Dona Desiree J S, Peters Marlies E W J, Senden Theo F, Bloem Sjaak, Bartstra Herman, Jacobs Marieke T, Schaafsma Frederieke G, Jeurissen Patrick
Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands.
Center for Marketing & Supply Chain Management, Nyenrode Business University, 3621, Breukelen, BG, The Netherlands.
J Occup Rehabil. 2025 Jun;35(2):411-422. doi: 10.1007/s10926-024-10215-w. Epub 2024 Jun 19.
The Netherlands faces 60% prevalence of chronic conditions by 2040, impacting societal participation and quality of life. Current clinical care inadequately addresses these consequences, and most hospitals do not integrate occupational health in their care.
To develop a generic person- and work-oriented medical care model (WMCM) based on real life experiences with work-oriented care and supporting the chronically ill in active societal participation.
A qualitative research project with a participative approach in one hospital (November 2019 until March 2020). In an expert meeting, a schematic representation of a work-oriented care model was developed. Subsequent discussion rounds, with professionals from different patient groups, iteratively refined the model to a WMCM.
Consensus was reached after seven rounds of discussion, defining the model's core elements (1) a combination of biomedical and biopsychosocial approaches, (2) involvement of a clinical occupational physician in the treatment team, (3) a coordinating role for nursing specialists, and (4) incorporation of a work-oriented intervention plan (WoIP) into the treatment plan. Advocating early attention to societal participation, the model emphasises the WoIP and consensus on monitoring indicators. The final goal is a sustainable return to societal participation, considering both quality of life and work.
It is feasible to develop a generic person- and work-oriented care model for patients with chronic illness within a hospital care setting. Collaboration between healthcare professionals and a specialised occupational physician, with a central role for nurses, is deemed crucial.
到2040年，荷兰慢性病患病率将达到60%，这对社会参与和生活质量产生影响。目前的临床护理未能充分应对这些后果，且大多数医院在其护理中未纳入职业健康内容。
基于以工作为导向的护理的实际经验，开发一种通用的以人为本和以工作为导向的医疗护理模式（WMCM），以支持慢性病患者积极参与社会活动。
在一家医院开展了一项采用参与式方法的定性研究项目（2019年11月至2020年3月）。在一次专家会议上，制定了一个以工作为导向的护理模式示意图。随后与来自不同患者群体的专业人员进行了多轮讨论，逐步将该模式完善为WMCM。
经过七轮讨论达成了共识，确定了该模式的核心要素：（1）生物医学和生物心理社会方法相结合；（2）临床职业医师参与治疗团队；（3）护理专家发挥协调作用；（4）将以工作为导向的干预计划（WoIP）纳入治疗计划。该模式倡导尽早关注社会参与，强调WoIP以及监测指标方面的共识。最终目标是在兼顾生活质量和工作的情况下，可持续地回归社会参与。
在医院护理环境中为慢性病患者开发一种通用的以人为本和以工作为导向的护理模式是可行的。医疗保健专业人员与专业职业医师之间的合作，以及护士发挥核心作用，被认为至关重要。
