Presentation T O38

T O38 (Oral Presentation):
Shared decision making involving key stakeholders in work disability: Reality or fiction?

Presented by: Marie-France Coutu

Authors

Legare F2, Durand MJ1, Stacey D3, Corbiere M1, Bainbridge L4

  1. CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil, Québec, Canada
  2. Research Center of Centre Hospitalier Universitaire de Québec, Hospital St-François d’Assise, Québec, Québec, Canada
  3. School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
  4. University of British Columbia, Vancouver, Canada

Abstract

Background

We developed with clinicians and coordinators a shared decision-making (SDM) rehabilitation model for workers facing the decision to return to work or not’ in rehabilitation programs. Objective: To establish the acceptability and feasibility of implementing the newly developed SDM rehabilitation model among stakeholders.

Methods

We used a sequential mixed methods design and a two-phase approach: 1) individual consultations using a self-administered questionnaire and 2) homogenous group discussions with each stakeholder. We contacted (May to Nov. 2011) a convenient sample of private or public employer, insurer and clinics to identify workers, employers, unions, and insurers’ representatives from Quebec, Canada. Inclusion criteria: having more than two years of experience in rehabilitation for insurer; being involved in a return to work process of one employee absent for more than three months in the last two years for employers and unions; for workers: having participated in a work rehabilitation program in the last year. We performed descriptive analyses and thematic analyses on transcripts.

Results

The response rate was 78% for the questionnaire (n = 39). We had 34 participants in 7 group discussions. Quantitative results showed low agreement scores on the necessity (M = 2,09/4; SD = 0.094) and the clarity (M = 2,05/4; SD = .10) of the objective. They found the model too complex. For the activities and human resources needed to perform SDM (M = 2.19/4; SD = .12), insurers asked that their role be more prominent in the model. Insurers and employers suggested adding interviews with the employer and the insurer. Before beginning the group discussions, we explained the model. The results from the thematic analyses supported the necessity and clarity of the objectives, contrary to what was initially observed in the questionnaires. They mentioned initially not understanding the model. They specified which decisions should be discussed in SDM, and suggested adding an interview guide to establish the insurance terms that needed to be taken into account in the SDM approach.

Conclusions

The newly developed SDM model for work rehabilitation was found to be applicable and feasible. Next steps are to assess the extent of implementation in rehabilitation settings.

Schedule Details

Tuesday September 30
15:45 - 17:30 Afternoon Concurrent Sessions (T O25 - T O38 and Seminar 6)
Session: Social Interventions for work disability
Room A