Development of a Multimodal, Physiotherapist-Led, Vocational Intervention for People with Inflammatory Arthritis and Reduced Work Ability: A Mixed-Methods Design Study.
N F Bakker, S F E van Weely, N Hutting, Y F Heerkens, J A Engels, J B Staal, M van der Leeden, A Boonen, T P M Vliet Vlieland, J Knoop
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引用次数: 0
Abstract
Purpose: Work ability of people with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) is reduced, but underexamined as a clinical treatment target. The evidence on vocational interventions indicates that delivery by a single healthcare professional (HCP) may be beneficial. Physiotherapist (PT)-led interventions have potential because PTs are most commonly consulted by RA/axSpA patients in the Netherlands. The aim was to develop a PT-led, vocational intervention for people with RA/axSpA and reduced work ability.
Methods: Mixed-methods design based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions, combining a rapid literature review and six group meetings with: patient representatives (n = 6 and 10), PTs (n = 12), (occupational) HCPs (n = 9), researchers (n = 6) and a feasibility test in patients (n = 4) and PTs (n = 4).
Results: An intervention was developed and evaluated. Patient representatives emphasized the importance of PTs' expertise in rheumatic diseases and work ability. The potential for PTs to support patients was confirmed by PTs and HCPs. The feasibility test confirmed adequate feasibility and underlined necessity of training PTs in delivery. The final intervention comprised work-focussed modalities integrated into conventional PT treatment (10-21 sessions over 12 months), including a personalized work-roadmap to guide patients to other professionals, exercise therapy, patient education and optional modalities.
Conclusion: A mixed-methods design with stakeholder involvement produced a PT-led, vocational intervention for people with RA/axSpA and reduced work ability, tested for feasibility and ready for effectiveness evaluation.
期刊介绍：
The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law. A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.
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