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在英国国民医疗服务体系中为多发性硬化症患者实施职业康复:一项混合方法可行性研究。

Implementing vocational rehabilitation for people with multiple sclerosis in the UK National Health Service: a mixed-methods feasibility study.

作者信息

De Dios Perez Blanca, Holmes Jain, Elder Tracey, Lindley Rebecca, Evangelou Nikos, das Nair Roshan, Senior Caolan, Booth Vicky, Hassard Juliet, Ford Helen L, Newsome Ian, Radford Kate

机构信息

Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK.

NIHR Nottingham Biomedical Research Centre, Nottingham, UK.

出版信息

Disabil Rehabil. 2024 Oct 22:1-13. doi: 10.1080/09638288.2024.2417031.

Abstract

PURPOSE

To implement a job retention vocational rehabilitation (VR) intervention (MSVR) for people with multiple sclerosis (MS) and their employers in the UK National Health Service (NHS).

METHODS

Multicentre, single-arm feasibility study with post-intervention interviews. MSVR was delivered by an occupational therapist (OT). Feasibility was assessed by recruitment rates, compliance, and practicality of delivery. Acceptability was assessed with post-intervention interviews. A survey assessed change in eight vocational outcomes (e.g., vocational goals, work instability) immediately post-intervention and at 3-month follow-up.

RESULTS

Recruitment and training an OT was challenging. Twenty participants with MS, three employers, and three healthcare professionals were recruited. All participants but one completed the intervention. Factors affecting intervention adherence included annual leave and family responsibilities.MSVR was associated with improved vocational goal attainment post-intervention ((18) = 7.41, 0.001) and at follow-up ((17) = 6.01, 0.001). There was no change to the remaining outcomes. Interviews identified six themes: intervention impact, accessibility of support, the OT's role, readiness for support, workplace supportiveness, and barriers to NHS delivery.

CONCLUSION

Challenges with recruitment, identifying newly diagnosed MS participants, and understanding the OT's training needs to deliver the intervention were identified. The intervention demonstrated acceptability, but participants wanted it to continue for longer to address further needs.

摘要

目的

在英国国家医疗服务体系(NHS)中,为多发性硬化症(MS)患者及其雇主实施一项工作保留职业康复(VR)干预措施(MSVR)。

方法

采用多中心单臂可行性研究,并进行干预后访谈。MSVR由职业治疗师(OT)提供。通过招募率、依从性和实施的实用性来评估可行性。通过干预后访谈评估可接受性。一项调查评估了干预后即刻及3个月随访时八项职业结果(如职业目标、工作稳定性)的变化。

结果

招募和培训职业治疗师具有挑战性。招募了20名MS患者、3名雇主和3名医疗保健专业人员。除一名参与者外,所有参与者均完成了干预。影响干预依从性的因素包括年假和家庭责任。MSVR与干预后((18)=7.41,P=0.001)及随访时((17)=6.01,P=0.001)职业目标达成情况的改善相关。其余结果无变化。访谈确定了六个主题:干预影响、支持的可及性、职业治疗师的角色、支持的准备情况、工作场所的支持性以及NHS实施的障碍。

结论

确定了在招募、识别新诊断的MS参与者以及了解职业治疗师实施干预的培训需求方面存在的挑战。该干预措施显示出可接受性,但参与者希望其持续更长时间以满足进一步需求。

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