title: Operationalizing a shared decision making model for work rehabilitation programs: a consensus process.
abstract: OBJECTIVE
  The objective of this study was to design and operationalize shared decision making (SDM) rehabilitation model for worker rehabilitation programs. SDM has previously been shown to improve decision outcomes in patient-health care professional relationships. To date, SDM has not yet been adapted to work rehabilitation, although it could be a valuable approach to better understand and agree on return-to-work decisions.
  
  
  METHODS
  We designed a preliminary model for return-to-work decisions for workers suffering from pain due to musculoskeletal injuries. We submitted the preliminary model and a questionnaire to expert health care professionals. Using the Technique for Research of Information by Animation of a Group of Experts method, a group consensus process was used to discuss and refine the experts' responses to operationalize a model adapted for rehabilitation.
  
  
  RESULTS
  Eleven occupational therapists (three were clinical coordinators) and four psychologists participated in three group consensus sessions. The final version of the model included one general longitudinal objective (the maintenance of a working alliance and assuring mutual comprehension among all stakeholders), and 11 specific objectives: establishing a working alliance, seven in the deliberation phase of the SDM process, and three in the implementation of the decision. Participants also reached consensus on between 1 and 8 indicators per objective.
  
  
  CONCLUSIONS
  We developed and operationalized an SDM rehabilitation model intended for a return-to-work implementation plan. The next step will be to document its feasibility among the main stakeholders (employer, union, insurer and worker) taking part in decisions about return to work.
authors.affiliation: Research Center - Hôpital Charles-Le Moyne, Université de Sherbrooke, 150, Place Charles LeMoyne, Longueuil, QC, J4K 0A8, 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: Lesley
authors.initials: L
authors.lastname: Bainbridge
authors.forename: Marie-Elise
authors.initials: ME
authors.lastname: Labrecque
mesh_terms: D000328:Adult; D032921:Consensus; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D017146:Models, Organizational; D009141:Musculoskeletal System / Q000293:injuries; D009788:Occupational Therapy / Q000379:methods / Q000458:organization & administration; D012050:Rehabilitation, Vocational / Q000379:methods*; D062707:Return to Work