在英国国民健康服务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。

IF 2.1 4区 医学 Q1 REHABILITATION Disability and Rehabilitation Pub Date : 2024-10-22 DOI:10.1080/09638288.2024.2417031
Blanca De Dios Perez, Jain Holmes, Tracey Elder, Rebecca Lindley, Nikos Evangelou, Roshan das Nair, Caolan Senior, Vicky Booth, Juliet Hassard, Helen L Ford, Ian Newsome, Kate Radford
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引用次数: 0

摘要

目的:在英国国民健康服务系统(NHS)中,为多发性硬化症(MS)患者及其雇主实施工作保留职业康复(VR)干预(MSVR):多中心、单臂可行性研究,干预后访谈。MSVR由职业治疗师(OT)实施。可行性通过招募率、依从性和实施的实用性进行评估。可接受性通过干预后访谈进行评估。一项调查评估了干预后即刻和 3 个月随访期间 8 项职业结果(如职业目标、工作不稳定性)的变化:招募和培训一名职业治疗师具有挑战性。招募了 20 名多发性硬化症患者、3 名雇主和 3 名医疗保健专业人员。除一人外,所有参与者都完成了干预。MSVR 与干预后(t(18) = 7.41,p = 0.001)和随访时(t(17) = 6.01,p = 0.001)职业目标实现情况的改善有关。其余结果没有变化。访谈确定了六个主题:干预的影响、支持的可及性、OT的作用、支持的准备程度、工作场所的支持性以及NHS提供服务的障碍:研究发现,在招募、确定新诊断的多发性硬化症参与者以及了解定向治疗师在实施干预时的培训需求方面存在挑战。干预显示了可接受性,但参与者希望干预能持续更长时间,以满足更多需求。
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Implementing vocational rehabilitation for people with multiple sclerosis in the UK National Health Service: a mixed-methods feasibility study.

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 (t(18) = 7.41, p = <0.001) and at follow-up (t(17) = 6.01, p = <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.

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来源期刊
Disability and Rehabilitation
Disability and Rehabilitation 医学-康复医学
CiteScore
5.00
自引率
9.10%
发文量
415
审稿时长
3-6 weeks
期刊介绍: Disability and Rehabilitation along with Disability and Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process.
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