Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Disabil Rehabil. 2022 Jun;44(13):3113-3121. doi: 10.1080/09638288.2020.1855263. Epub 2020 Dec 5.
To identify facilitators of and barriers to the coordination of return-to-work between the primary care services, the employee, and the employers from the perspective of coordinators and employees on sick leave due to common mental disorders (CMDs).
Descriptive qualitative study. Semi-structured interviews were conducted with eighteen coordinators and nine employees on sick leave due to CMDs. The Consolidated Framework for Implementation Research (CFIR) was used as a starting point for the interview guides and in the thematic analysis of data.
The results show facilitators and barriers related to the CFIR domains "intervention characteristics," "outer setting," "inner setting," and "characteristics of individuals." Positive attitudes, an open dialogue in a three-party meeting, and a common ground for the sick leave process at the primary care centre facilitated coordination, while an unclear packaging, conflicts at the employee's workplace, and a lack of team-based work were examples of barriers.
The results indicate a need for the detailed packaging of coordination; formalization of coordinators' qualifications and levels of training; and acknowledgement of the role of organizational factors in the implementation of coordination. This is important to further develop and evaluate the efficacy of coordination.IMPLICATIONS FOR REHABILITATIONPositive attitudes to coordination, an open dialogue in a three-party meeting, leadership engagement, routines for the return to work (RTW) process at the primary care centre, and collegial alliances were identified as facilitators.An unclear packaging of the intervention, conflicts at the employee's workplace, lack of team-based work, and lack of coordinator training were identified as barriers.A detailed intervention packaging adapted for the specific setting and formalization of coordinators' qualifications and training is necessary for coordination of RTW.Recognizing organizational factors were identified as being important for the implementation of coordination of RTW for persons on sick leave due to CMDs.
从协调员和因常见精神障碍(CMD)休病假的员工的角度出发,确定初级保健服务、员工和雇主之间协调重返工作岗位的促进因素和障碍。
描述性定性研究。对 18 名协调员和 9 名因 CMD 休病假的员工进行了半结构化访谈。采用实施研究综合框架(CFIR)作为访谈指南的起点,并对数据进行主题分析。
结果显示与 CFIR 领域“干预特征”、“外部环境”、“内部环境”和“个体特征”相关的促进因素和障碍。积极的态度、三方会议中的开放对话以及初级保健中心病假流程的共同点促进了协调,而包装不明确、员工工作场所的冲突以及缺乏团队合作则是协调的障碍。
结果表明需要详细包装协调;正式规定协调员的资格和培训水平;并承认组织因素在协调实施中的作用。这对于进一步开发和评估协调的效果非常重要。
对协调的积极态度、三方会议中的开放对话、领导力的参与、初级保健中心重返工作(RTW)流程的常规以及同事联盟被确定为促进因素。干预措施包装不明确、员工工作场所的冲突、缺乏团队合作以及协调员培训不足被确定为障碍。需要针对特定环境进行详细的干预包装,并正式规定协调员的资格和培训,以实现 RTW 的协调。认识到组织因素对于协调因 CMD 休病假的人员的 RTW 实施非常重要。