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重返工作岗位:探索专业人员对脊髓损伤患者支持的经验。

Return-to-work: Exploring professionals' experiences of support for persons with spinal cord injury.

机构信息

Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.

Spinalis SCI Unit, Rehab Station Stockholm, Stockholm, Sweden.

出版信息

Scand J Occup Ther. 2021 Oct;28(7):571-581. doi: 10.1080/11038128.2020.1795245. Epub 2020 Aug 5.

Abstract

PURPOSE

To generate knowledge about how professional stakeholders organise and experience the support of the return-to-work (RTW) process for persons with spinal cord injury (SCI).

METHODS

Constructivist grounded theory approach. Professional stakeholders ( = 34) involved in the RTW process and representing three Swedish Regions were recruited into seven focus groups. Analysis followed initial, focussed, and theoretical coding.

FINDINGS

The core category - mediating intentions to support work and possibilities of working through social, labour market, and societal context - illustrates complexities of when and how to support a person with SCI in the RTW process, and a risk of delayed, unequal, or absent RTW processes. Analysis outlines: (1) Assessment of ability to work - uncertainty of how and when; (2) Planning RTW - divide between dynamic and rule-based perspectives; (3) Work re-entry - unequal paths towards viable solutions.

CONCLUSIONS

In RTW after SCI, it is critical to acknowledge how the RTW process is situated in relation to the person and context. A possible direction - grounded in an occupational perspective - through early identification of needs and resources and coordination derived from the SCI rehabilitation setting within healthcare is suggested. This can facilitate a time-sensitive and equal RTW process.

摘要

目的

了解专业利益相关者如何组织和体验脊髓损伤(SCI)患者重返工作岗位(RTW)过程的支持。

方法

建构主义扎根理论方法。参与 RTW 过程并代表瑞典三个地区的专业利益相关者(共 34 人)被招募到七个焦点小组中。分析遵循初始、聚焦和理论编码。

发现

核心类别 - 通过社会、劳动力市场和社会背景来调解支持工作和工作可能性的意图 - 说明了在 RTW 过程中何时以及如何支持 SCI 患者的复杂性,以及 RTW 过程延迟、不平等或缺失的风险。分析概述了:(1)工作能力评估 - 不确定性的方式和时间;(2)RTW 计划 - 动态和基于规则的观点之间的分歧;(3)工作重新进入 - 可行解决方案的不平等路径。

结论

在 SCI 后的 RTW 中,必须承认 RTW 过程与个人和环境的关系。建议通过在医疗保健中从 SCI 康复环境中早期确定需求和资源并进行协调,基于职业视角,为 RTW 提供一个可能的方向。这可以促进及时和平等的 RTW 过程。

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