Purpose

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.

Conclusion

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.

中文翻译：

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当前实践中的临床工作整合护理：范围界定审查

目的

临床工作整合护理（CWIC）是指关注临床环境中的工作参与。在职患者可能会受益于 CWIC。本研究的目的是探讨医学专家提供 CWIC 的程度和性质，以及政策和指南要求或建议专家做什么。

方法

进行了范围界定审查。对数据库 MEDLINE、EMBASE、Psychinfo、CINAHL 和 Web of Science 进行了搜索，以查找有关 CWIC 范围和性质的研究，并补充了有关政策和指南的灰色文献。预先定义了六个主要类别。采用元聚合方法，随后使用定性数据定义子类别。接下来，定量研究结果被整合到这些子类别中。使用相同的主要类别对政策和指导方针进行了单独的叙述。

结果

总共纳入 70 项研究和 55 篇灰色文献。每个类别的主要发现如下：（1）收集的患者职业数据差异很大；(2) 大多数专家并不经常讨论工作，但最近的研究表明这样做的趋势日益明显，这与最近的政策和指导方针相符；(3) 与工作相关的建议，从一般建议到医患关于工作相关决策的协作；（4）CWIC是由许多国家的立法驱动的；(5) 专家有时会组成多学科团队合作提供 CWIC；(6) 一般没有关于 CWIC 的医疗指南。

结论

医疗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。缺乏医疗指南可以解释这些做法的多样性。