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瑞典中风后重返工作岗位需要结构化的医疗保健组织和支持:中风幸存者的经验。

Need for structured healthcare organization and support for return to work after stroke in Sweden: Experiences of stroke survivors.

机构信息

Dept of Health Sciences, Lund University , 221 00 Lund, Sweden.

出版信息

J Rehabil Med. 2019 Oct 29;51(10):741-748. doi: 10.2340/16501977-2591.

Abstract

OBJECTIVE

To explore stroke survivors' experiences of healthcare-related facilitators and barriers concerning return to work after stroke.

DESIGN

A qualitative study.

SETTING

Outpatient stroke rehabilitation unit at a University Hospital in southern Sweden.

PARTICIPANTS

A convenient sample of 20 persons admitted to Skåne University Hospital for acute stroke care (median age 52 years), in employment of at least 10 h per week at stroke onset and having been referred to stroke rehabilitation within 180 days.

METHODS

The interviews were performed by focus groups, and the data were analysed by content analysis.

RESULTS

Facilitating factors were a tailored rehabilitation content with relevant treatments, adequate timing and a structured stepwise return-to-work process. A lack of sufficient early healthcare information, rehabilitation planning and coordination were perceived as barriers. An early rehabilitation plan, a contact person, and improved communication between rehabilitation actors were requested, as well as help with work transport, home care, children and psychosocial support for families.

CONCLUSION

Tailored rehabilitation content and a structured stepwise return-to-work process facilitated return to work. Insufficient structure within the healthcare system and lack of support in daily life were perceived barriers to return to work, and need to be improved. These aspects should be considered in the return-to-work process after stroke.

摘要

目的

探讨脑卒中幸存者在重返工作岗位过程中与医疗保健相关的促进因素和障碍的体验。

设计

定性研究。

地点

瑞典南部一所大学医院的门诊脑卒中康复病房。

参与者

在斯科讷大学医院接受急性脑卒中治疗的 20 名便利样本患者(中位年龄 52 岁),发病时每周至少工作 10 小时,并在 180 天内被转介至脑卒中康复治疗。

方法

通过焦点小组进行访谈,采用内容分析法进行数据分析。

结果

促进因素包括针对性的康复内容、相关治疗、适当的时机和结构化的逐步重返工作岗位过程。缺乏足够的早期医疗保健信息、康复计划和协调被认为是障碍。患者希望得到早期康复计划、联系人、改善康复治疗人员之间的沟通,并希望得到工作交通、家庭护理、儿童和家庭心理社会支持方面的帮助。

结论

针对性的康复内容和结构化的逐步重返工作岗位过程促进了重返工作岗位。医疗体系内缺乏结构和日常生活中缺乏支持被认为是重返工作岗位的障碍,需要加以改进。这些方面应在脑卒中后的重返工作岗位过程中得到考虑。

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