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中重度损伤患者的疾病认知与重返工作岗位情况

Illness Perceptions and Return to Work in Patients With Moderate to Severe Injuries.

作者信息

Lee Bih-O, Fan Jun-Yu, Chan Pi-Tuan, Hung Chang-Chiao

机构信息

School of Nursing, Kaohsiung Medical University, Taiwan.

Department of Nursing, Chang Gung University of Science and Technology, Taiwan.

出版信息

Rehabil Nurs. 2018 Sep/Oct;43(5):297-304. doi: 10.1097/rnj.0000000000000101.

Abstract

AIM

Research indicates that injured patients' illness perceptions constitute a strong influence on their return to work (RTW). This study examined the relationships between illness perceptions and RTW in injured patients.

DESIGN

A prospective cohort design was employed.

METHODS

One hundred fifty-six patients were recruited from three hospitals, and 132 completed follow-up data at 3 months after injury. Three-month illness perceptions were measured using the Chinese Illness Perception Questionnaire Revised-Trauma. Return to work was defined as being able to return to a paying job covered by national work insurance.

RESULTS

Non-RTW in injured patients tended to occur among patients who were older, less educated, more severely injured, and more likely to be admitted to intensive care units than patients who did RTW. Return to work patients also had more positive illness perceptions than non-RTW patients. Illness perceptions were associated with non-RTW, but the most important determinants of non-RTW were serious injury and older age.

CONCLUSIONS

This study provides evidence to indicate that illness perceptions, personal data, and illness characteristics are associated with injured patients' RTW or non-RTW. The role of rehabilitation nurses may be extended accordingly based on findings from this study.

IMPLICATIONS FOR PRACTICE

Case management with an interprofessional team may have positive impacts on RTW in injured patients. Rehabilitation nurses should identify patients' expectations of RTW and should work with an interdisciplinary team to develop interventions to reshape the patients' perceptions of returning to work, facilitating their transition back to work, if possible.

摘要

目的

研究表明,受伤患者的疾病认知对其重返工作岗位(RTW)有很大影响。本研究探讨了受伤患者的疾病认知与RTW之间的关系。

设计

采用前瞻性队列设计。

方法

从三家医院招募了156名患者,其中132名在受伤后3个月完成了随访数据。使用中文版修订创伤疾病认知问卷测量3个月时的疾病认知。重返工作岗位的定义为能够回到由国家工伤保险覆盖的有薪工作。

结果

与能够重返工作岗位的患者相比,受伤后无法重返工作岗位的情况往往发生在年龄较大、受教育程度较低、受伤更严重且更有可能入住重症监护病房的患者中。能够重返工作岗位的患者也比无法重返工作岗位的患者有更积极的疾病认知。疾病认知与无法重返工作岗位有关,但无法重返工作岗位的最重要决定因素是重伤和年龄较大。

结论

本研究提供的证据表明,疾病认知、个人数据和疾病特征与受伤患者能否重返工作岗位有关。根据本研究的结果,康复护士的作用可能会相应扩大。

对实践的启示

跨专业团队进行的病例管理可能对受伤患者的RTW产生积极影响。康复护士应确定患者对RTW的期望,并应与跨学科团队合作制定干预措施,以重塑患者对重返工作岗位的认知,尽可能促进他们重返工作岗位。

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