Holmlund Lisa, Guidetti Susanne, Hultling Claes, Seiger Åke, Eriksson Gunilla, Asaba Eric
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
Rehab Station Stockholm/Spinalis, R&D Unit, Rehab Station Stockholm, Stockholm, Sweden.
BMJ Open. 2020 Aug 20;10(8):e036000. doi: 10.1136/bmjopen-2019-036000.
To evaluate the feasibility of: (1) ReWork-SCI with regard to adherence and acceptability and (2) a study design for evaluating ReWork-SCI with regard to recruitment, retention and outcome measures.
Pre-test and post-test, single group, feasibility study.
Spinal cord injury (SCI) unit at a regional rehabilitation centre in Sweden.
Two women and five men (n=7). Eligible criteria: (1) sustained traumatic or non-traumatic SCI; (2) completed the first acute care episode in a hospital; (3) between 18 to 65 years of age; (4) assessed by a physician as approachable for participation in the intervention; (5) history of permanent or temporary employment; (6) self-reported desire to return to work; and (7) ability to communicate in English or Swedish.
ReWork-SCI is a person-centred intervention for return-to-work (RTW), developed and evaluated using the Medical Research Council's guidelines. ReWork-SCI follows a person-centred, structured and coordinated intervention process led by a coordinator within a SCI rehabilitation team.
The feasibility of ReWork-SCI and a study design was evaluated using a set of outcome measurement tools, vocational data, logbooks and semi-structured interviews.
All eligible participants accepted enrolment and follow-up. All participants had a plan for RTW after 3 months and four participants had initiated part-time work or work trial 6 months after commencement of intervention. Adherence and acceptability were overall good. Challenges of the intervention related to the person-centred follow-up, staff shortage and rootedness in the SCI team.
ReWork-SCI was feasible and can contribute to a systematic design of an individualised plan, facilitate decision-making and build trust in the RTW process after SCI. Core features of the intervention was the systematic structure, use of a person-centred approach and dialogue with the employer. For the effectiveness of ReWork-SCI, modifications and considerations of study design are needed.
评估以下方面的可行性：（1）关于依从性和可接受性的重返工作岗位脊髓损伤干预方案（ReWork-SCI），以及（2）关于招募、保留和结果测量来评估ReWork-SCI的研究设计。
前测和后测，单组可行性研究。
瑞典一家地区康复中心的脊髓损伤（SCI）单元。
两名女性和五名男性（n = 7）。入选标准：（1）遭受创伤性或非创伤性脊髓损伤；（2）在医院完成首次急性护理阶段；（3）年龄在18至65岁之间；（4）经医生评估适合参与干预；（5）有永久或临时工作经历；（6）自我报告有重返工作的愿望；以及（7）具备用英语或瑞典语交流的能力。
ReWork-SCI是一种以个人为中心的重返工作岗位干预方案，采用医学研究理事会的指南进行开发和评估。ReWork-SCI遵循由脊髓损伤康复团队中的协调员主导的以个人为中心、结构化且协调的干预过程。
使用一组结果测量工具、职业数据、日志和半结构化访谈来评估ReWork-SCI和研究设计的可行性。
所有符合条件的参与者均接受了入组和随访。所有参与者在3个月后都有重返工作岗位的计划，4名参与者在干预开始6个月后开始了兼职工作或工作试用。总体而言，依从性和可接受性良好。干预的挑战涉及以个人为中心的随访、人员短缺以及在脊髓损伤团队中的根基问题。
ReWork-SCI是可行的，有助于系统设计个性化计划，促进决策制定，并在脊髓损伤后建立对重返工作岗位过程的信任。干预的核心特征是系统结构、采用以个人为中心的方法以及与雇主对话。为了ReWork-SCI的有效性，需要对研究设计进行修改和考虑。
