Acceptability and Feasibility of a Shared Decision-Making Model in Work Rehabilitation: A Mixed-Methods Study of Stakeholders’ Perspectives
Purpose To establish the acceptability and feasibility of implementing a shared decision-making (SDM) model in work rehabilitation. Methods We used a sequential mixed-methods design with diverse stakeholder groups (representatives of private and public employers, insurers, and unions, as well as workers having participated in a work rehabilitation program). First, a survey using a self-administered questionnaire enabled stakeholders to rate their level of agreement with the model’s acceptability and feasibility and propose modifications, if necessary. Second, eight focus groups representing key stakeholders (n = 34) and four one-on-one interviews with workers were conducted, based on the questionnaire results. For each stakeholder group, we computed the percentage of agreement with the model’s acceptability and feasibility and performed thematic analyses of the transcripts. Results Less than 50% of each stakeholder group initially agreed with the overall acceptability and feasibility of the model. Stakeholders proposed 37 modifications to the objectives, 17 to the activities, and 39 to improve the model’s feasibility. Based on in-depth analysis of the transcripts, indicators were added to one objective, an interview guide was added as proposed by insurers to ensure compliance of the SDM process with insurance contract requirements, and one objective was reformulated. Conclusion Despite initially low agreement with the model’s acceptability on the survey, subsequent discussions led to three minor changes and contributed to the model’s ultimate acceptability and feasibility. Later steps will involve assessing the extent of implementation of the model in real rehabilitation settings to see if other modifications are necessary before assessing its impact.
KeywordsRehabilitation Shared decision making Work Injuries People with disabilities Chronic pain
This study was supported by the Fonds de Recherche Québec – Santé and the Institut de recherche Robert-Sauvé en santé et sécurité du travail.
Compliance with Ethical Standards
Conflict of interest
None of the authors have any conflicts of interest to declare.
All procedures followed were in accordance with the ethical standards of the committee responsible for experiments on human subjects (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent for inclusion in the study was obtained from all patients.
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