基层医疗干预促进常见精神障碍患者重返工作岗位的护理经理和康复协调员的体验：一项定性研究。
The experiences of care managers and rehabilitation coordinators of a primary care intervention to promote return to work for patients with common mental disorders: a qualitative study.
机构信息
Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Research and Development Primary Health Care, Region Västra Götaland, Göteborg, Sweden.
出版信息
BMC Fam Pract. 2020 Dec 18;21(1):272. doi: 10.1186/s12875-020-01348-x.
BACKGROUND
In an earlier study, PRIM-CARE RCT, a care manager implementation at the primary care centre showed improved return to work and reduced sick leave for patients with CMD. To further improve return to work, the project Co-Work-Care added a person-centered dialogue meeting between the patient, the employer and the rehabilitation coordinator, preceded by an increased collaboration between care manager, rehabilitation coordinator and GP. In this first qualitative study of the Co-Work-Care project, we explored how care managers and rehabilitation coordinators experienced the Co-Work-Care model. The purpose of this study was to explore care managers' and rehabilitation coordinators' perceptions and experiences of a close collaboration and the use of the person-centred dialogue meeting.
METHODS
From an ongoing RCT with 20 primary care centres, care managers (CMs) (n = 13) and rehabilitation coordinators (RCs) (n = 12) participated in a qualitative study with focus groups. The study was conducted in the primary health care in a Swedish region. The data was analysed with Systematic Text Condensation by Malterud.
RESULTS
Seven codes describing the participants' experiences of the Co-Work-Care model were identified: 1) The importance of collaboration at the primary care centre, 2) Collaboration and division of roles between the RC and the CM, 3) Collaboration with the General practitioner (GP), 4) The person-centred dialogue meeting, 5) Initiating the person-centred dialogue meeting, 6) The person-centred dialogue meeting to improve collaboration with the employer, and 7) The person-centred dialogue meeting to teach about the return to work process.
CONCLUSION
The increased collaboration within the Co-Work-Care model created a common picture and understanding of the patient's situation. The person-centred dialogue meeting in the rehabilitation process became a bridge between the employer and the patient.
TRIAL REGISTRATION
NCT03250026 (registered August 15, 2017).
背景
在早期的 PRIM-CARE RCT 研究中，初级保健中心的护理经理实施取得了改善患者 CMD 的工作回归和减少病假的效果。为了进一步提高工作回归率，项目 Co-Work-Care 增加了患者、雇主和康复协调员之间的以人为中心的对话会议，在此之前，护理经理、康复协调员和全科医生之间的合作增加了。在 Co-Work-Care 项目的首次定性研究中，我们探讨了护理经理和康复协调员对 Co-Work-Care 模式的体验。本研究的目的是探讨护理经理和康复协调员对密切合作的看法和使用以人为中心的对话会议的经验。
方法
从正在进行的 20 个初级保健中心的 RCT 中，护理经理（CM）（n=13）和康复协调员（RC）（n=12）参加了焦点小组的定性研究。该研究在瑞典一个地区的初级保健中进行。使用 Malterud 的系统文本浓缩法对数据进行分析。
结果
确定了描述参与者对 Co-Work-Care 模型的体验的七个代码：1）初级保健中心合作的重要性，2）RC 和 CM 之间的合作和角色分工，3）与全科医生（GP）的合作，4）以人为中心的对话会议，5）发起以人为中心的对话会议，6）以人为中心的对话会议以改善与雇主的合作，以及 7）以人为中心的对话会议以教授工作回归过程。
结论
在 Co-Work-Care 模型中增加的合作创造了患者情况的共同图景和理解。康复过程中的以人为中心的对话会议成为雇主和患者之间的桥梁。
试验注册
NCT03250026（2017 年 8 月 15 日注册）。
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