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一项职业治疗干预措施对改善初级保健中患有精神健康障碍的工人康复及重返工作岗位的可接受性和探索性效果:一项混合方法研究方案

Acceptability and exploratory effects of an occupational therapy intervention to improve recovery and return to work of workers with mental health disorders in primary care: a mixed methods study protocol.

作者信息

Labourot Justine, Hong Quan Nha, Briand Catherine, Cameron Cynthia, Durand Marie-José, Giguère Nadia, Marois Élyse, Menear Matthew, Trottier Marielle, Vasiliadis Helen-Maria, Vachon Brigitte

机构信息

École de réadaptation, Faculté de médecine, Université de Montréal, Montréal, QC, Canada.

Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.

出版信息

Front Psychiatry. 2024 Nov 28;15:1441855. doi: 10.3389/fpsyt.2024.1441855. eCollection 2024.

Abstract

BACKGROUND

People with common mental disorders (CMD) are prone to experience work disabilities, which can lead to sick leave. To support their recovery and return to work, evidence recommends providing a combination of primary care services including psychological and work rehabilitation interventions. Furthermore, interventions to coordinate return to work are required to ensure timely access to services and concerted action among stakeholders. Occupational therapists are qualified to provide these interventions and to facilitate sick leave management. However, current medical practices, lack of collaboration among stakeholders, and lack of occupational therapists working within family medicine groups create highly variable care pathways and delays in access to appropriate services.

AIM

This study aims to evaluate the acceptability and explore the effects of an occupational therapist-led program integrated within family medicine groups designed to improve the management of CMD-related sick leave and promote patients' recovery and sustainable return to work in the Canadian province of Québec.

METHODS

This study will consist of a mixed methods multiple case study design. It will also use a participatory research approach, actively engaging family medicine group team members and patient partners throughout the study. The occupational therapy program will include three components: 1) consultation for prevention of sick leave and support for return-to-work decisions, 2) coordination of recovery and return-to-work services, and 3) provision of recovery and work rehabilitation services adapted to each patient's needs. Questionnaires, interviews, and focus groups will be used to collect data on the eight dimensions of the acceptability model described by Sekhon et al. and to measure pre- and post-outcomes to assess the effects of the occupational therapy program. Data will be analyzed using the Framework Method and repeated measures statistical analysis.

DISCUSSION

We expect that the provision of this innovative occupational therapy program will improve patients' outcomes and the service trajectory of people with CMD. This study will document how to enhance interprofessional collaboration within family medicine groups and to ensure equitable access to work rehabilitation services for all patients, thereby improving recovery and healthy sustainable return-to-work.

摘要

背景

患有常见精神障碍(CMD)的人容易出现工作残疾,进而导致病假。为支持他们康复并重返工作岗位,有证据建议提供包括心理和工作康复干预在内的初级保健服务组合。此外,需要采取干预措施来协调重返工作岗位,以确保及时获得服务并促使利益相关者采取一致行动。职业治疗师有资格提供这些干预措施并促进病假管理。然而,当前的医疗实践、利益相关者之间缺乏协作以及在家庭医疗团队中工作的职业治疗师短缺,导致护理途径差异很大,且获得适当服务存在延迟。

目的

本研究旨在评估由职业治疗师主导、整合于家庭医疗团队中的项目在加拿大魁北克省的可接受性,并探讨其对改善与CMD相关病假管理、促进患者康复及可持续重返工作岗位的效果。

方法

本研究将采用混合方法多案例研究设计。还将采用参与式研究方法,在整个研究过程中让家庭医疗团队成员和患者合作伙伴积极参与。职业治疗项目将包括三个组成部分:1)预防病假咨询及对重返工作岗位决策的支持;2)康复及重返工作岗位服务的协调;3)根据每位患者的需求提供康复及工作康复服务。将使用问卷调查、访谈和焦点小组来收集关于Sekhon等人描述的可接受性模型八个维度的数据,并测量前后结果以评估职业治疗项目的效果。将使用框架法和重复测量统计分析对数据进行分析。

讨论

我们预计提供这一创新的职业治疗项目将改善CMD患者的治疗效果和服务轨迹。本研究将记录如何加强家庭医疗团队内部的跨专业协作,并确保所有患者公平获得工作康复服务,从而改善康复情况并实现健康可持续的重返工作岗位。

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