Multimodal rehabilitation for people with pain problems : experiences of primary health care collaborating with workplaces

摘要

Introduction: The labour market is diverse and places different demands on people's mental and physical abilities. When a person is affected by pain problems work may be difficult to cope with. In order to identify the demands that a workplace places on an individual, knowledge of how the work environment affects the person based on the person's ability and capacity is needed. Within the framework of the Rehabilitation Guarantee, teams in primary health care work with multimodal rehabilitation (MMR) to help these people increase their work ability. The rehabilitation entails that primary health care interacts with the workplace.Purpose: The purpose of this study is to highlight the effect of primary health care MMR1 teams collaborating with the workplace to help people with pain problems.Method: This study is based on qualitative research. Seven people who worked in teams that conducted MMR1 in primary health care were interviewed with semi-structured interviews. The material was then analysed using content analysis method.Results: The manifestation categories that emerged were; "No clear practice for the MMR1 work", "Impeding factors for collaboration," "Success factors for collaboration" and "Desired changes, ideas for the future". All of the informants in this study didn’t met with employers through multilateral meetings. Follow-ups where informants contacted the employer after the rehabilitation was completion were not performed. Collaboration efforts worked best when the patient took a personal responsibility for the rehabilitation, when the MMR1 team established an employer point of contact early in the process and then designed a rehabilitation plan together. Obstruction factors proved to be due to insufficiencies in procedures and lack of time and benefit levels that did not always cover the full extent of the rehabilitation needs. The patient's concern having their employers being part of the rehabilitation process as well as rehabilitation intensity were other identified obstacles. Clearer focus on work, clearer procedures and easier methods and tools to use were desired as future developments.Conclusion: The study's results showed how different MMR1 can look like when collaborating with the workplace. Both factors of success, obstacles and thoughts on future developments was identified. Further studies is necessary to get the whole picture about this phenomenon’s complexity. To continue the development of MMR1 in primary health care it’s also necessary to illuminate employers and patients experiences.