工人疼痛和残疾表征在物理治疗和职业治疗中的干预挑战:一项混合方法研究。

IF 2.5 3区 医学 Q1 REHABILITATION
Patricia Godbout, Marie-France Coutu, Marie-José Durand
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引用次数: 0

摘要

目的:本研究的目的是(1)确定普遍存在的无帮助工人持有的疼痛和残疾表征,(2)探讨临床医生对这些表征的干预挑战。方法:采用解释性序贯混合方法设计(quan→QUAL)。首先对数据库进行二次分析。该数据库包括297名患有肌肉骨骼疾病的患病工人在修订的工作残疾疾病感知问卷上获得的分数。描述性统计确定了最普遍的无益的工人持有的表征。定量结果用于制定面试指南。半结构化访谈探讨了物理治疗专业人员(n = 8)和职业治疗师(n = 6)对工人疼痛和残疾表征的干预挑战。结果:二级数据分析显示,对严重后果、不可预测的症状和负面情绪的感知是最普遍的无帮助工人持有的表征。访谈将临床医生的主要干预挑战确定为两种特定的疼痛和残疾表现模式。第一个描述了工人对不可预测和无法控制的痛苦的感知,这种感知会产生负面情绪。临床医生将这种模式与工人的无助感联系起来。第二种模式涉及员工对生物医学事业的坚定信念,导致他们认为低水平的治疗和个人疼痛控制。根据临床医生的说法,这种模式导致工人对积极康复的抵制。临床医生认为这两种模式都阻碍了工人参与康复治疗。结论:临床医生的主要干预挑战是两种疼痛和残疾表征模式,包括或不包括普遍的无帮助工人持有的表征。结果强调需要开发一个跨学科的干预工作康复临床医生考虑到疼痛和残疾的表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intervention challenges experienced in physiotherapy and occupational therapy with workers' pain and disability representations: a mixed methods study.

Purpose: The study objectives were to (1) identify prevalent unhelpful worker-held pain and disability representations and (2) explore clinicians' intervention challenges with these representations.

Methods: An explanatory sequential mixed methods design was used (quan → QUAL). Secondary analysis of a database was performed first. The database included the scores obtained by 297 sick-listed workers with musculoskeletal disorders on the Revised Illness Perception Questionnaire for Work Disability. Descriptive statistics identified the most prevalent unhelpful worker-held representations. Quantitative results were used to develop an interview guide. Semi-structured interviews explored the physiotherapy professionals' (n = 8) and occupational therapists' (n = 6) intervention challenges with workers' pain and disability representations.

Results: The secondary data analysis showed that perceptions of severe consequences, unpredictable symptoms, and negative emotions were the most prevalent unhelpful worker-held representations. The interviews identified clinicians' key intervention challenges as two specific pain-and-disability representation patterns. The first depicted workers' perceptions of unpredictable and uncontrollable pain, perceptions that generate negative emotions. The clinicians associated this pattern with workers' sense of helplessness. The second pattern involved workers' firm beliefs in a biomedical cause, leading to their perceptions of low levels of treatment and personal pain control. According to clinicians, this pattern led to workers' resistance to active rehabilitation. The clinicians regarded both patterns as hindering worker engagement in rehabilitation treatment.

Conclusion: The clinicians' key intervention challenges were two pain-and-disability representation patterns, which included or not, prevalent unhelpful worker-held representations. The results underscore the need to develop a transdisciplinary intervention for work rehabilitation clinicians that takes pain and disability representations into account.

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来源期刊
CiteScore
5.80
自引率
12.10%
发文量
64
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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