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. 2004 May;63(5):562–568. doi: 10.1136/ard.2003.007260

A multidisciplinary job retention vocational rehabilitation programme for patients with chronic rheumatic diseases: patients' and occupational physicians' satisfaction

P D M de Buck 1, J Breedveld 1, F J van der Giesen 1, V Vliet 1
PMCID: PMC1754975  PMID: 15082488

Abstract

Objective: To investigate patients' and occupational physicians' satisfaction with the quality of a vocational rehabilitation programme for maintaining work ability in chronic rheumatic diseases.

Methods: The vocational rehabilitation programme was developed for patients with rheumatic diseases and consisted of systematic assessment of the problems at work and the development of individual solutions. The programme was run by a multidisciplinary team comprising a rheumatologist, a social worker, a physical and occupational therapist, and a psychologist. Satisfaction ratings were measured using a multidimensional questionnaire involving a rating scale (0–10) and a structured telephone interview.

Results: 59 of the 65 patients who participated in the programme (91%) completed the questionnaire. Patients were most satisfied with the interpersonal approach and professional knowledge, and least satisfied with the waiting time for the final report and the practical application of the given advice. Mean satisfaction score was 7.3 (SD 1.0). Twenty eight of the occupational physicians involved were interviewed. They were satisfied with the programme overall; 21 (75%) stated that their role in the vocational rehabilitation process could be defined more clearly, and they would appreciate more contact with the team members, preferably in the early phases.

Conclusions: Patients' and occupational physicians' satisfaction with a multidisciplinary vocational rehabilitation programme was good. Areas for improvement mainly concerned the speed of the process and the communication between team members and occupational physicians.

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Selected References

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  1. Allaire S. H., Partridge A. J., Andrews H. F., Liang M. H. Management of work disability. Resources for vocational rehabilitation. Arthritis Rheum. 1993 Dec;36(12):1663–1670. doi: 10.1002/art.1780361204. [DOI] [PubMed] [Google Scholar]
  2. Andries F., Wevers C. W., Wintzen A. R., Busch H. F., Höweler C. J., de Jager A. E., Padberg G. W., de Visser M., Wokke J. H. Vocational perspectives and neuromuscular disorders. Int J Rehabil Res. 1997 Sep;20(3):255–273. doi: 10.1097/00004356-199709000-00003. [DOI] [PubMed] [Google Scholar]
  3. Arnett F. C., Edworthy S. M., Bloch D. A., McShane D. J., Fries J. F., Cooper N. S., Healey L. A., Kaplan S. R., Liang M. H., Luthra H. S. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. doi: 10.1002/art.1780310302. [DOI] [PubMed] [Google Scholar]
  4. Boonen A., Chorus A., Miedema H., van der Heijde D., Landewé R., Schouten H., van der Tempel H., van der Linden S. Withdrawal from labour force due to work disability in patients with ankylosing spondylitis. Ann Rheum Dis. 2001 Nov;60(11):1033–1039. doi: 10.1136/ard.60.11.1033. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Broersen J. P., de Zwart B. C., van Dijk F. J., Meijman T. F., van Veldhoven M. Health complaints and working conditions experienced in relation to work and age. Occup Environ Med. 1996 Jan;53(1):51–57. doi: 10.1136/oem.53.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Buijs P., van Amstel R., van Dijk F. Dutch occupational physicians and general practitioners wish to improve cooperation. Occup Environ Med. 1999 Oct;56(10):709–713. doi: 10.1136/oem.56.10.709. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Chorus A. M., Miedema H. S., Wevers C. W., van der Linden S. Work factors and behavioural coping in relation to withdrawal from the labour force in patients with rheumatoid arthritis. Ann Rheum Dis. 2001 Nov;60(11):1025–1032. doi: 10.1136/ard.60.11.1025. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Doeglas D., Suurmeijer T., Krol B., Sanderman R., van Leeuwen M., van Rijswijk M. Work disability in early rheumatoid arthritis. Ann Rheum Dis. 1995 Jun;54(6):455–460. doi: 10.1136/ard.54.6.455. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Franco G. Occupational physicians' education and training across European Union countries. Int Arch Occup Environ Health. 1999 Aug;72(5):338–342. doi: 10.1007/s004200050385. [DOI] [PubMed] [Google Scholar]
  10. Gilworth G., Haigh R., Tennant A., Chamberlain M. A., Harvey A. R. Do rheumatologists recognize their patients' work-related problems? Rheumatology (Oxford) 2001 Nov;40(11):1206–1210. doi: 10.1093/rheumatology/40.11.1206. [DOI] [PubMed] [Google Scholar]
  11. Guillemin F., Briançon S., Pourel J., Gaucher A. Long-term disability and prolonged sick leaves as outcome measurements in ankylosing spondylitis. Possible predictive factors. Arthritis Rheum. 1990 Jul;33(7):1001–1006. doi: 10.1002/art.1780330712. [DOI] [PubMed] [Google Scholar]
  12. Lehnert G., Wrbitzky R. Occupational health in Germany and other countries of the European Union. Int J Occup Med Environ Health. 1998;11(1):9–18. [PubMed] [Google Scholar]
  13. Mancuso C. A., Paget S. A., Charlson M. E. Adaptations made by rheumatoid arthritis patients to continue working: a pilot study of workplace challenges and successful adaptations. Arthritis Care Res. 2000 Apr;13(2):89–99. [PubMed] [Google Scholar]
  14. Mau W., Bornmann M., Weber H., Weidemann H. F. Defizite rehabilitativer Massnahmen im Verlauf der frühen chronischen Polyarthritis. Z Rheumatol. 1996 Jul-Aug;55(4):223–229. [PubMed] [Google Scholar]
  15. Mau W., Bornmann M., Weber H., Weidemann H. F., Hecker H., Raspe H. H. Prediction of permanent work disability in a follow-up study of early rheumatoid arthritis: results of a tree structured analysis using RECPAM. Br J Rheumatol. 1996 Jul;35(7):652–659. doi: 10.1093/rheumatology/35.7.652. [DOI] [PubMed] [Google Scholar]
  16. McMillan J. R. Measuring consumer satisfaction to improve quality of care. Health Prog. 1987 Mar;68(2):54-5, 76-80. [PubMed] [Google Scholar]
  17. Merkesdal S., Ruof J., Schöffski O., Bernitt K., Zeidler H., Mau W. Indirect medical costs in early rheumatoid arthritis: composition of and changes in indirect costs within the first three years of disease. Arthritis Rheum. 2001 Mar;44(3):528–534. doi: 10.1002/1529-0131(200103)44:3<528::AID-ANR100>3.0.CO;2-U. [DOI] [PubMed] [Google Scholar]
  18. Mitchell J. M., Burkhauser R. V., Pincus T. The importance of age, education, and comorbidity in the substantial earnings losses of individuals with symmetric polyarthritis. Arthritis Rheum. 1988 Mar;31(3):348–357. doi: 10.1002/art.1780310306. [DOI] [PubMed] [Google Scholar]
  19. Nijboer I. D., Wevers C. J. Vocational rehabilitation of young adults with a disability of one arm or hand. Int J Rehabil Res. 1993;16(1):45–47. doi: 10.1097/00004356-199303000-00006. [DOI] [PubMed] [Google Scholar]
  20. Partridge A. J., Karlson E. W., Daltroy L. H., Lew R. A., Wright E. A., Fossel A. H., Straaton K. V., Stern S. H., Kavanaugh A. F., Roberts W. N. Risk factors for early work disability in systemic lupus erythematosus: results from a multicenter study. Arthritis Rheum. 1997 Dec;40(12):2199–2206. doi: 10.1002/art.1780401214. [DOI] [PubMed] [Google Scholar]
  21. Schmidt S. H., Oort-Marburger D., Meijman T. F. Employment after rehabilitation for musculoskeletal impairments: the impact of vocational rehabilitation and working on a trial basis. Arch Phys Med Rehabil. 1995 Oct;76(10):950–954. doi: 10.1016/s0003-9993(95)80073-5. [DOI] [PubMed] [Google Scholar]
  22. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  23. Tijhuis Gerhardus J., Kooiman Kees G., Zwinderman Aeilko H., Hazes J. M. W., Breedveld F. C., Vliet Vlieland T. P. M. Validation of a novel satisfaction questionnaire for patients with rheumatoid arthritis receiving outpatient clinical nurse specialist care, inpatient care, or day patient team care. Arthritis Rheum. 2003 Apr 15;49(2):193–199. doi: 10.1002/art.10994. [DOI] [PubMed] [Google Scholar]
  24. Weiss B. D., Senf J. H. Patient satisfaction survey instrument for use in health maintenance organizations. Med Care. 1990 May;28(5):434–445. doi: 10.1097/00005650-199005000-00003. [DOI] [PubMed] [Google Scholar]
  25. Wevers C. W., Brouwer O. F., Padberg G. W., Nijboer I. D. Job perspectives in facioscapulohumeral muscular dystrophy. Disabil Rehabil. 1993 Jan-Mar;15(1):24–28. doi: 10.3109/09638289309165865. [DOI] [PubMed] [Google Scholar]
  26. Yelin E., Henke C., Epstein W. The work dynamics of the person with rheumatoid arthritis. Arthritis Rheum. 1987 May;30(5):507–512. doi: 10.1002/art.1780300504. [DOI] [PubMed] [Google Scholar]
  27. de Bono A. M. Communication between an occupational physician and other medical practitioners--an audit. Occup Med (Lond) 1997 Aug;47(6):349–356. doi: 10.1093/occmed/47.6.349. [DOI] [PubMed] [Google Scholar]
  28. de Buck P. D. M., van Amstel R. J., Buijs P. C., Maasen J. H. W., van Dijk F. J. H., Hazes J. M. W., Vliet Vlieland T. P. M. Communication between Dutch rheumatologists and occupational physicians in the occupational rehabilitation of patients with rheumatic diseases. Ann Rheum Dis. 2002 Jan;61(1):62–65. doi: 10.1136/ard.61.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. de Buck Petronella D. M., Schoones Johannes W., Allaire Saralyn H., Vliet Vlieland Theodora P. M. Vocational rehabilitation in patients with chronic rheumatic diseases: a systematic literature review. Semin Arthritis Rheum. 2002 Dec;32(3):196–203. doi: 10.1053/sarh.2002.34609. [DOI] [PubMed] [Google Scholar]
  30. de Zwart B. C., Broersen J. P., van der Beek A. J., Frings-Dresen M. H., van Dijk F. J. Occupational classification according to work demands: an evaluation study. Int J Occup Med Environ Health. 1997;10(3):283–295. [PubMed] [Google Scholar]
  31. van Campen C., Sixma H. J., Kerssens J. J., Peters L., Rasker J. J. Assessing patients' priorities and perceptions of the quality of health care: the development of the QUOTE-Rheumatic-Patients instrument. Br J Rheumatol. 1998 Apr;37(4):362–368. doi: 10.1093/rheumatology/37.4.362. [DOI] [PubMed] [Google Scholar]
  32. van Dijk F. J., Prins R. Occupational health care and work incapacity: recent developments in The Netherlands. Occup Med (Lond) 1995 Jun;45(3):159–166. doi: 10.1093/occmed/45.3.159. [DOI] [PubMed] [Google Scholar]
  33. van Jaarsveld C. H., Jacobs J. W., Schrijvers A. J., van Albada-Kuipers G. A., Hofman D. M., Bijlsma J. W. Effects of rheumatoid arthritis on employment and social participation during the first years of disease in The Netherlands. Br J Rheumatol. 1998 Aug;37(8):848–853. doi: 10.1093/rheumatology/37.8.848. [DOI] [PubMed] [Google Scholar]
  34. van der Linden S., Valkenburg H. A., Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984 Apr;27(4):361–368. doi: 10.1002/art.1780270401. [DOI] [PubMed] [Google Scholar]
  35. van der Waal M. A., Casparie A. F., Lako C. J. Quality of care: a comparison of preferences between medical specialists and patients with chronic diseases. Soc Sci Med. 1996 Mar;42(5):643–649. doi: 10.1016/0277-9536(95)00200-6. [DOI] [PubMed] [Google Scholar]
  36. van der Weide W. E., Verbeek J. H., van Dijk F. J. Relation between indicators for quality of occupational rehabilitation of employees with low back pain. Occup Environ Med. 1999 Jul;56(7):488–493. doi: 10.1136/oem.56.7.488. [DOI] [PMC free article] [PubMed] [Google Scholar]

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