School of Organisation and Development, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
School for Allied Health, HAN University of Applied Sciences, Physical Therapy, Nijmegen, The Netherlands.
BMC Musculoskelet Disord. 2021 Nov 2;22(1):923. doi: 10.1186/s12891-021-04806-4.
Musculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person's ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists' experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors.
An exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the groups were audio recorded. Data were analysed using inductive thematic analysis.
Sixteen therapists (mean age 44 years, range 25-59) participated in this study. Participants were aware of the importance of taking occupational factors into account. Whether they address occupational factors is largely dependent on the patient's request for help. However, ETs and OTs consider it normal to ask about occupational factors during the diagnostic process, while PTs often address this in later consultations. Almost all participants were unaware of the existence of PTs, OTs or ETs who are specialised in occupational health. Moreover, almost all participants struggled with when to refer a patient to other (occupational) healthcare professionals. This study identified several needs of therapists. These included knowledge about laws and legislation and skills for identifying and addressing work-related or work-relevant complaints.
Participants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.
肌肉骨骼疾病（MSD）可导致暂时性或永久性残疾，从而降低个人的工作能力。物理治疗师（PTs）、作业治疗师（OTs）和运动治疗师（ETs）通常参与 MSD 的早期管理。需要进一步了解治疗师在工作为重点的护理方面的经验、障碍和需求。此外，没有证据表明 OTs 和 ETs 如何解决工作参与问题。因此，本定性研究的目的是 1）调查通用型 PTs、OTs 和 ETs 如何提供以工作为重点的医疗保健，以及 2）深入了解影响他们解决职业因素能力的感知障碍和需求。
采用 3 个焦点小组进行探索性定性研究。如果治疗师治疗患有 MSD 的工作患者，则有资格参加通用型 PTs、OTs 和 ETs。制定了一份带有开放式问题的半结构化访谈指南。两名主持人使用访谈指南促进每个焦点小组的讨论，并对所有小组进行录音。使用归纳主题分析对数据进行分析。
16 名治疗师（平均年龄 44 岁，范围 25-59 岁）参加了这项研究。参与者意识到考虑职业因素的重要性。他们是否解决职业因素在很大程度上取决于患者寻求帮助的意愿。然而，ETs 和 OTs 认为在诊断过程中询问职业因素是正常的，而 PTs 通常在以后的咨询中才会这样做。几乎所有参与者都不知道专门从事职业健康的 PTs、OTs 或 ETs 的存在。此外，几乎所有参与者都难以确定何时将患者转介给其他（职业）医疗保健专业人员。这项研究确定了治疗师的一些需求。这些需求包括了解法律和法规的知识，以及识别和处理与工作相关或与工作相关的投诉的技能。
本定性研究的参与者意识到考虑职业因素的重要性。然而，PTs、OTs 和 ETs 解决工作参与问题的方式以及他们解决问题的程度可以得到改善。治疗师对职业健康专业人员（包括专门从事职业健康的 PTs、OTs 或 ETs）缺乏了解和合作。
