Battista Simone, Parker Jennifer, Ching Angela, Culley June, Long Sarah, Heard Alison, Hammond Alison, Radford Kathryn, Holland Paula, O'Neill Terence, Walker-Bone Karen, Prior Yeliz
School of Health and Society, Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK.
Patient Research Partner, East Midlands, UK.
Rheumatol Adv Pract. 2025 Mar 14;9(2):rkaf034. doi: 10.1093/rap/rkaf034. eCollection 2025.
This study aimed to qualitatively examine the delivery of the WORKWELL trial, a job retention vocational rehabilitation (JRVR) programme designed to help individuals with inflammatory arthritis (IA) maintain employment. A qualitative process evaluation used the Normalization Process Theory (NPT) to understand participant experiences and identify factors influencing implementation and outcomes.
Data were collected via one-to-one telephone interviews with trial participants at 12 and 36 months. An inductive reflexive thematic analysis was followed by a deductive analysis based on NPT's four constructs (coherence, cognitive participation, collective action and reflexive monitoring).
Sixty-two participants (mean age 51.0; 82.3% female) were interviewed, most diagnosed with RA (75.8%). Four secondary themes were generated under NPT constructs. For 'Coherence', themes included 'Exploring the Purpose and Impact of Taking Part in WORKWELL' and 'Questionnaires as Instrument for Reflection'. In 'Cognitive Participation', the theme was 'Commitment and Investment to WORKWELL'. For 'Collective Action', we identified 'Key Actions for Successful WORKWELL', and under 'Reflexive Monitoring', the theme was 'Suggestions for Improving WORKWELL'. These themes reflected participants' mixed feelings about the intervention, finding value in the intervention but highlighting the need for more tailored, timely and relevant content. Workplace support was crucial but often insufficient. Follow-up calls from researchers to ensure questionnaire completion were seen as a way to reflect and monitor their conditions. The pandemic's impact on work environments also influenced outcomes.
Findings suggest that WORKWELL provided work support for participants, though its impact could be enhanced through greater customization, early intervention and stronger workplace engagement.
ClinicalTrials.gov NCT03942783. Registered on 8 May 2019. ISRCTN Registry ISRCTN61762297. Registered on 13 May 2019. Retrospectively registered.
本研究旨在对WORKWELL试验的实施情况进行定性分析。WORKWELL试验是一项工作保留职业康复（JRVR）计划，旨在帮助炎性关节炎（IA）患者维持就业。一项定性过程评估运用了正常化过程理论（NPT）来了解参与者的体验，并确定影响实施和结果的因素。
通过在12个月和36个月时与试验参与者进行一对一电话访谈来收集数据。先进行归纳性反思主题分析，然后基于NPT的四个构建要素（连贯性、认知参与、集体行动和反思性监测）进行演绎分析。
共访谈了62名参与者（平均年龄51.0岁；82.3%为女性），大多数被诊断为类风湿关节炎（RA，75.8%）。在NPT构建要素下产生了四个次要主题。对于“连贯性”，主题包括“探索参与WORKWELL的目的和影响”以及“作为反思工具的问卷”。在“认知参与”方面，主题是“对WORKWELL的承诺和投入”。对于“集体行动”，我们确定了“WORKWELL成功的关键行动”，在“反思性监测”下，主题是“改进WORKWELL的建议”。这些主题反映了参与者对干预措施的复杂感受，他们在干预措施中找到了价值，但也强调需要更具针对性、更及时和更相关的内容。工作场所支持至关重要，但往往不足。研究人员的跟进电话以确保问卷完成被视为一种反思和监测自身状况的方式。疫情对工作环境的影响也影响了结果。
研究结果表明，WORKWELL为参与者提供了工作支持，不过通过更大程度的定制化、早期干预和更强的工作场所参与度，其影响可以得到增强。
ClinicalTrials.gov NCT03942783。于2019年5月8日注册。ISRCTN注册库ISRCTN61762297。于2019年5月13日注册。追溯注册。
