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Kluit L, de Wind A, Oosting IJ, van Velzen JM, Beumer A, Sluman MA, van Bennekom CAM, de Boer AGEM. Current practices, needs, and expectations of discussing work with a medical specialist from a patient's perspective: a qualitative study. Disabil Rehabil 2024; 46:115-128. [PMID: 36564948 DOI: 10.1080/09638288.2022.2157500] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Attention to paid work in clinical health care-clinical work-integrating care (CWIC)-might be beneficial for patients of working age. However, the perceptions and expectations of patients about CWIC are unknown. The aim of this study was to develop an understanding of current practices, needs, and expectations among patients for discussing work with a medical specialist. MATERIALS AND METHODS A qualitative study was undertaken involving patients with diverse medical conditions (n = 33). Eight online synchronous focus groups were held. A thematic analysis was then performed. RESULTS Three themes emerged from the data: (1) the process of becoming a patient while wanting to work again, (2) different needs for different patients, (3) patients' expectations of CWIC. We identified three different overarching categories of work-concerns: (a) the impact of work on disease, (b) the impact of disease or treatment on work ability, and (c) concerns when work ability remained decreased. For each category of concerns, patients expected medical specialists to perform differing roles. CONCLUSIONS Patients indicated that they need support for work-related concerns from their medical specialists and/or other professionals. Currently, not all work concerns received the requested attention, leaving a portion of the patients with unmet needs regarding CWIC.
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Affiliation(s)
- Lana Kluit
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ilse J Oosting
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith M van Velzen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Heliomare Rehabilitation Center, Research and Development, The Netherlands
| | - Annechien Beumer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Upper Limb Unit Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Maayke A Sluman
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | - Coen A M van Bennekom
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Heliomare Rehabilitation Center, Research and Development, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Kluit L, van Bennekom CAM, Beumer A, Sluman MA, de Boer AGEM, de Wind A. Clinical Work-Integrating Care in Current Practice: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10143-1. [PMID: 37966538 DOI: 10.1007/s10926-023-10143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Clinical work-integrating care (CWIC) refers to paying attention to work participation in a clinical setting. Working patients may benefit from CWIC. The purpose of this study is to explore the extent and nature to which medical specialists provide CWIC and what policies and guidelines oblige or recommend specialists to do. METHODS A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed. RESULTS In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available. CONCLUSION Medical specialists provide a wide variety of CWIC ranging from assessing a patient's occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.
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Affiliation(s)
- Lana Kluit
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands.
| | - Coen A M van Bennekom
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Research and Development, Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands
| | - Annechien Beumer
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Upper Limb Unit Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Maayke A Sluman
- Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
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Worm MS, Kruse M, Valentin JB, Svendsen SW, Nielsen JF, Thomsen JF, Johnsen SP. Acquired Brain Injury Among Adolescents and Young Adults: A Nationwide Study of Labor Market Attachment. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:592-601. [PMID: 36795230 DOI: 10.1007/s10926-023-10097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Purpose Young patients represent a particularly vulnerable group regarding vocational prognosis after an acquired brain injury (ABI). We aimed to investigate how sequelae and rehabilitation needs are associated with vocational prognosis up to 3 years after an ABI in 15-30-year-old patients. Methods An incidence cohort of 285 patients with ABI completed a questionnaire on sequelae and rehabilitation interventions and needs 3 months after the index hospital contact. They were followed-up for up to 3 years with respect to the primary outcome "stable return to education/work (sRTW)", which was defined using a national register of public transfer payments. Data were analyzed using cumulative incidence curves and cause-specific hazard ratios. Results Young individuals reported a high frequency of mainly pain-related (52%) and cognitive sequelae (46%) at 3 months. Motor problems were less frequent (18%), but negatively associated with sRTW within 3 years (adjusted HR 0.57, 95% CI 0.39-0.84). Rehabilitation interventions were received by 28% while 21% reported unmet rehabilitation needs, and both factors were negatively associated with sRTW (adjusted HR 0.66, 95% CI 0.48-0.91 and adjusted HR 0.72, 95% CI 0.51-1.01). Conclusions Young patients frequently experienced sequelae and rehabilitation needs 3 months post ABI, which was negatively associated with long-term labor market attachment. The low rate of sRTW among patients with sequelae and unmet rehabilitation needs indicates an untapped potential for ameliorated vocational and rehabilitating initiatives targeted at young patients.
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Affiliation(s)
- M S Worm
- Department of Neurology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - M Kruse
- Danish Centre for Health Economics, DaCHE, University of Southern Denmark, Odense, Denmark
| | - J B Valentin
- Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark
| | - S W Svendsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Herning Hospital, Herning, Denmark
| | - J F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Aarhus, Denmark
| | - J F Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - S P Johnsen
- Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark
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Lindsay S, Patel S, Ragunathan S, Fuentes K. Ableism among children and youth with acquired brain injury and their caregivers: a systematic review. Brain Inj 2023:1-12. [PMID: 36856419 DOI: 10.1080/02699052.2023.2184869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE Children and youth with acquired brain injury (ABI) experience persistent discrimination and ableism. The purpose of this systematic review was to understand the experiences and impact of ableism among children and youth with ABI. METHOD Six international databases were systematically searched for articles from 2002-2022. Studies were screened independently by four researchers who performed the data extraction. Study quality was appraised using the Standard quality assessment criteria for evaluating primary research. RESULTS Of the 2085 studies identified in the search, 15 met the inclusion criteria, which involved 1442 children and youth with brain injuries or caregivers representing them. Studies in the review showed the following key trends: (1) incidence of ableism among children and youth with ABI; (2) experiences of ableism at the individual and institutional levels, (3) impact of ableism (i.e., mental health, social relationships, quality of life) and (4) coping strategies (i.e., resources, supports). CONCLUSIONS Our findings reveal the alarming incidence of ableism among youth with ABI. Therefore, there is a critical need for more research to explore youth's lived experiences of ableism, especially from their perspectives along with the co-development of solutions to help enhance their social inclusion and well-being.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Stuti Patel
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Psychology, University of Toronto Mississauga, Mississauga, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Norman A, Curro V, Holloway M, Percuklievska N, Ferrario H. Experiences of individuals with acquired brain injury and their families interacting with community services: a systematic scoping review. Disabil Rehabil 2023; 45:739-751. [PMID: 35244507 DOI: 10.1080/09638288.2022.2043465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This scoping review aims to (1) synthesise the research findings on the experiences of individuals with acquired brain injuries, and their families, when interacting with, or accessing, community-based services and (2) identify where gaps in service provision may exist and their cause. METHODS A systematic search strategy was employed across multiple databases to identify all studies relating to the experiences of individuals with acquired brain injuries and their families when interacting with, or accessing, community-based services. Inclusion was assessed by at least two reviewers at each stage and data extraction was completed by one researcher and validity checked by another. A narrative synthesis was employed. RESULTS A total of 101 papers met the inclusion criteria with the narrative synthesis identifying three main themes of (1) unmet needs, (2) types of access, and (3) barriers to access. CONCLUSIONS The results identify that those with acquired brain injuries, and their families, experience significant difficulties interacting with community-based services and often do not receive appropriate access. Many barriers to access were identified including a lack of knowledge of the long-term effects of acquired brain injury amongst professionals working in health and social care services.Implications for rehabilitationBrain injury is a leading cause of disability worldwide with a range of physical, cognitive, emotional, and behavioural difficulties.It is important that service users and families are given appropriate information about the long-term difficulties associated with ABI so they are better informed about the types of support they may need upon discharge from hospital.Rehabilitation professionals need to ensure they have good level of knowledge of the difficulties associated with ABI to ensure appropriate access to services for individuals and their families.Understanding more about unmet needs allows community rehabilitation services to be tailored and person-centred.
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Affiliation(s)
- Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, UK
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Hanafy S, Colantonio A, Mollayeva T, Munce S, Lindsay S. Employment and accommodation needs and the effect of COVID-19 on men and women with traumatic brain injury. Work 2022; 75:41-58. [PMID: 36591690 DOI: 10.3233/wor-220437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) impacts an individual's workforce involvement post-injury. Support services and workplace accommodations that can help with work re-integration post-TBI may differ based on a person's sex and gender. The added impact of COVID-19 remains under-explored. OBJECTIVE We aimed to investigate the support services and workplace accommodation needs and the impact of COVID-19 on work and mental health for persons with TBI, considering sex and gender. METHODS A cross-sectional online survey was distributed. Descriptive and regression analyses were applied to uncover sex and gender differences, along with content analysis for open-ended responses. RESULTS Thirty-two persons with TBI (62% women, 38% men) participated. Physiotherapy, occupational therapy, and counselling services were indicated as the most needed services by women and men. Modified hours/days and modified/different duties were the most needed workplace accommodations. Mental challenges impacting well-being was a highlighted concern for both men and women. Women scored poorer on the daily activity domain of the Quality of Life after Brain Injury - Overall Scale (p = 0.02). Assistance with daily activities was highlighted by women for a successful transition to work, including housekeeping and caregiving. Men were more likely than women to experience change in employment status because of COVID-19 (p = 0.02). Further, a higher percentage of men expressed concern about the inability to pay for living accommodations, losing their job, and not having future job prospects. CONCLUSION Findings reveal important differences between men and women when transitioning to work post-TBI and emphasize the need for sex and gender considerations.
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Affiliation(s)
- Sara Hanafy
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Tatyana Mollayeva
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sally Lindsay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Murray CM, Weeks S, van Kessel G, Guerin M, Watkins E, Mackintosh S, Fryer C, Hillier S, Stanley M. Perspectives of choice and control in daily life for people following brain injury: A qualitative systematic review and meta‐synthesis. Health Expect 2022; 25:2709-2725. [DOI: 10.1111/hex.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Carolyn M. Murray
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Scott Weeks
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | | | - Michelle Guerin
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | | | - Shylie Mackintosh
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Caroline Fryer
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Susan Hillier
- Allied Health and Human Performance Academic Unit University of South Australia Adelaide South Australia Australia
| | - Mandy Stanley
- School of Medical and Health Sciences Edith Cowan University Joondalup Western Australia Australia
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Kitchin PJ, Peile C, Lowther J. Mobilizing capacity to achieve the mainstreaming of disability sport. MANAGING SPORT AND LEISURE 2019. [DOI: 10.1080/23750472.2019.1684839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- P. J. Kitchin
- School of Sport, Ulster University, Newtownabbey, Northern Ireland
| | - Charlotte Peile
- Students’ Union, Ulster University, Newtownabbey, Northern Ireland
| | - Jim Lowther
- School of Sport, Ulster University, Newtownabbey, Northern Ireland
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