Institute for Quality Assurance in Prevention and Rehabilitation (iqpr GmbH), German Sport University Cologne, Cologne, Germany.
Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany.
Rehabilitation (Stuttg). 2024 Feb;63(1):39-50. doi: 10.1055/a-2129-2731. Epub 2023 Aug 21.
The aim of this study was to synthesize the findings of qualitative meta-syntheses (QMS) on return to work (RTW) of people with different chronic illnesses and to develop a generic RTW model that can provide advice on how to improve RTW interventions and strategies.
We conducted a systematic literature search in PubMed, Epistemonikos, CENTRAL, and PsycARTICLES to find relevant QMS, published in English or German between 2000 and 2021, and adapted the meta-ethnographic approach of Noblit and Hare to synthesize their findings.
Nineteen QMS (five focusing on musculoskeletal disorders or chronic pain, four on acquired or traumatic brain injuries, four on cancer, two on mental disorders, one on spinal cord injury, and three on mixed samples) met our inclusion criteria for the meta-ethnographic synthesis. Through systematic comparison and reciprocal translation of the single QMS findings, we could identify a set of key cross-cutting themes/concepts, which formed the basis for four RTW principles and a generic RTW model.
RTW is a multifactorial and highly interactive multistakeholder process, embedded in an individual's life and working history, as well as in a determined social and societal context. It runs parallel and interdependently to the process of coping with the disease and realigning one's own identity, thus emphasizing the significance of RTW for the person. Besides symptoms and consequences of the disease, individual coping strategies, and RTW motivation, the course and success of RTW are strongly affected by the adaptability of the person's working environment and the social support in their private and working life. Thus, RTW is not only a problem of the individual, but also a matter of the social environment, especially the workplace, requiring a holistic, person-centered, and systemic approach, coordinated by a designated body, which considers the interests of all actors involved in the RTW process.
本研究旨在综合不同慢性病患者重返工作岗位（RTW）的定性荟萃分析（QMS）的研究结果，并构建一个通用的 RTW 模型，为改善 RTW 干预和策略提供建议。
我们在 PubMed、Epistemonikos、CENTRAL 和 PsycARTICLES 中进行了系统文献检索，以查找发表于 2000 年至 2021 年间的英文或德文的相关 QMS，并采用 Noblit 和 Hare 的元人种学方法对其研究结果进行综合。
19 项 QMS（5 项专注于肌肉骨骼疾病或慢性疼痛，4 项专注于获得性或创伤性脑损伤，4 项专注于癌症，2 项专注于精神障碍，1 项专注于脊髓损伤，3 项为混合样本）符合我们对元人种学综合分析的纳入标准。通过对单个 QMS 研究结果进行系统比较和相互翻译，我们可以确定一组关键的跨领域主题/概念，这些主题/概念构成了四项 RTW 原则和一个通用 RTW 模型的基础。
RTW 是一个多因素、高度互动的多利益相关者过程，嵌入在个人的生活和工作历史以及特定的社会和社会环境中。它与应对疾病和重新调整自身身份的过程平行且相互依存，从而强调了 RTW 对个人的重要性。除了疾病的症状和后果、个人应对策略和 RTW 动机外，RTW 的过程和成功还受到个人工作环境的适应性以及私人和工作生活中的社会支持的强烈影响。因此，RTW 不仅是个人的问题，也是社会环境的问题，特别是工作场所的问题，需要采用整体的、以个人为中心的系统方法，由指定的机构协调，同时考虑到所有参与 RTW 过程的利益相关者的利益。
