Case management training needs to support vocational rehabilitation for case managers and general practitioners: a survey study

BMC Medical Education

Ewan B Macdonald²  John K Lando¹  Furzana Khan²  Mairi Gaffney²  Evangelia Demou² 

[1] Motherwell Health Centre, 138 Windmillhill Street, Motherwell ML1 1 TB, UK;Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

关键词: Training needs;    Vocational rehabilitation;    General practitioners;    Condition management;    Case management;   

Others  :  866713
DOI  :  10.1186/1472-6920-14-95

 received in 2013-04-30, accepted in 2014-05-14,  发布年份 2014

【 摘 要 】

Background

The use of the biopsychosocial model of health and case management for effective vocational rehabilitation (VR) has been confirmed for many health conditions. While Case and Condition Managers (CCMPs) use this approach in their everyday work, little is known about their views on training needs. A review of the training curriculum for General Practitioners’ (GPs) revealed little training in VR and the biopsychosocial model of care. This study aims to identify Case and Condition Managers and GPs perceptions of their training needs in relation to employability and VR.

Methods

80 Case and Condition Managers and 304 GPs working in NHS Lanarkshire, providing a comparison group, were invited to participate in this study. A self-completion questionnaire was developed and circulated for online completion with a second round of hardcopy questionnaires distributed.

Results

In total 45 responses were obtained from CCMPs, 5 from occupational health nurses (62% response rate) and 60 from GPs (20% response rate). CCMPs and the nursing group expressed a need for training but to a lesser extent than GP’s. The GP responses demonstrated a need for high levels of training in case/condition management, the biopsychosocial model, legal and ethical issues associated with employment and VR, and management training.

Conclusions

This survey confirms a need for further training of CCMPs and that respondent GPs in one health board are not fully equipped to deal with patients employability and vocational needs. GPs also reported a lack of understanding about the role of Case and Condition managers. Training for these professional groups and others involved in multidisciplinary VR could improve competencies and mutual understanding among those advising patients on return-to-work.

【 授权许可】

   
2014 Demou et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Scottish Executive: Coordinated, Integrated and Fit for Purpose: A Delivery Framework for Adult Rehabilitation in Scotland. Edinburgh; 2007.
• [2]Waddell G, Burton K: Is work good for your health and wellbeing?. The Stationery Office: The Stationery Office (TSO); 2006.
• [3]The Process of VR
• [4]Pransky GS, Loisel P, Anema JR: Work disability prevention research: current and future prospects. J Occup Rehabil 2011, 21(3):287-292.
• [5]Waddell G, Burton K: Concepts of Rehabilitation for the Management of Common Health Problems. London: The Stationery Office; 2004.
• [6]Black CD: Dame Carol Black’s Review of the health of Britain’s working age population: Working for a healthier tomorrow. London: The Stationery Office; 2008.
• [7]Engel G: The need for a new medical model: a challenge for biomedicine. Science 1977, 196(4286):129-136.
• [8]Campbell J, Wright C, Moseley A, Chilvers R, Richards S, Stabb L: Avoiding long-term incapacity for work: developing an early intervention in primary care. Exeter: Peninsula Medical School, Primary Care Research Group on behalf of the Department for Work and Pensions (Health Work and Wellbeing); 2007.
• [9]Macdonald E: Tackling the Failures of the Welfare State - “Thinking the Do-able”. A Paper for Policy Makers. Glasgow; 2010. http://www.gla.ac.uk/media/media_166963_en.pdf webcite
• [10]Joyce KE, Smith KE, Henderson G, Greig G, Bambra C: Patient perspectives of condition management programmes as a route to better health, well-being and employability. Fam Pract 2010, 27(1):101-109.
• [11]Case Management Society UK. http://www.cmsuk.org/ webcite
• [12]Kennedy F, Senior Case Manager: Role of Condition Managers (personal communication). In Edited by Demou E. 2014.
• [13]Demou E, Gibson I, Macdonald EB: Identification of the factors associated with outcomes in a Condition Management Programme. BMC Public Health 2012, 12:927.
• [14]O’Reilly SC, Muir KR, Doherty M: Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: a randomised controlled trial. Ann Rheum Dis 1999, 58(1):15-19.
• [15]Russo D, Innes E: An organizational case study of the case manager’s role in a client’s return-to-work programme in Australia. Occup Ther Int 2002, 9(1):57-75.
• [16]Chouinard M-C, Hudon C, Dubois M-F, Roberge P, Loignon C, Tchouaket E, Fortin M, Couture E-M, Sasseville M: Case management and self-management support for frequent users with chronic disease in primary care: a pragmatic randomized controlled trial. BMC Health Serv Res 2013, 13:49-49.
• [17]McDonald J, Jayasuriya R, Harris MF: The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus. BMC Health Serv Res 2012, 12:63.
• [18]You EC, Dunt D, Doyle C, Hsueh A: Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies. BMC Health Serv Res 2012, 12:395.
• [19]Higgins RO, Murphy BM, Goble AJ, Le Grande MR, Elliott PC, Worcester MUC: Cardiac rehabilitation program attendance after coronary artery bypass surgery: overcoming the barriers. Med J Aust 2008, 188(12):712-714.
• [20]Coole C, Watson PJ, Drummond A: Work problems due to low back pain: what do GPs do? A questionnaire survey. Fam Pract 2010, 27(1):31-37.
• [21]Farrell C, Nice K, Lewis J, Sainsbury R: Experiences of the Job Retention and Rehabilitation Pilot. In Research Report No 339. Edited by Department for Work and Pensions. Leeds: National Centre for Social Research and Social Policy Research Unit at the University of York, on behalf of the Department for Work and Pensions; 2006.
• [22]Frank AO, Chamberlain MA: Keeping our patients at work: implications for the management of those with rheumatoid arthritis and musculoskeletal conditions. Rheumatology 2004, 40(11):1201-1205.
• [23]RCGP: RCGP - GP Curriculum Documents. Royal College of General Practitioners, Curriculum and Assessment Site 2010. http://www.rcgp-curriculum.org.uk/rcgp_-_gp_curriculum_documents.aspx webcite
• [24]Gensichen J, Guethlin C, Kleppel V, Jaeger C, Mergenthal K, Gerlach FM, Petersen JJ: Practice-based depression case management in primary care: a qualitative study on family doctors’ perspectives. Fam Pract 2011, 28(5):565-571.
• [25]Gruffydd-Jones K, Richman J, Jones RCM, Wang X: A pilot study of identification and case management of high-risk COPD patients in a general practice. Fam Pract 2010, 27(5):494-498.
• [26]Powell S, Towers A, Milne P: The public health view on closing the gap between public health and primary care. Fam Pract 2008, 25:I17-I19.
• [27]Wermeling M, Scherer M, Himmel W: GPs’ experiences of managing non-specific neck pain-a qualitative study. Fam Pract 2011, 28(3):300-306.
• [28]Sikorski C, Luppa M, Koenig H-H, van den Bussche H, Riedel-Heller SG: Does GP training in depression care affect patient outcome? - A systematic review and meta-analysis. BMC Health Serv Res 2012, 12:10.
• [29]Anema JR, Jettinghoff K, Houtman I, Schoemaker CG, Buijs PC, Berg R: Medical care of employees long-term sick listed due to mental health problems: a cohort study to describe and compare the care of the occupational physician and the general practitioner. J Occup Rehabil 2006, 16(1):38-49.
• [30]de Stampa M, Vedel I, Bergman H, Novella J-L, Lapointe L: Fostering participation of general practitioners in integrated health services networks: incentives, barriers, and guidelines. BMC Health Serv Res 2009, 9:48.
• [31]Morales-Asencio JM, Gonzalo-Jimenez E, Martin-Santos FJ, Morilla-Herrera JC, Celdraan-Manas M, Carrasco AM, Garcia-Arrabal JJ, Toral-Lopez I: Effectiveness of a nurse-led case management home care model in Primary Health Care. A quasi-experimental, controlled, multi-centre study. BMC Health Serv Res 2008, 8:193.
• [32]Raven MC, Doran KM, Kostrowski S, Gillespie CC, Elbel BD: An intervention to improve care and reduce costs for high-risk patients with frequent hospital admissions: a pilot study. BMC Health Serv Res 2011, 11:270.
• [33]Rasmussen K, Andersen JH: Individual factors and GP approach as predictors for the outcome of rehabilitation among long-term sick listed cases. J Occup Rehabil 2005, 15(2):227-235.
• [34]Sampere M, Gimeno D, Serra C, Plana M, Lopez JC, Martinez JM, Delclos GL, Benavides FG: Return to work expectations of workers on long-term non-work-related sick leave. J Occup Rehabil 2012, 22(1):15-26.
• [35]Souville M, Cabut S, Viau A, Iarmarcovai G, Arnaud S, Verger P: General practitioners and patients with psychological stress at work. J Occup Rehabil 2009, 19(3):256-263.
• [36]Armstrong D, Ashworth M: When questionnaire response rates do matter: a survey of general practitioners and their views of NHS changes. Br J Gen Pract 2000, 50(455):479-480.
• [37]Barclay S, Todd C, Finlay I, Grande G, Wyatt P: Not another questionnaire! Maximizing the response rate, predicting non-response and assessing non-response bias in postal questionnaire studies of GPs. Fam Pract 2002, 19(1):105-111.
• [38]Creavin ST, Creavin AL, Mallen CD: Do GPs respond to postal questionnaire surveys? A comprehensive review of primary care literature. Fam Pract 2011, 28(4):461-467.
• [39]Crouch S, Robinson P, Pitts M: A comparison of general practitioner response rates to electronic and postal surveys in the setting of the National STI Prevention Program. Aust N Z J Public Health 2011, 35(2):187-189.
• [40]Stocks N, Gunnell D: What are the characteristics of general practitioners who routinely do not return postal questionnaires: a cross sectional study. J Epidemiol Community Health 2000, 54(12):940-941.
• [41]Templeton L, Deehan A, Taylor C, Drummond C, Strang J: Surveying general practitioners: does a low response rate matter? Br J Gen Pract 1997, 47(415):91-94.
• [42]Bonevski B, Magin P, Horton G, Foster M, Girgis A: Response rates in GP surveys trialling two recruitment strategies. Aust Fam Physician 2011, 40(6):427-430.
• [43]Charlton R: Research: is an ‘ideal’ questionnaire possible? Int J Clin Pract 2000, 54(6):356-359.
• [44]Barclay S, Todd C, Grande G, Lipscombe J: How common is medical training in palliative care? A postal survey of general practitioners. Br J Gen Pract 1997, 47(425):800-804.