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一项探索如何将多发性硬化症患者的职业康复纳入英国现有医疗保健服务中的定性研究。

A qualitative study exploring how vocational rehabilitation for people with multiple sclerosis can be integrated within existing healthcare services in the United Kingdom.

机构信息

Centre for Rehabilitation and Ageing Research, Queens Medical Centre, University of Nottingham, Room B1387, D Floor, Nottingham, NG7 2RD, UK.

NIHR Nottingham Biomedical Research Centre, Nottingham, UK.

出版信息

BMC Health Serv Res. 2024 Aug 27;24(1):995. doi: 10.1186/s12913-024-11424-y.

Abstract

BACKGROUND

To explore how a vocational rehabilitation (VR) intervention can be integrated within existing healthcare services for people with multiple sclerosis (MS) in the United Kingdom (UK) National Health Service (NHS).

METHODS

Data from 37 semi-structured interviews with 22 people with MS, eight employers, and seven healthcare professionals were analysed using a framework method informed by the Consolidated Framework for Implementation Research and an intervention logic model.

RESULTS

Four themes were identified relating to the structure of current NHS services, how to improve access to and awareness of VR services, the collaboration between internal and external networks, and the benefits of integrating VR within the NHS services. Participants identified several implementation barriers such as poor links with external organisations, staffing issues, and lack of funding. To overcome these barriers, participants suggested enablers such as technology (e.g., apps or online assessments) and collaboration with third-sector organisations to reduce the pressure on the NHS.

CONCLUSION

Significant organisational changes are required to ensure a successful implementation of a VR intervention within current NHS services. Despite this, the NHS was seen as a trustworthy organisation to offer support that can optimise the health and professional lives of people with MS.

摘要

背景

探索如何将职业康复(VR)干预措施融入英国国家医疗服务体系(NHS)中现有的医疗服务,以满足多发性硬化症(MS)患者的需求。

方法

采用框架方法分析了 37 名 MS 患者、8 名雇主和 7 名医疗保健专业人员的 22 名半结构化访谈数据,该方法受实施研究综合框架和干预逻辑模型的启发。

结果

确定了四个与 NHS 服务结构、如何改善 VR 服务的可及性和认知度、内部和外部网络之间的协作以及将 VR 整合到 NHS 服务中的好处相关的主题。参与者确定了一些实施障碍,例如与外部组织的联系不佳、人员配备问题以及缺乏资金。为了克服这些障碍,参与者建议利用技术(例如,应用程序或在线评估)和与第三方组织合作来减轻 NHS 的压力等促进因素。

结论

需要进行重大的组织变革,以确保在当前的 NHS 服务中成功实施 VR 干预措施。尽管如此,NHS 仍被视为一个可信赖的组织,可以提供支持,优化 MS 患者的健康和职业生活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5c2/11350982/ae84b79fe788/12913_2024_11424_Fig1_HTML.jpg

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