Fostering shared decision making by occupational therapists and workers involved in accidents resulting in persistent musculoskeletal disorders: A study protocol
1 Centre for action in work disability prevention and rehabilitation (CAPRIT) and School of Rehabilitation, Université de Sherbrooke, 1111, rue St-Charles ouest, bureau 101, Longueuil (Québec), J4K 5G4C, Canada
2 Research Center of Centre Hospitalier Universitaire de Québec, Hospital St-François d'Assise, CHUQ, 10 rue Espinay Québec (Québec), G1L 3L5, Canada
3 Department of Family Medicine and Emergency Medicine, Faculty of medicine, Université Laval, Pavillon Landry, avenue de la medicine, Québec (Québec), G1K 7P4, Canada
4 School of Nursing, Faculty of Health Sciences, University of Ottawa, Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
5 Dalla Lana School of Public Health, University of Toronto 155 College Sreet, 5th Floor, Toronto (Ontario), M5T 3M7, Canada
6 Faculty of Medicine, College of Health Disciplines 400 - 2194 Health Sciences Mall, Vancouver (British Colombia), V6T 1Z3, Canada
Implementation Science 2011, 6:22 doi:10.1186/1748-5908-6-22Published: 17 March 2011
From many empirical and theoretical points of view, the implementation of shared decision making (SDM) in work rehabilitation for pain due to a musculoskeletal disorder (MSD) is justified but typically the SDM model applies to a one on one encounter between a healthcare provider and a patient and not to an interdisciplinary team.
To adapt and implement an SDM program adapted to the realities of work rehabilitation for pain associated with a MSD. More specific objectives are to adapt an SDM program applicable to existing rehabilitation programs, and to evaluate the extent of implementation of the SDM program in four rehabilitation centres.
For objective one, we will use a mixed perspective combining a theory-based development program/intervention and a user-based perspective. The users are the occupational therapists (OTs) and clinical coordinators. The strategies for developing an SDM program will include consulting the scientific literature and group consensus with clinicians-experts. A sample of convenience of eight OTs, four clinical coordinators and four psychologists all of whom have been working full-time in MSD rehabilitation for more than two years will be recruited from four collaborating rehabilitation centres. For objective two, using the same criteria as for objective one, we will first train eight OTs in SDM. Second, using a descriptive design, the extent to which the SDM program has been implemented will be assessed through observations of the SDM process. The observation data will be triangulated with the dyadic working alliance questionnaire, and findings from a final individual interview with each OT. A total of five patients per trained OT will be recruited, for a total of 40 patients. Patients will be eligible if they have a work-related disability for more than 12 weeks due to musculoskeletal pain and plan to start their work rehabilitation programs.
This study will be the first evaluation of the program and it is expected that improvements will be made prior to a broader-scale implementation. The ultimate aim is to improve the quality of decision making, patients' quality of life, and reduce the duration of their work-related disability by improving the services offered during the rehabilitation process.