Tsang B, McDonald D, McNamara I, Kottam L, Rangan A, Baker P
South Tees Hospitals NHS Foundation Trust, Department of Trauma & Orthopaedics, Middlesbrough, UK.
Whole System Patient Flow Programme, Scottish Government, Scotland, UK.
Occup Med (Lond). 2020 Apr 20;70(2):123-126. doi: 10.1093/occmed/kqaa006.
Little is known what advice or support patients are given about return to work (RTW) after hip or knee replacement surgery.
This study aims to understand the delivery, timing and content of 'RTW' advice currently delivered by surgical teams offering hip and knee replacements across the UK.
National online survey exploring five specific areas relating to 'RTW' advice: (i) timings of interactions between hospital orthopaedic teams and patients prior to surgery, (ii) routine delivery of 'RTW' advice, (iii) methods used to deliver 'RTW' advice, (iv) confidence delivering advice and (v) need for an occupational 'RTW' advice intervention.
A total of 152 participants including surgeons, physiotherapists, occupational therapists and nurses from 59 different public and private health providers responded. Only 20% (n = 30) of respondents reported that working patients were identified as a specific subgroup in need of additional support. Overall, 62% (n = 92) stated that they did not routinely offer 'RTW' advice. When given, 'RTW' advice was almost always verbal, generic advice using blanket timescales and based on the respondent's anecdotal experience rather than the patients individualized needs. Overall, 116 (78%) felt an occupational advice intervention was needed.
This national survey demonstrated wide variation in the timing, content and delivery of information and advice for patients in work and intending to RTW after hip and knee replacement surgery. Current RTW advice provided to hip and knee replacement patients is inadequate.
对于髋关节或膝关节置换手术后患者恢复工作（RTW）会得到何种建议或支持，我们知之甚少。
本研究旨在了解英国各地提供髋关节和膝关节置换手术的外科团队目前提供“RTW”建议的方式、时间和内容。
开展全国性在线调查，探究与“RTW”建议相关的五个特定领域：（i）术前医院骨科团队与患者互动的时间；（ii）“RTW”建议的常规提供情况；（iii）提供“RTW”建议的方法；（iv）提供建议的信心；（v）对职业“RTW”建议干预的需求。
共有152名参与者做出回应，包括来自59家不同公立和私立医疗服务机构的外科医生、物理治疗师、职业治疗师和护士。只有20%（n = 30）的受访者表示，在职患者被确定为需要额外支持的特定亚组。总体而言，62%（n = 92）表示他们没有常规提供“RTW”建议。当提供“RTW”建议时，几乎总是口头的一般性建议，使用笼统的时间范围，基于受访者的轶事经验而非患者的个性化需求。总体而言，116人（78%）认为需要职业建议干预。
这项全国性调查表明，对于髋关节和膝关节置换手术后仍在工作且打算恢复工作的患者，在信息和建议的提供时间、内容和方式上存在很大差异。目前向髋关节和膝关节置换患者提供的RTW建议并不充分。
