Authors (including presenting author) :
Lam HW(1), Cheung WL(1), Cheung TY(1)
Affiliation :
(1) Occupational Therapy Department, Tuen Mun Hospital
Introduction :
An early work rehabilitation model in Occupational Therapy (OT) service was developed in Day Rehabilitation Management (DRM) to facilitate patients with medical illnesses returning to work. The service included preliminary work assessment, work simulation training, fundamental work conditioning, work advice, and fast-track work rehabilitation outpatient (OPD) triage.
Objectives :
To review effectiveness of the early work rehabilitation service model in DRM.
To identify potential predictor(s) of vocational outcome based on patient’s outcomes.
Methodology :
Patients attending DRM from 1/4/2023 to 31/3/2024 with return to work (RTW) plan were recruited. Outcome measures included occupation classification, Modified Barthel Index (MBI), and Montreal Cognitive Assessment (MoCA).
Grouping was based on status of work upon 31/12/2024 (group A: successful RTW, group B: failed RTW). Mann-Whitney U test was applied to compare between-groupo baseline, final and change in MBI and MoCA.
Result & Outcome :
221 patients attended DRM. 47 patients were with RTW plan. 36 patients were recruited as 11 patients’ work status was unidentifiable. (group A=30, group B=6)
There was a significant difference in baseline (p=0.005) and final MoCA (p=0.017) between the groups. Both scores of group A were significantly higher than those of group B.
There was no significant difference in other outcomes between the groups.
The successful rate of RTW in occupation classification of sedentary, light, medium and heavy was 88.9% (n=9), 78.9% (n=19), 83.8% (n=6) and 100% (n=2) respectively.
Patients attending OT work rehabilitation OPD training required 6 to 8 weeks waiting time. While the average waiting time of DRM was 13.6 days that the service gap for patients after acquiring medical diseases was largely reduced.
A fast-track work rehabilitation OPD with less than 1 month waiting time was developed to speed up post-DRM work-related follow-up. Seamless bridging to continuous rehabilitation was guaranteed. Among the successful RTW patients, 13 of them required subsequent follow-up services for successful duty resumption.
Preserved cognitive function after disease was deemed to be a significant predictor of better vocational outcome. However, the predictability of other factors was not negligible due to influence of confounding factors. A continuous review with larger sample size in future could guarantee factors with higher predictability in vocational outcome.
