Butink Maarten, Hooper Shari, Boonen Annelies, Baadjou Vera, Boymans Tim, Pierik Marieke, de Rijk Angelique
Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+ (MUMC+), P. Debyelaan 25, Maastricht, 6229 HX, The Netherlands.
Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, 6200 MD, The Netherlands.
BMC Health Serv Res. 2024 Mar 11;24(1):325. doi: 10.1186/s12913-024-10752-3.
Healthcare professionals (HCPs) are increasingly recommended to play an important role in supporting people with chronic disease in work participation. An intervention for HCPs to provide work-related support to their patients in clinical care was developed with intervention mapping (Maastricht Work-Related Support; Maastricht WRS). Action research proposes 'combining research and practice', which allows us to incorporate experiences of HCPs while implementing and to realize intervention's full potential. Therefore, the aim of this study is to explore, by integrating action research into an intervention mapping approach, how experiences of HCPs with early implementation can be used to optimize the Maastricht WRS in clinical care.
Semi-structured interviews were held with nine HCPs (response rate 82%), involved in care for people with inflammatory arthritis, knee problems or inflammatory bowel disease. Some of them were not yet trained in the Maastricht WRS while others had received the training and were providing the Maastricht WRS.
All participants regarded WRS an important part of clinical care. Untrained HCPs indicated a lack of knowledge and skills in providing the Maastricht WRS, and a need for tools. Trained HCPs were satisfied with the training and tools, but stressed that practical limitations hindered providing the Maastricht WRS. Action research showed that the intervention meets the needs of HCPs, but need some optimizations: (1) organizing 'intervision' for HCPs, (2) inform and activate patients to discuss work with their HCP, (3) update initial tools and (4) including patients' work status in the electronic patient system.
Action research integrated into intervention mapping proved to improve the Maastricht WRS intervention. By involving HCPs, the intervention could be optimized to provide to support people with chronic diseases in clinical care in healthy and sustainable work participation.
越来越多的人建议医疗保健专业人员（HCPs）在支持慢性病患者参与工作方面发挥重要作用。通过干预映射法开发了一种让HCPs在临床护理中为患者提供与工作相关支持的干预措施（马斯特里赫特工作相关支持；Maastricht WRS）。行动研究提倡“将研究与实践相结合”，这使我们能够在实施过程中纳入HCPs的经验，并充分发挥干预措施的潜力。因此，本研究的目的是通过将行动研究整合到干预映射方法中，探索如何利用HCPs早期实施的经验来优化临床护理中的Maastricht WRS。
对九名参与照顾炎性关节炎、膝关节问题或炎性肠病患者的HCPs进行了半结构化访谈（回复率82%）。他们中的一些人尚未接受Maastricht WRS培训，而其他人已经接受了培训并正在提供Maastricht WRS。
所有参与者都认为工作相关支持是临床护理的重要组成部分。未接受培训的HCPs表示在提供Maastricht WRS方面缺乏知识和技能，并且需要工具。接受培训的HCPs对培训和工具感到满意，但强调实际限制阻碍了Maastricht WRS的提供。行动研究表明，该干预措施满足了HCPs的需求，但需要一些优化：（1）为HCPs组织“相互监督”；（2）告知并促使患者与他们的HCP讨论工作；（3）更新初始工具；（4）在电子患者系统中纳入患者的工作状态。
事实证明，将行动研究整合到干预映射中可改进Maastricht WRS干预措施。通过让HCPs参与进来，可以优化干预措施，以支持慢性病患者在临床护理中健康、可持续地参与工作。
