Acceptability and Feasibility of a Shared Decision-Making Model in Work Rehabilitation: A Mixed-Methods Study of Stakeholders’ Perspectives

Abstract

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.

Developing Normative Integration among Professionals in an Intersectoral Collaboration: A Multi-Method Investigation of an Integrated Intervention for People on Sick Leave Due to Common Mental Disorders

“…This challenge is prominent in the area of vocational rehabilitation for people with mental disorders where multidisciplinary support is recommended to help individuals recover their mental health and re-enter the labour market [567]. Service providers and stakeholders involved in vocational recovery come from health care, social services, occupational health services, social or private insurance companies, as well as workplaces and trade unions [58]. They often have different plans, success criteria and expectations for the individual on sick leave [8910], which can cause increased stress for the person on sick leave [11].…”

“…Service providers and stakeholders involved in vocational recovery come from health care, social services, occupational health services, social or private insurance companies, as well as workplaces and trade unions [58]. They often have different plans, success criteria and expectations for the individual on sick leave [8910], which can cause increased stress for the person on sick leave [11]. Lack of coordination between stakeholders is problematic for mentally ill persons [12] who frequently experience loss of control, decreased planning capabilities, and poor predictability regarding their recovery [13].…”

Shared Decision Making in an Integrated Mental Health and Vocational Rehabilitation Intervention: Stakeholder Practices and Experiences

“…A feasibility study of shared decision making in vocational rehabilitation confirms the importance of intermediate goals in vocational rehabilitation and the relevance of shared decision making to setting them [16]. In this study, all stakeholders identified return-to-work conditions and action plans (such as the shared plan) as the most important problems requiring shared decision making.…”

“…should occur in collaboration between clients and professionals [6]. It was also recommended to make the client perspective the central organising principle and that professionals should provide services that are respectful of and responsive to the client's individual preferences, needs, and values and let client values guide decisions [6,[13][14][15][16][17][18][19].…”

“…Shared decision making has primarily been used in health care and was originally developed to support physician-patient collaboration and decision making related to somatic illness, but its relevance has been tested and evaluated in various fields including mental health care [24]. Its potential in integrated health and vocational rehabilitation has rarely been explored [16,17].…”