P077 Upskilling rheumatology therapists in work rehabilitation: an evaluation of the Workwell training programme
Authors: Hammond Alison , Woodbridge Sarah , O'Brien Rachel , Ching Angela , Parker Jen 
Published: April 2021

Background/Aims 

Keeping people with arthritis working is an important goal of rehabilitation. Rheumatology therapists may provide work advice to employed patients but conducting a structured work assessment and providing vocational rehabilitation (VR) is unusual. As part of a VR trial, we developed a VR training course (Workwell). The course consisted of 3 elements: a pre-training self-study module (reading on ergonomics and activity analysis; activity analysis of at least 2 videos of people working; observing people working); a 2-day training course (how to conduct a structured work interview (the Work Environment Survey: WES); case studies; planning work interventions; practical workshops about VR strategies and solutions; addressing disclosure; writing reports); followed by a 1:1 one hour telephone call practising conducting the WES with a trainer, developing a treatment plan, and individual feedback. A “Workwell Solutions Manual” was also provided for use in practice, with information on legislation, patient booklets and work solutions linked to problems identified in the WES. Our aim was to evaluate therapists’ views about the course and its impact.

Methods 

All therapists attending the Workwell course were asked to complete questionnaires pre- and post-training. These included: knowledge of and confidence in providing VR (measured on a 0-4 scale of very limited to excellent); the Evidence Based Practice Attitude Scale (EBPAS); and views about course content and duration.

Results 

Three courses were delivered: 32/40 attendees completed pre-and-post training questionnaires. All were occupational therapists (OTs): 30 women and 2 men; 2 NHS Band 5, 15 Band 6, 11 Band 7 and 4 Band 8; with 11 (SD 7) years’ experience in Rheumatology. Median scores of Knowledge of: VR; the VR process; VR strategies; relevant legislation and policies; and Confidence in: conducting a work assessment; and identifying work solutions, significantly increased from 1 (limited: IQR 1-2) to 3 (good: IQR 2-3) (p &lt; 0.001). Total EBPAS scores did not change. However, Openness sub-scale scores did (i.e. extent to which willing to use new research -based interventions): Pre 2 (moderate: IQR2-3) to Post 3 (great: IQR 3-3): p = 0.04. Most (i.e. 26-30) considered very/extremely relevant: the pre-training self-study; conducting the WES and case studies; practical workshops (workstation assessment; upper limb strategies; load handling; environment; disclosure); and the post-training 1:1 practice WES, treatment planning and feedback. The training about using the WES (roleplay by trainers; case studies and 1:1 telephone practice) was considered the most beneficial aspect. Of the 21 commenting on course length, 16 considered it about right and 5 wanted longer.

Conclusion 

The 2-day VR course, plus 2 days self-study, led to significant improvements in knowledge and confidence in delivering VR amongst attending OTs. Work is a key component of OT. This training course could help expand work services in Rheumatology to keep patients working.

Disclosure 

A. Hammond: None. S. Woodbridge: None. R. O'Brien: None. A. Ching: None. J. Parker: None.