联合与灵活：脊柱病房中早期职业康复的协作方法。一项实际研究。
United and flexible: a collaborative approach to early vocational rehabilitation on a spinal unit. A realist study.
机构信息
Burwood Academy | Hā-i-mano, Christchurch, New Zealand.
John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia.
出版信息
Spinal Cord Ser Cases. 2023 Jul 13;9(1):33. doi: 10.1038/s41394-023-00587-1.
STUDY DESIGN
Qualitative study using realist review.
OBJECTIVES
To conceptualise how Early Intervention Vocational Rehabilitation (EIVR) functions within inpatient multidisciplinary contexts during spinal cord injury (SCI) rehabilitation.
SETTING
New Zealand Spinal Unit.
METHODS
People with newly acquired SCI and members of their rehabilitation team were observed in a range of rehabilitation sessions, team meetings and therapeutic interactions. Participants were also interviewed to explore how EIVR functioned alongside the multidisciplinary team (MDT). Interviews and observations were transcribed, coded and analysed using realist methods.
RESULTS
We identified three primary contexts which influenced how EIVR was delivered within the MDT: (1) a united approach, (2) a flexible approach, and (3) a hesitant approach. These contexts generated four work-related outcomes for people with SCI; enhanced work self-efficacy, strengthened hope for work, maintained work identity, and the less desirable outcome of increased uncertainty about work.
CONCLUSIONS
To optimise work outcomes for people after SCI, it is important to consider how EIVR is delivered and integrated within the wider MDT. Such an understanding can also inform the establishment of new EIVR services in different settings. Results suggest that unity, flexibility and clarity between EIVR services and the wider MDT are essential foundations for supporting people with SCI on their journey to employment.
SPONSORSHIP
This research was funded by Health Research Council NZ grant in partnership with Canterbury District Health Board.
研究设计
定性研究采用现实主义综述。
目的
概念化早期干预职业康复（EIVR）在脊髓损伤（SCI）康复期间在住院多学科环境中的作用。
设置
新西兰脊髓科。
方法
观察新获得 SCI 的人和他们的康复团队在一系列康复课程、团队会议和治疗互动中的表现。还对参与者进行了采访，以探讨 EIVR 如何与多学科团队（MDT）一起发挥作用。使用现实主义方法对访谈和观察进行转录、编码和分析。
结果
我们确定了三个主要环境，这些环境影响了 EIVR 在 MDT 中的交付方式：（1）统一方法，（2）灵活方法，（3）犹豫方法。这些环境为 SCI 患者带来了四项与工作相关的结果；增强了工作自我效能感，增强了对工作的希望，保持了工作身份，以及对工作的不确定性增加的不太理想的结果。
结论
为了优化 SCI 后患者的工作结果，重要的是要考虑 EIVR 是如何在更广泛的 MDT 中提供和整合的。这种理解还可以为在不同环境中建立新的 EIVR 服务提供信息。结果表明，EIVR 服务与更广泛的 MDT 之间的团结、灵活性和清晰度是支持 SCI 患者就业之旅的必要基础。
赞助
这项研究由新西兰健康研究委员会资助，与坎特伯雷地区卫生委员会合作。
Zotero 插件