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WORK-ON可行性测试:一项针对慢性炎症性关节炎患者的职业康复干预措施

Feasibility test of WORK-ON: a vocational rehabilitation intervention for people with chronic inflammatory arthritis.

作者信息

Madsen Christina Merete Tvede, Christensen Jeanette Reffstrup, Bremander Ann, Eggen Linda, Primdahl Jette

机构信息

The Danish Center for Expertise in Rheumatology, Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Engelshøjgade 9A, Sønderborg, 6400, Denmark.

Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

出版信息

BMC Musculoskelet Disord. 2024 Oct 1;25(1):755. doi: 10.1186/s12891-024-07862-8.

Abstract

BACKGROUND

People with chronic inflammatory arthritis (IA) often have a reduced work ability. Consequently, they are at high risk of losing their jobs and being permanently excluded from the labor market. Therefore, we developed a new context-specific vocational rehabilitation intervention for people with IA based on the Medical Research Council's framework for complex interventions. This intervention is called "WORK-ON" and consists of: (1) Initial assessment and goal setting by an occupational therapist experienced in rheumatology rehabilitation; (2) coordinated support from the same occupational therapist, including assistance in navigating the primary and secondary healthcare and social care systems; (3) group sessions for peer support; and (4) individually tailored consultations with physiotherapists, nurses, and/or social workers. This study investigates the feasibility of WORK-ON.

METHODS

A 6-month single-arm feasibility study with a pre-test post-test design was conducted to evaluate recruitment, intervention fidelity and delivery, data collection, and possible outcome measures. Work ability was the primary outcome, and sick leave, quality of life, fatigue, pain, physical activity, sleep, and well-being were the secondary outcomes evaluated.

RESULTS

In total, 19 participants (17 women and 2 men) with a median age of 55 years (range, 34-64) participated and completed WORK-ON. Of these, 17 participants completed patient-reported outcomes at baseline and follow-up, and the results indicated a tendency to improvement in work ability, quality of life, level of physical activity, decrease in pain, and increase in days of sick leave during the 6-month intervention period. The rehabilitation clinicians spent an average of 15.3 h per participant, and the participants spent an average of 13.5 h in the intervention.

CONCLUSIONS

WORK-ON is considered feasible and has the potential to increase work ability among people with IA who are concerned about their future ability to keep working. Though, an adjustment of the intervention is needed before testing in a randomized controlled trial.

摘要

背景

慢性炎症性关节炎(IA)患者的工作能力往往会下降。因此,他们面临失业和被永久排除在劳动力市场之外的高风险。因此,我们基于医学研究理事会的复杂干预框架,为IA患者开发了一种新的针对特定情境的职业康复干预措施。这种干预措施称为“WORK-ON”,包括:(1)由一位在风湿病康复方面经验丰富的职业治疗师进行初始评估和目标设定;(2)同一位职业治疗师提供的协调支持,包括协助患者在初级和二级医疗保健及社会护理系统中进行操作;(3)同伴支持小组会议;以及(4)与物理治疗师、护士和/或社会工作者进行的个性化咨询。本研究调查了WORK-ON的可行性。

方法

进行了一项为期6个月的单臂可行性研究,采用前测后测设计,以评估招募情况、干预保真度和实施情况、数据收集以及可能的结局指标。工作能力是主要结局指标,病假、生活质量、疲劳、疼痛、身体活动、睡眠和幸福感是评估的次要结局指标。

结果

共有19名参与者(17名女性和2名男性)参与并完成了WORK-ON,中位年龄为55岁(范围34 - 64岁)。其中,17名参与者在基线和随访时完成了患者报告的结局指标,结果表明在6个月的干预期内,工作能力、生活质量、身体活动水平有改善的趋势,疼痛减轻,病假天数增加。康复临床医生平均为每位参与者花费15.3小时,参与者平均在干预中花费13.5小时。

结论

WORK-ON被认为是可行的,并且有潜力提高那些担心自己未来继续工作能力的IA患者的工作能力。不过,在进行随机对照试验之前,需要对干预措施进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ed5/11446068/6537ac80dd16/12891_2024_7862_Fig1_HTML.jpg

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