Menzies Health Institute Queensland and School of Medicine, Griffith University, Southport, Australia.
Division of Specialty and Procedural Services, Gold Coast University Hospital and School of Medicine, Griffith University, Southport, Australia.
Disabil Rehabil. 2019 Dec;41(24):2865-2880. doi: 10.1080/09638288.2018.1479780. Epub 2018 Jun 22.
To synthesize evidence of the effectiveness of socio-ecological resilience rehabilitation programs on returning to work (RTW), self-efficacy, and stress mitigation following traumatic physical injuries. PubMed, Scopus, Proquest, Cinahl, Web of Science, Clinical Trials Database, and the Cochrane Central Register of Controlled Trials databases were searched. Methodological quality was assessed using the PEDro tool. Randomized interventions aimed at promoting resilience. Twenty one studies were reviewed (11,904 participants). Data from 19 studies of high methodological quality were pooled using a random-effects meta-analysis. Mean differences for continuous outcomes and risk ratios for binary outcomes were calculated. Resilience rehabilitation programs significantly increased the likelihood of ever RTW (OR 2.09, 95% CI 0.99-4.44, = 0.05), decreased the number of days taken to return to work (mean difference -7.80, 95% CI -13.16 to -2.45, ≤ 0.001), and increased total self-efficacy scores (mean difference 5.19, 95% CI 3.12-7.26, < 0.001). Subgroup analyses found that favorable return to work outcomes resulted from programs involving workplace support ( < 0.001) and for people with musculoskeletal or orthopedic injuries ( = 0.02). Compared to rehabilitation programs providing standard care following injuries, programs aimed at developing resilience could improve reemployment outcomes and self-efficacy.Implications for rehabilitationIndividual resilience may be an important factor promoting functional recovery after traumatic injury.Resilience rehabilitation programs are effective in enabling patients' return to work and increasing their self efficacy. In particular, programs involving the workplace are important components for enabling optimal work participation outcomes.
为了综合评估社会生态弹性康复方案对创伤后身体损伤患者重返工作岗位（RTW）、自我效能和减轻压力的有效性。我们检索了 PubMed、Scopus、Proquest、Cinahl、Web of Science、临床试验数据库和 Cochrane 对照试验注册中心数据库。使用 PEDro 工具评估方法学质量。随机干预旨在促进弹性。共回顾了 21 项研究（11904 名参与者）。19 项高质量研究的数据采用随机效应荟萃分析进行汇总。计算了连续结局的均值差异和二分结局的风险比。弹性康复方案显著增加了重返工作岗位的可能性（OR 2.09，95%CI 0.99-4.44，=0.05），减少了重返工作岗位的天数（平均差异-7.80，95%CI -13.16 至-2.45，≤0.001），并提高了总自我效能评分（平均差异 5.19，95%CI 3.12-7.26，<0.001）。亚组分析发现，有利于重返工作岗位的结果来自于涉及工作场所支持的方案（<0.001）和针对肌肉骨骼或骨科损伤患者的方案（=0.02）。与提供受伤后标准康复的方案相比，旨在培养弹性的方案可以改善再就业结果和自我效能。
康复意义
个体弹性可能是促进创伤后功能恢复的一个重要因素。
弹性康复方案在促进患者重返工作岗位和提高自我效能方面非常有效。特别是，涉及工作场所的方案是实现最佳工作参与结果的重要组成部分。
