基于社区的脑卒中幸存者留守工作干预(SAWI)的可行性

IF 1.2 Q3 REHABILITATION

Journal of Vocational Rehabilitation Pub Date : 2022-08-04 DOI:10.3233/jvr-221206

A. Turner, Theunis Jacobus De Wet, Jade McMurray, A. Wrobel, Heather Smith, Ben Clissold, M. Mohebbi, I. Kneebone

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引用次数: 0

摘要

背景:工作年龄人群的中风发病率正在上升。中风后重返工作岗位(RTW)是年轻中风幸存者的一个关键康复愿望。2017年3月至2019年12月，制定并实施了一项以社区为基础的“留在工作岗位上”试点计划。SAWI采用基于协调的方法，包括康复和职业康复，以支持年轻中风幸存者的RTW。目的:本研究的目的是对SAWI进行可行性评估。方法:采用定量和定性相结合的方法。定量数据包括参与服务时和中风后6个月的就业、情绪、焦虑和疲劳结果。对自愿参加半结构化访谈的SAWI客户的子样本收集定性数据。结果:总体而言，有93个转介到SAWI, 42个客户完成了初始服务会议。中风前的平均工作时间较高(平均46.9小时，标准差22.0，范围5-100小时/周)。中风后6个月，71% (n = 29 / 41)的SAWI患者恢复了工作。对于那些有6个月问卷信息的人(n = 19)，认知疲劳、整体疲劳水平和卒中对就业的感知影响显著降低(中等效应量r分别为0.36、0.34和0.40)。干预前和干预后在情绪和焦虑方面没有显著差异。对六名SAWI参与者的定性访谈强调了个性化支持的重要性，以解决RTW旅程中的个人需求。结论:相当数量符合条件的SAWI参与者可以参与该服务。RTW可以作为潜在的预测变量进行评估。71%的参与者在中风后6个月进行了RTW。情绪、自我效能、调整和疲劳可能影响RTW。定性访谈表明，SAWI针对个人需求量身定制的个性化支持受到重视。

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Feasibility of the community-based Stay at Work Intervention (SAWI) for stroke survivors

BACKGROUND: Rates of stroke in people of working age are increasing. Returning to work (RTW) after stroke is a key rehabilitation aspiration for younger stroke survivors. A pilot community-based Stay at Work Initiative (SAWI) was developed and delivered from March 2017 to December 2019. SAWI used a co-ordination based approach, covering rehabilitation and vocational recovery to support RTW in younger stroke survivors. OBJECTIVE: The aim of the study was to conduct a feasibility evaluation of SAWI. METHODS: A mixed methods approach was taken considering quantitative and qualitative data. Quantitative data included employment, mood, anxiety and fatigue outcomes at time of engagement with the service and at 6-months post-stroke. Qualitative data was collected on a sub-sample of SAWI clients who volunteered to participate in a semi-structured interview. RESULTS: Overall, there were 93 referrals to SAWI, with 42 clients completing an initial service meeting. Average working hours pre-stroke were high (mean 46.9, SD 22.0, range 5–100 hours/week). By 6 months post stroke, 71% (n = 29 of 41) of SAWI clients were working. For those with 6-month questionnaire information (n = 19), there was a significant reduction in cognitive fatigue, overall fatigue levels, and perceived impact of stroke on employment (medium effect sizes of r = 0.36, 0.34 and 0.40 respectively). No significant difference was seen on measures of mood or anxiety from pre- to post-intervention. Qualitative interviews with six SAWI participants highlighted the importance of personalised support that addresses individual needs during the RTW journey. CONCLUSIONS: A significant number of eligible participants referred to SAWI can engage with the service. RTW is able to be assessed as are potential predictor variables. Seventy one percent of participants had RTW at 6 months post-stroke. Mood, self-efficacy, adjustment, and fatigue likely impact RTW. Qualitative interviews identified that SAWI’s personalised support, tailored to individual need, was valued.

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来源期刊

Journal of Vocational Rehabilitation REHABILITATION-

CiteScore

1.70

自引率

33.30%

发文量

期刊介绍： The Journal of Vocational Rehabilitation will provide a forum for discussion and dissemination of information about the major areas that constitute vocational rehabilitation. Periodically, there will be topics that are directed either to specific themes such as long term care or different disability groups such as those with psychiatric impairment. Often a guest editor who is an expert in the given area will provide leadership on a specific topic issue. However, all articles received directly or submitted for a special issue are welcome for peer review. The emphasis will be on publishing rehabilitation articles that have immediate application for helping rehabilitation counselors, psychologists and other professionals in providing direct services to people with disabilities.