PDF(Pubmed)
Abstract：
OBJECTIVE: Clinical work-integrating care (CWIC) refers to paying attention to work participation in a clinical setting. Working patients may benefit from CWIC. The purpose of this study is to explore the extent and nature to which medical specialists provide CWIC and what policies and guidelines oblige or recommend specialists to do.
METHODS: A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed.
RESULTS: In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available.
CONCLUSIONS: Medical specialists provide a wide variety of CWIC ranging from assessing a patient\'s occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.
METHODS: A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed.
RESULTS: In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available.
CONCLUSIONS: Medical specialists provide a wide variety of CWIC ranging from assessing a patient\'s occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.
摘要：
目的：临床工作整合护理（CWIC）是指在临床环境中注意工作参与。工作患者可以从CWIC中受益。这项研究的目的是探讨医学专家提供CWIC的程度和性质，以及哪些政策和指南要求或建议专家做。
方法：进行了范围审查。MEDLINE数据库,EMBASE,Psychinfo,CINAHL,和WebofScience进行了有关CWIC的范围和性质的研究，并辅以有关政策和准则的灰色文献。六个主要类别是先验定义的。应用元聚合方法，随后使用定性数据定义子类别.接下来,定量结果被整合到这些子类别中.使用相同的主要类别构建了单独的政策和准则说明。
结果：总计，包括70项研究和55篇灰色文献。每个类别的主要发现如下：（1）收集有关患者职业的数据差异很大；（2）大多数专家没有常规讨论工作，但是最近的研究表明这样做的趋势越来越大，这符合最近的政策和指南;(3)与工作相关的建议范围从一般建议到与工作相关的决定的患者-医师合作;(4)CWIC受到许多国家立法的推动;(5)专家有时在多学科团队中合作提供CWIC;(6)通常没有关于CWIC的医学指南.
结论：医学专家提供各种各样的CWIC，从评估患者的职业到与患者和其他专业人员的广泛合作以支持工作参与。缺乏医学指南可以解释这些做法的多样性。
方法：进行了范围审查。MEDLINE数据库,EMBASE,Psychinfo,CINAHL,和WebofScience进行了有关CWIC的范围和性质的研究，并辅以有关政策和准则的灰色文献。六个主要类别是先验定义的。应用元聚合方法，随后使用定性数据定义子类别.接下来,定量结果被整合到这些子类别中.使用相同的主要类别构建了单独的政策和准则说明。
结果：总计，包括70项研究和55篇灰色文献。每个类别的主要发现如下：（1）收集有关患者职业的数据差异很大；（2）大多数专家没有常规讨论工作，但是最近的研究表明这样做的趋势越来越大，这符合最近的政策和指南;(3)与工作相关的建议范围从一般建议到与工作相关的决定的患者-医师合作;(4)CWIC受到许多国家立法的推动;(5)专家有时在多学科团队中合作提供CWIC;(6)通常没有关于CWIC的医学指南.
结论：医学专家提供各种各样的CWIC，从评估患者的职业到与患者和其他专业人员的广泛合作以支持工作参与。缺乏医学指南可以解释这些做法的多样性。
