title: Fostering shared decision making by occupational therapists and workers involved in accidents resulting in persistent musculoskeletal disorders: a study protocol.
abstract: BACKGROUND
  From many empirical and theoretical points of view, the implementation of shared decision making (SDM) in work rehabilitation for pain due to a musculoskeletal disorder (MSD) is justified but typically the SDM model applies to a one on one encounter between a healthcare provider and a patient and not to an interdisciplinary team.
  
  
  OBJECTIVE
  To adapt and implement an SDM program adapted to the realities of work rehabilitation for pain associated with a MSD. More specific objectives are to adapt an SDM program applicable to existing rehabilitation programs, and to evaluate the extent of implementation of the SDM program in four rehabilitation centres.
  
  
  METHODS
  For objective one, we will use a mixed perspective combining a theory-based development program/intervention and a user-based perspective. The users are the occupational therapists (OTs) and clinical coordinators. The strategies for developing an SDM program will include consulting the scientific literature and group consensus with clinicians-experts. A sample of convenience of eight OTs, four clinical coordinators and four psychologists all of whom have been working full-time in MSD rehabilitation for more than two years will be recruited from four collaborating rehabilitation centres. For objective two, using the same criteria as for objective one, we will first train eight OTs in SDM. Second, using a descriptive design, the extent to which the SDM program has been implemented will be assessed through observations of the SDM process. The observation data will be triangulated with the dyadic working alliance questionnaire, and findings from a final individual interview with each OT. A total of five patients per trained OT will be recruited, for a total of 40 patients. Patients will be eligible if they have a work-related disability for more than 12 weeks due to musculoskeletal pain and plan to start their work rehabilitation programs.
  
  
  CONCLUSIONS
  This study will be the first evaluation of the program and it is expected that improvements will be made prior to a broader-scale implementation. The ultimate aim is to improve the quality of decision making, patients' quality of life, and reduce the duration of their work-related disability by improving the services offered during the rehabilitation process.
authors.affiliation: Centre for action in work disability prevention and rehabilitation (CAPRIT) and School of Rehabilitation, Université de Sherbrooke, 1111, rue St-Charles ouest, bureau 101, Longueuil (Québec), J4K 5G4C, Canada. Marie-France.Coutu@USherbrooke.ca
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Coutu
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Durand
authors.forename: Marc
authors.initials: M
authors.lastname: Corbière
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.forename: Patrick
authors.initials: P
authors.lastname: Loisel
authors.forename: Lesley
authors.initials: L
authors.lastname: Bainbridge
mesh_terms: D000062:Accidents, Occupational; D003657:Decision Making; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009788:Occupational Therapy; D016730:Program Development; D015397:Program Evaluation; D011594:Psychometrics; D012047:Rehabilitation Centers; D062707:Return to Work; D011795:Surveys and Questionnaires