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First Contact Practitioners' (FCPs) and General Practitioners' Perceptions Towards FCPs Delivering Vocational Advice to Patients with Musculoskeletal Conditions: A Qualitative Investigation of the Implementation Potential of the I-SWAP Initiative.

Saunders, Benjamin; Foster, Nadine E; Hill, Jonathan C; Sowden, Gail; Evans, Nicola; Bishop, Annette; Stynes, Siobhan; Dziedzic, Krysia; Campbell, Laura; Rankin, Gabrielle; Salmon, Paula; Wynne-Jones, Gwenllian

First Contact Practitioners' (FCPs) and General Practitioners' Perceptions Towards FCPs Delivering Vocational Advice to Patients with Musculoskeletal Conditions: A Qualitative Investigation of the Implementation Potential of the I-SWAP Initiative. Thumbnail


Authors

Nadine E Foster

Gail Sowden

Annette Bishop

Gabrielle Rankin

Paula Salmon



Abstract

Purpose Musculoskeletal (MSK) pain is a common cause of work absence. The recent SWAP (Study of Work And Pain) randomised controlled trial (RCT) found that a brief vocational advice service for primary care patients with MSK pain led to fewer days' work absence and provided good return-on-investment. The I-SWAP (Implementation of the Study of Work And Pain) initiative aimed to deliver an implementation test-bed of the SWAP vocational advice intervention with First Contact Practitioners (FCP). This entailed adapting the SWAP vocational advice training to fit the FCP role. This qualitative investigation explored the implementation potential of FCPs delivering vocational advice for patients with MSK pain. Methods Semi-structured interviews and focus groups were conducted with 10 FCPs and 5 GPs. Data were analysed thematically and findings explored using Normalisation Process Theory (NPT). Results I-SWAP achieved a degree of 'coherence' (i.e. made sense), with both FCPs and GPs feeling FCPs were well-placed to discuss work issues with these patients. However, for many of the FCPs, addressing or modifying psychosocial and occupational barriers to return-to-work was not considered feasible within FCP consultations, and improving physical function was prioritised. Concerns were also raised that employers would not act on FCPs' recommendations regarding return-to-work. Conclusion FCPs appear well-placed to discuss work issues with MSK patients, and signpost/refer to other services; however, because they often only see patients once they are less suited to deliver other aspects of vocational advice. Future research is needed to explore how best to provide vocational advice in primary care settings.

Journal Article Type Article
Acceptance Date Jun 25, 2021
Online Publication Date Jul 9, 2021
Publication Date 2022-03
Publicly Available Date Mar 29, 2024
Journal Journal of Occupational Rehabilitation
Print ISSN 1053-0487
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 32
Pages 147–155
DOI https://doi.org/10.1007/s10926-021-09992-5
Publisher URL https://link.springer.com/article/10.1007%2Fs10926-021-09992-5

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