinced that successful recovery and RTW depend on being aware of how mental and physical health is intertwined and treating both issues. Organizational barriers within WC processes and adversarial relationships between injured workers (IWs) and WC boards made it difficult for HCPs to adequately treat patients and facilitate RTW. Dealing with IWs' MHCs and their emotional distress due to 'going through WC systems' was challenging.

CONCLUSIONS

WC boards must identify how policies can be modified to mitigate compensation processes and RTW for WC claimants with MHC.

摘要

背景

关于加拿大医疗服务提供者(HCPs)如何处理心理健康索赔以及受伤工人的复工事宜,我们所知甚少。

目的

探讨在工人赔偿(WC)流程背景下,HCPs在治疗心理健康状况(MHCs)方面的经验和挑战,以及他们在复工过程中的参与情况。

方法

在不列颠哥伦比亚省、曼尼托巴省、安大略省和纽芬兰对97名HCPs(全科医生,n = 59;专职HCPs,n = 19;专科医生,n = 19)进行了访谈。采用主题内容分析法对访谈进行分析。

结果

HCPs报告称,虽然WC委员会几乎不惜一切代价推崇复工,但他们并不总是认为复工有益。大多数HCPs确信,成功康复和复工取决于了解心理健康与身体健康是如何相互交织的,并对这两个问题进行治疗。WC流程中的组织障碍以及受伤工人(IW)与WC委员会之间的对抗关系,使得HCPs难以充分治疗患者并促进复工。处理IW的MHCs以及他们因“经历WC系统”而产生的情绪困扰具有挑战性。

结论

WC委员会必须确定如何修改政策,以减轻WC索赔人患有MHC时的赔偿流程和复工难度。

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