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Angerer P, Gündel H, Kröger C, Rothermund E. [Rationale, models, and impact of workplace-based psychotherapeutic services]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:743-750. [PMID: 38806746 PMCID: PMC11231002 DOI: 10.1007/s00103-024-03892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Mental illnesses and behavioral disorders are very common among the working population, affecting up to a third of employees each year, and are associated with great suffering, the risk of chronicity, and the loss of employment. Economically, mental illnesses cause high costs. In order to mitigate these consequences and increase the chances of recovery, rapid diagnosis, early and appropriate treatment where necessary, and-over and above the usual psychotherapy approach-attention to the work-related causes are of crucial importance.Psychotherapeutic Consultation at the Workplace (PT-A) attempts to meet these requirements. It offers psychotherapeutic help at short notice and close to the workplace for employees suffering from mental stress; provides (depending on the problem) counseling, diagnostics, prevention, and short-term or bridging therapy; and supports reintegration after a longer period of mental illness. It is helpful to cooperate closely with the company medical service, which consults the PT‑A, refers employees to it, provides information on the company situation, and can support reintegration if necessary. Funding is often provided by the company but can also be provided by health insurance companies in integrated care models.This article begins by describing the history and principles of PT‑A and the role of work stress in the development of psychological and psychosomatic disorders. The implementation of PT‑A is then outlined using two examples. Finally, the current study "Early Intervention at the Workplace" ("Frühe Intervention am Arbeitsplatz" [friaa]), to which several articles in this special issue refer, is briefly presented.
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Affiliation(s)
- Peter Angerer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Harald Gündel
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Christoph Kröger
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Deutschland
| | - Eva Rothermund
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
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Kutsuna I, Hoshino A, Morisugi A, Mori Y, Shirato A, Takeda M, Isaji H, Suwa M. Relationship between duration of sick leave and time variation of words used in return-to-work programs for depression. Work 2024; 77:981-991. [PMID: 37781845 DOI: 10.3233/wor-230083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Return-to-work (RTW) programs are provided as rehabilitation for people who have taken sick leave from work because of mental health problems. However, methods to present this information to workplaces objectively remain limited. OBJECTIVE This study aimed to conduct an exploratory investigation of the relationship between duration of sick leave and time variation of words used in RTW programs for depression from textual data collected from electronic medical records as a new evaluation indicator. METHODS The study subjects were those who had taken sick leave because of major depressive or adjustment disorder and had participated in an RTW program. The study data comprised demographic characteristics and texts. Textual data were collected from electronic medical records and classified based on the SOAP note. Thereafter, the textual data were quantified into category scores based on a standard text analysis dictionary. A generalized linear mixed model was used for the statistical analysis, with the score for each category (emotional, social, cognitive, perceptual, biological, motivational, relativity, and informal) as the dependent variable and the duration of sick leave, time, and interaction between the duration of sick leave and time as the independent variables. The level of statistical significance was set at 0.05. RESULTS In total, 42 participants were included in the analysis. The results revealed a significant interaction between the social (p = 0.001) and emotional (p = 0.002) categories. CONCLUSION The findings suggest a relationship between word changes in electronic medical records and the duration of sick leave.
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Affiliation(s)
- Ichiro Kutsuna
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Aiko Hoshino
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Ami Morisugi
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Yukari Mori
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Aki Shirato
- Hinaga General Center for Mental Care, Mie, Japan
| | - Mirai Takeda
- Hinaga General Center for Mental Care, Mie, Japan
| | - Hikari Isaji
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Mami Suwa
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
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Gelaw AY, Sheehan L, Gray SE, Collie A. Time off work following psychological injury among health and social care workers: a population-based retrospective cohort study in New South Wales, Australia. Occup Environ Med 2023:oemed-2023-109105. [PMID: 38071593 DOI: 10.1136/oemed-2023-109105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/28/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVE This study aimed to determine the disability duration and burden of compensated time loss in the health and social care (HSC) sector following psychological injury. METHODS A retrospective cohort study was conducted using data from the New South Wales workers' compensation system. The median weeks disability duration and total weeks of working time lost (WWL) per 1000 workers were compared between the HSC sector and all other industries, and between specific occupational groups in the HSC sector, using accelerated failure time models. RESULTS HSC workers had a median (IQR) disability duration of 12.4 (3.3-40.0) weeks, which was less than the 15.3 (4.3-48.3) weeks observed in other industries. Within the HSC sector, ambulance officers had the longest disability duration at 31.1 (6.1-104.0) weeks and highest WWL at 15 734 weeks per 1000 workers. Conversely, nurses and midwives had the shortest disability duration at 8.0 (2.0-25.8) weeks, while other healthcare workers had the lowest WWL (17.0). Controlling for other determinants, ambulance officers had the highest likelihood of longer disability duration (time ratio (TR) 2.14; 95% CI 1.64 to 2.78), followed by social workers (TR 1.46; 95% CI 1.20 to 1.79) and administrators and managers (TR 1.41; 95% CI 1.15 to 1.71). Older age, female sex, full-time employment and working in small organisations correlated with extended disability duration. CONCLUSION There is considerable variation in the duration and burden of work disability due to psychological injury across occupational groups in the HSC sector. Findings suggest the need for occupation-specific workplace rehabilitation and psychological support to reduce the impact of psychological injury on HSC workers and improve return-to-work outcomes.
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Affiliation(s)
- Asmare Y Gelaw
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Luke Sheehan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shannon Elise Gray
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Taubman DS, Parikh SV. Understanding and Addressing Mental Health Disorders: a Workplace Imperative. Curr Psychiatry Rep 2023; 25:455-463. [PMID: 37589777 DOI: 10.1007/s11920-023-01443-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE OF REVIEW This article seeks to provide a broad overview of the workplace mental health literature, highlight practical implications of current research, and formulate key recommendations for stakeholders. Various aspects of disability related to mental health disorders, their associated financial costs, and the impact of stigma are covered. This article also discusses key strategies for assessing mental health problems among employees and reviews different types of interventions in the workplace. RECENT FINDINGS Workplace mental health is an evolving area, particularly in the wake of the pandemic. While established national workplace mental health standards do not currently exist, mental illness continues to have a severe impact on the health of organizations, employees, and the economy. Additional research is needed to fully understand and address the diversity of mental health needs among the broad range of employees and organizations across the USA. Employers have a responsibility and an opportunity to create workplaces that support the whole person, not just the employee. While research in the area has increased in the last decade, there is still much to learn in terms of the most effective ways to support our workforce.
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Ravinskaya M, Verbeek JH, Langendam M, Madan I, Verstappen SMM, Kunz R, Hulshof CTJ, Hoving JL. Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work). BMJ Open 2023; 13:e069174. [PMID: 36792339 PMCID: PMC9933745 DOI: 10.1136/bmjopen-2022-069174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed. STUDY DESIGN AND SETTING Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%-80% consensus was required for candidate outcomes. RESULTS Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: 'any type of employment including self-employment', 'proportion of workers that return to work after being absent because of illness' and 'time to return to work'. Ten candidate outcomes were proposed, among others: 'sustainable employment', 'work productivity' and 'workers' perception of return to work'. CONCLUSION As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.
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Affiliation(s)
- Margarita Ravinskaya
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jos H Verbeek
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Miranda Langendam
- Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ira Madan
- Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Regina Kunz
- Research Unit EbIM, Evidence Based Insurance Medicine, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
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Crawford J, Spence J, Lovegrove T, Tam E, Collins D, Harvey SB, Deady M. Pilot Trial of Workable: A Therapist-Supported Digital Program for Injured Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2460. [PMID: 36767833 PMCID: PMC9916348 DOI: 10.3390/ijerph20032460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Workplace sickness absence is a major public health and economic problem, and common mental disorders (CMDs) such as anxiety and depression are associated with particularly high rates of long-term sickness absence. Effective return-to-work (RTW) interventions are required. This pilot study investigates the feasibility, acceptability, and potential effectiveness of a new therapist-assisted Web-based RTW intervention (Workable) for injured workers on sick leave for a psychological or physical injury. A single-group open pilot trial design was used, with assessments at pre-treatment and post-treatment. The intervention consisted of 6 weeks of online modules and 6 coaching calls from a psychologist. A total of 13 participants were recruited and 9 completed all questionnaires. Program adherence was high, with 92% of participants completing the 6-week intervention. Participants reported high levels of intervention satisfaction and ease of use. There were large and significant reductions between pre- and post-treatment on measures of depression, anxiety, stress, and workdays missed over the past four weeks, along with a significant increase in self-reported work ability. These results suggest that Workable is a feasible and acceptable intervention for injured workers, with the potential to improve mental health and RTW outcomes. A randomized controlled trial is required to determine the efficacy of the intervention.
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Affiliation(s)
- Joanna Crawford
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Jay Spence
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | | | - Edman Tam
- Uprise Services Pty Ltd., Sydney, NSW 2000, Australia
| | - Daniel Collins
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Samuel B. Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2031, Australia
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Ravinskaya M, Verbeek JH, Langendam MW, Madan I, Verstappen SMM, Kunz R, Hulshof CTJ, Hoving JL. Preferred Methods of Measuring Work Participation: An International Survey Among Trialists and Cochrane Systematic Reviewers. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:620-628. [PMID: 35347539 PMCID: PMC9668767 DOI: 10.1007/s10926-022-10031-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
Purpose Heterogeneity in work participation (WP) outcomes measurements hampers large scale evidence synthesis in systematic reviews of trials. In this survey we explore authors' reasons for choosing specific WP outcomes and their measurement methods, including employment status, absence from work, at-work productivity loss, and employability. Methods We contacted authors of 260 trials and 69 systematic reviews and asked closed and open-ended questions about previously used WP outcomes and measurement methods as well as their opinion on the best way to measure WP. Results In total, 91 authors from a wide range of professional backgrounds completed the survey. The majority of authors (86%) chose WP outcomes based on their use in previous similar studies. In most studies (88%), patients had not been involved in the process of selecting the WP outcome. Authors judged feasibility to be an important factor for choosing a measurement instrument (67%). Additionally, valid measurement tools should be available, easy to administer and not too time consuming. Although authors preferred registry data for long term follow-up, the availability and validity of registries was seen as a barrier. Most of the reviewers (72%) struggled to pool data because of variation in follow-up times and cut off points and varying definitions of work outcomes. Almost all (92%) respondents support the use of a Core Outcome Set for Work. Conclusions There is strong support from authors of trials and systematic reviews to develop a core outcome set on work participation outcomes for the evaluation of interventions.
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Affiliation(s)
- Margarita Ravinskaya
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Jos H Verbeek
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Miranda W Langendam
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ira Madan
- Guy's and St Thomas' NHS Trust and Faculty of Life Sciences and Medicine, King's College London, Centre for Musculoskeletal Health and Work, London, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Regina Kunz
- Academic Unit EbIM, Evidence Based Insurance Medicine, Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Carel T J Hulshof
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jan L Hoving
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Rothermund E, Pößnecker T, Antes A, Kilian R, Kessemeier F, von Wietersheim J, Mayer D, Rieger MA, Gündel H, Hölzer M, Balint EM, Mörtl K. Conceptual Framework of a Psychotherapeutic Consultation in the Workplace: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14894. [PMID: 36429612 PMCID: PMC9690206 DOI: 10.3390/ijerph192214894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: A new health care offer called 'psychotherapeutic consultation in the workplace' is an early and effective intervention for employees with common mental disorders. Although cost-effective, it lacks a broader roll-out. This might be attributable to undefined context, mechanisms of change, and a lack of communication; therefore, this study explores how the new model works and where problems occur. (2) Methods: Semi-structured interviews on motivation, expectations and experiences with 20 involved experts. Experts were members of the company health promotion team, service users, and cooperating mental health specialists. Analysis was conducted with ATLAS.ti. (3) Results: The conceptual framework comprises three main topics: (a) structured implementation concept; (b) persons involved, shaping the concept's processes; (c) and meaning and function of the offer within the given context. Concerning (c) we found three potential areas of conflict: (1) intra-corporate conflicts, (2) conflicts between company and employee, (3) and conflicts between the company health promotion and the health care system. Category (c) comprises the offer's core characteristics which were described as low-threshold and preventive. Furthermore, the offer was perceived as convenient in handling, confidential, and having immediate impact on a person's well-being. (4) Conclusions: Here we define structures, address the needs of the involved persons, and communicate foreseeable areas of conflict influences whether the implementation of the intervention succeeds.
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Affiliation(s)
- Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Tim Pößnecker
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Andreas Antes
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, Ulm University Medical Center at BKH Günzburg, Lindenallee 2, 89312 Günzburg, Germany
| | - Franziska Kessemeier
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Dorothea Mayer
- Health and Safety Sindelfingen, Daimler AG, Bela-Barenyi-Straße, 71059 Sindelfingen, Germany
| | - Monika A. Rieger
- Institute for Occupational and Social Medicine and Health Services Research, University Clinic Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Michael Hölzer
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
- Sonnenbergklinik, ZfP Südwürttemberg, Christian-Belser-Straße 79, 70597 Stuttgart, Germany
| | - Elisabeth M. Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
- Leadership Personality Center Ulm (LPCU), Ulm University, Kornhausgasse 9, 89073 Ulm, Germany
| | - Kathrin Mörtl
- Faculty of Psychotherapy Science, Sigmund Freud University, Freudplatz 1, 1020 Vienna, Austria
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Scharf J, Loerbroks A, Angerer P. Rückkehr an den Arbeitsplatz von Beschäftigten nach einer psychischen Erkrankung. ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2022; 72:228-235. [PMID: 35729896 PMCID: PMC9188830 DOI: 10.1007/s40664-022-00471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 10/30/2022]
Abstract
Zusammenfassung
Zielstellungen
Die Rückkehr an den Arbeitsplatz scheitert häufig an widersprüchlichen Erwartungen und Zielen der beteiligten Akteure. Aufgrund ihrer medizinischen Expertise und arbeitsplatzbezogenen Kenntnisse könnten Betriebsärzte bzw. Betriebsärztinnen gegenseitiges Verständnis und Zusammenarbeit der Beteiligten effektiv fördern. Es soll ein Leitfaden und eine Schulung zu dessen Anwendung entwickelt werden, die Betriebsärzte bzw. Betriebsärztinnen unterstützen, eine vermittelnde Rolle bei der Eingliederung psychisch erkrankter Beschäftigter einzunehmen.
Methoden
Basierend auf einer Literaturrecherche sowie umfangreichen qualitativen Vorarbeiten zu den Erwartungen der Akteure, wurden in mehreren konsekutiven Schritten ein Leitfaden und Schulungsmaterialien partizipativ mit Arbeitsmedizinerinnen und Arbeitsmedizinern und anderen Experten bzw. Expertinnen entwickelt, diskutiert und überarbeitet. Schließlich wurden Betriebsärzte und Betriebsärztinnen in Weiterbildungskursen in der Anwendung des Leitfadens geschult, um ihn anschließend im Arbeitsalltag auf Praktikabilität zu überprüfen.
Ergebnisse
Der Leitfaden informiert über die potenziell unterschiedlichen Erwartungen der Akteure bzw. Akteurinnen an den Rückkehrprozess und bietet umfassende Handlungshilfen für die vermittelnde Arbeit des Betriebsarztes/der Betriebsärztin. Nach der etwa zweistündigen manualisierten Schulung setzten innerhalb von 4 Monaten 9 von 37 Teilnehmern den Leitfaden für Rückkehrgespräche ein, 6 von 9 bewerteten ihn als hilfreich.
Schlussfolgerung
Die ersten positiven Anwendungserfahrungen des mit der Zielgruppe entwickelten Materials rechtfertigt eine größere Interventionsstudie, um den zu vermutenden positiven Effekt auf den Wiedereingliederungserfolg zu untersuchen.
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The Relationship between Late-Life Depression and Cognitive Function in Older Korean Adults: A Moderation Analysis of Physical Activity Combined with Lower-Body Muscle Strength. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148769. [PMID: 35886621 PMCID: PMC9318399 DOI: 10.3390/ijerph19148769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 12/10/2022]
Abstract
Background: This study examined the relationship of physical activity (PA) combined with lower-body muscle strength to late-life depression and cognitive impairment in 10,097 participants (6062 females) ≥ 65 years of age. Methods: Exposures were PA, sit-to-stand test (STST), and depressive symptoms. Outcome was cognitive performance. Results: Depressed individuals had an increased risk of mild cognitive impairment (MCI; odds ratio (OR), adjusted OR = 1.845 and 95% confidence interval (CI) = 1.580−2.154, p < 0.001) compared with non-depressed individuals. Individuals who had insufficient PA and a poor STST and either insufficient PA or a poor STST had an increased risk of MCI (adjusted OR = 1.329 and 95% CI = 1.209−1.46, p < 0.001 and adjusted OR = 2.822 and 95% CI = 2.488−3.200, p < 0001, respectively) compared with individuals who had sufficient PA and a good STST. A significant moderation effect of PA combined with lower-body muscle strength on the relationship between depression and cognitive function was observed (β = −1.3923; 95% CI = −2.1505 to −0.6341, p < 0.003). Conclusions: The negative effect of late-life depression on cognitive function was incremental in the order of sufficient PA and a good STST, insufficient PA or a poor STST, and insufficient PA and a poor STST.
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Kutsuna I, Hoshino A, Morisugi A, Mori Y, Shirato A, Takeda M, isaji H, Suwa M. Relationship between emotional words in electronic medical records and leave periods of users of a return-to-work program with depression. Br J Occup Ther 2022. [DOI: 10.1177/03080226221107773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction We attempted to score data extracted from written medical records containing assessment results using natural language processing, and to clarify the relationship between duration of sick leave and the use of emotional words among return-to-work (RTW) program users on sick leave due to mental health problems. Method Participants were users of an RTW program. We extracted textual data from their electronic medical records, and gave all words a score based on the following two considerations: positivity score (the degree of positive emotion a word has) and emotion score with respect to seven emotions (sadness, anxiety, anger, disgust, trust, surprise, and joy), with the score for each emotion measured for each word. We analyzed relationships between duration of sick leave and each score. Results Forty-two users participated. The results showed that high positive scores (β = −0.42, p < 0.00) and high sadness scores (β = −0.60, p < 0.00) were related to a shorter duration of sick leave, and high anger score (β = 0.52, p < 0.00) was related to a longer duration of sick leave. Conclusion Professional assessments based on occupational therapy and natural language processing of medical records may predict the appropriate timing of RTW.
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Affiliation(s)
- Ichiro Kutsuna
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Aiko Hoshino
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Ami Morisugi
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Yukari Mori
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
| | - Aki Shirato
- Hinaga General Center for Mental Care, Mie, Japan
| | - Mirai Takeda
- Hinaga General Center for Mental Care, Mie, Japan
| | - Hikari isaji
- Department of Health Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Mami Suwa
- Mental Clinic Anser, Medical Corporation Seiseikai, Aichi, Japan
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12
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Cederberg M, Alsén S, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial. JMIR Ment Health 2022; 9:e30966. [PMID: 35289756 PMCID: PMC8965681 DOI: 10.2196/30966] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. OBJECTIVE The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. METHODS A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. RESULTS At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. CONCLUSIONS A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave. TRIAL REGISTRATION ClinicalTrials.gov NCT03404583; https://clinicaltrials.gov/ct2/show/NCT03404583.
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Affiliation(s)
- Matilda Cederberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Alsén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden
| | - Kristina Glise
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karl Swedberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden.,Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Research and Development, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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13
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Tikka C, Verbeek J, Hoving JL, Kunz R. Evidence-informed decision about (de-)implementing return-to-work coordination to reduce sick leave: a case study. Health Res Policy Syst 2022; 20:19. [PMID: 35164766 PMCID: PMC8842546 DOI: 10.1186/s12961-022-00823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coordination of return to work (RtW) is implemented in many countries, but a Cochrane review found no considerable effect on workers' sick leave compared to usual care. The aim of the study is to analyse how the evidence from this review can be used for decisions about (de-)implementing RtW coordination in a country-specific setting, using Finland as an example. METHODS We conducted a systematic literature search and online survey with two groups of experts to compare interventions included in the Cochrane review to Finnish RtW practice using content analysis methods. We applied the evidence-to-decision (EtD) framework criteria to draw conclusions about (de-)implementing RtW coordination in Finland, including benefits, harms and costs of the intervention compared to usual care. RESULTS We included seven documents from the literature search and received data from 10 of 42 survey participants. RtW coordination included, both in Finland and in the review, at least one face-to-face meeting between the physician and the worker, a workers' needs assessment, and an individual RtW plan and its implementation. Usual care focuses on medical treatment and may include general RtW advice. RtW coordination would be cost-saving if it decreases sick leave with at least 2 days compared to usual care. The evidence in the Cochrane review was mainly of low certainty, and the effect sizes had relatively wide confidence intervals. Only a new, high-quality and large randomized controlled trial (RCT) can decrease the current uncertainty, but this is unlikely to happen. The EtD framework did not provide arguments for further implementation or for de-implementation of the intervention. CONCLUSIONS Interventions evaluated in the Cochrane review are similar to RtW coordination and usual care interventions in Finland. Considering all EtD framework criteria, including certainty of the evidence and costs, de-implementation of RtW coordination interventions in Finland seems unnecessary. Better evidence about the costs and stakeholders' values regarding RtW coordination is needed to improve decision-making.
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Affiliation(s)
- Christina Tikka
- Finnish Institute of Occupational Health, Neulaniementie 4, 70101, Kuopio, Finland.
| | - Jos Verbeek
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, University of Amsterdam, Coronel Institute of Occupational Health, Cochrane Work Review Group, Amsterdam, North Holland, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, University of Amsterdam, Coronel Institute of Occupational Health, Cochrane Work Review Group, Amsterdam, North Holland, The Netherlands
| | - Regina Kunz
- Research Unit Evidence-based Insurance Medicine, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
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14
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Foldal VS, Solbjør M, Standal MI, Fors EA, Hagen R, Bagøien G, Johnsen R, Hara KW, Fossen H, Løchting I, Eik H, Grotle M, Aasdahl L. Barriers and Facilitators for Implementing Motivational Interviewing as a Return to Work Intervention in a Norwegian Social Insurance Setting: A Mixed Methods Process Evaluation. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:785-795. [PMID: 33761083 PMCID: PMC8558277 DOI: 10.1007/s10926-021-09964-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 05/03/2023]
Abstract
Purpose The aim of this study was to evaluate potential barriers and facilitators for implementing motivational interviewing (MI) as a return to work (RTW) intervention in a Norwegian social insurance setting. Methods A mixed-methods process evaluation was conducted alongside a randomized controlled trial involving MI sessions delivered by social insurance caseworkers. The study was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework using focus groups with the caseworkers. MI fidelity was evaluated through audio-recordings of MI sessions and questionnaires to sick-listed participants. Results Lack of co-worker and managerial support, time and place for practicing to further develop MI skills, and a high workload made the MI intervention challenging for the caseworkers. The MI method was experienced as useful, but difficult to master. MI fidelity results showed technical global scores over the threshold for "beginning proficiency" whereas the relational global score was under the threshold. The sick-listed workers reported being satisfied with the MI sessions. Conclusions Despite caseworker motivation for learning and using MI in early follow-up sessions, MI was hard to master and use in practice. Several barriers and facilitators were identified; these should be addressed before implementing MI in a social insurance setting.Trial registration ClinicalTrials.gov: NCT03212118 (registered July 11, 2017).
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Affiliation(s)
- Vegard Stolsmo Foldal
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marit Solbjør
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Martin Inge Standal
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Egil Andreas Fors
- Department of Public Health and Nursing, General Practice Research Unit, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Roger Hagen
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Institute, Modum Bad, Oslo, Norway
| | - Gunnhild Bagøien
- Division of Psychiatry, Tiller Community Mental Health Centre, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Norwegian Labour and Welfare Service of Trøndelag, Trondheim, Norway
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Heidi Fossen
- The Norwegian Labour and Welfare Service of Trøndelag, Trondheim, Norway
| | - Ida Løchting
- Faculty of Health Science, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Hedda Eik
- Faculty of Health Science, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Faculty of Health Science, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI) Clinic for Surgery and Neurology, Oslo University Hospital, Oslo, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
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15
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Løchting I, Hagen R, Monsen CK, Grotle M, Storheim K, Aanesen F, Øiestad BE, Eik H, Bagøien G. Fidelity of a Motivational Interviewing Intervention for Improving Return to Work for People with Musculoskeletal Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910324. [PMID: 34639624 PMCID: PMC8507704 DOI: 10.3390/ijerph181910324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
The objective of this study was to conduct a fidelity evaluation of a motivational interviewing (MI) intervention delivered by social insurance caseworkers, in a three-arm randomized controlled trial (RCT) for improving return to work for people on sick leave with musculoskeletal disorders. The caseworkers received six days of MI training, including an intervention manual prior to the trial onset, as well as supervision throughout the trial. The caseworkers recorded 21 MI sessions at regular intervals during the trial. An independent MI analysis center scored the recordings using the MI treatment integrity code (MITI 4). In addition, three experienced MI trainers assessed the adherence to the MI intervention manual on a 1–4 Likert scale and MI competence. Total MITI 4 mean scores were at beginning proficiency levels for two components (global technical, mean 3.0; SD 0.6 and the reflections/questions ratio, mean 1.1; SD 0.2) and under beginning proficiency for two components (global relational, mean 3.2; SD 0.7 and complex question, mean 34.0; SD 21.2). The MI trainers’ assessment showed similar results. The mean adherence score for the MI sessions was 2.96 (SD 0.9). Despite delivering a thorough course and supervision package, most of the caseworkers did not reach proficiency levels of good MI competence during the study. The fidelity evaluation showed that a large amount of training, supervision and practice is needed for caseworkers to become competent MI providers. When planning to implement MI, it is important that thorough consideration is given regarding the resources and the time needed to train caseworkers to provide MI in a social insurance setting.
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Affiliation(s)
- Ida Løchting
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Correspondence: ; Tel.: +47-9183-2700
| | - Roger Hagen
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway;
- Department of Psychology, Norwegian University of Science and Technology, P.O. Box 8900, 7491 Trondheim, Norway
- Research Institute, Modum Bad, P.O. Box 33, 3370 Vikersund, Norway
| | - Christine K. Monsen
- Division of Mental Health & Addiction, Vestfold Hospital Trust, P.O. Box 2168, 3103 Tønsberg, Norway;
| | - Margreth Grotle
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Kjersti Storheim
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, 0424 Oslo, Norway; (M.G.); (K.S.)
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Fiona Aanesen
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Britt Elin Øiestad
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Hedda Eik
- Department of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, P.O. Box 4, 0130 Oslo, Norway; (F.A.); (B.E.Ø.); (H.E.)
| | - Gunnhild Bagøien
- Nidelv Community Mental Health Centre, Department of Mental Health, Trondheim University Hospital, P.O. Box 3250, 7006 Trondheim, Norway;
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16
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Norvell Gustavsson I, Müssener U, Ståhl C. Acting the part: how social and organisational factors shape managers' actions towards employees with repeated short-term sickness absence. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-09-2020-0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe aim of the study was to understand the social and organisational factors in the workplace that shape managers' actions and attitudes towards workers with repeated short-term sickness absence.Design/methodology/approachThis was a qualitative interview study. Semi-structured interviews were conducted with 19 managers at 15 different workplaces. The analysis had an abductive approach, using thematic analysis which focused on the latent content of managers attitudes towards employees with repeated short-term sickness absence.FindingsResults indicate that the managers' views of people on short-term sick leave shift and move through several phases, which was analysed as they were acts in a play, where their given roles are prescribing which actions to take given the available resources for acting these parts. These acts depict an increasingly controlling attitude, where the sick leave is ultimately seen as an individual problem best managed by repressive tactics.Originality/valueRole theory offers the possibility to analyse managers' attitudes and behaviours by considering the workplace and the manager-employee relationship as regulated by norms and organisational factors.
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17
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Oh JW, Park JY, Lee S. Association between exercise variations and depressive symptoms among precarious employees in South Korea. Sci Rep 2021; 11:15952. [PMID: 34354166 PMCID: PMC8342533 DOI: 10.1038/s41598-021-95383-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022] Open
Abstract
Research regarding the association between depression and exercise has been limited regarding precariously employed individuals. The current study investigated the association between exercise variations and depressive symptoms among precarious employees in South Korea. Data from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. In total, 13,080 participants aged ≥ 19 years responded to the survey. The Korean version of the PHQ-9 was utilized in addition to questions assessing regular exercise. Precariously employed men engaging in two or more variations of exercise each week were significantly less likely to report depressive symptoms (adjusted (OR): 0.78; 95% CI 0.62-0.97; p = 0.025), and the likelihood of depression was also lower for women who engaged in one or more forms of exercise (adjusted OR: 0.82; 95% CI 0.71-0.94; p = 0.006). These findings support the association between depression and exercise and suggest that greater variations in regular exercise are associated with a reduction in depression for men whereas any form of exercise reduces the risk of depression in women.
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Affiliation(s)
- Jae Won Oh
- Department of Psychiatry, Yongin Severance Hospital, Yongin, South Korea.,Mind Health Clinic, Yongin Severance Hospital, Yongin, South Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yongin, South Korea.,Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - San Lee
- Department of Psychiatry, Yongin Severance Hospital, Yongin, South Korea. .,Mind Health Clinic, Yongin Severance Hospital, Yongin, South Korea. .,Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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18
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Nybergh L, Bergström G, Jensen I, Hellman T. Experiences of interventions and rehabilitation activities in connection with return-to-work from a gender perspective. A focus group study among employees on sick leave for common mental disorders. PLoS One 2021; 16:e0253049. [PMID: 34170934 PMCID: PMC8232439 DOI: 10.1371/journal.pone.0253049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/28/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Common mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of this paper is to explore how employees on sick leave for common mental disorders experience interventions and rehabilitation activities during return-to-work, as well as to explore similarities and differences between the experiences of the interviewed women and men. MATERIAL AND METHODS A qualitative design was applied with semi-structured focus group interviews. Seven focus groups were conducted with a total of 28 participants (13 women and 15 men). The focus group discussions were audiotaped and transcribed verbatim, and data analyzed with conventional content analysis. Similarities and differences in the women's and men's experiences were written down in reflective notes during all steps of the analysis. RESULTS The results comprise of one main category, "To be met with respect and recognition", and subcategories at two levels. Both similarities and differences emerged in how women and men sick-listed because of common mental disorders experienced return-to-work interventions and rehabilitation activities. It was important for both women and men to be met with respect and recognition, which was essential to all forms of help that the participants discussed during the focus group interviews. Women expressed a need for home-related interventions, whereas men expressed a need for organizational interventions to counter feelings of resignation at work. Women could also more easily understand their mental health condition as compared with men. CONCLUSION A key implication of this study is that research on interventions and rehabilitation activities during return-to-work among employees on sick leave for common mental disorders should consider whether the findings are relevant equally to both women and men. Similarly, return-to-work professionals may need to consider possible differences among women and men on sick leave for common mental disorders, and to further customize offered interventions and rehabilitation activities. Doing so may help enhance the effectiveness of such interventions.
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Affiliation(s)
- Lotta Nybergh
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Therese Hellman
- Unit of Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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19
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Weber J, Angerer P, Brenner L, Brezinski J, Chrysanthou S, Erim Y, Feißt M, Hansmann M, Hondong S, Kessemeier FM, Kilian R, Klose C, Köllner V, Kohl F, Krisam R, Kröger C, Sander A, Schröder UB, Stegmann R, Wegewitz U, Gündel H, Rothermund E, Herrmann K. Early intervention, treatment and rehabilitation of employees with common mental disorders by using psychotherapeutic consultation at work: study protocol of a randomised controlled multicentre trial (friaa project). BMC Public Health 2021; 21:1187. [PMID: 34158017 PMCID: PMC8218449 DOI: 10.1186/s12889-021-11195-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/03/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. METHODS This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. DISCUSSION Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. TRIAL REGISTRATION The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049 .
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Affiliation(s)
- Jeannette Weber
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Lorena Brenner
- Research Group Psychosomatic Rehabilitation, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Jolanda Brezinski
- Institute of Medical Biometry and Informatics, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Sophia Chrysanthou
- Research Group Psychosomatic Rehabilitation, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Manuel Feißt
- Institute of Medical Biometry and Informatics, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Marieke Hansmann
- Institute of Psychology, University of Hildesheim Foundation, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Sinja Hondong
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Franziska Maria Kessemeier
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Straße 49, 79106, Freiburg, Germany
| | - Reinhold Kilian
- Department Psychiatry II, Section of Health Economics and Psychiatric Services Research, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
| | - Christina Klose
- Institute of Medical Biometry and Informatics, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Volker Köllner
- Research Group Psychosomatic Rehabilitation, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Fiona Kohl
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Regina Krisam
- Institute of Medical Biometry and Informatics, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Christoph Kröger
- Institute of Psychology, University of Hildesheim Foundation, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Anja Sander
- Institute of Medical Biometry and Informatics, University Hospital of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Ute Beate Schröder
- Federal Institute for Occupational Safety and Health (BAuA) Division 3 Work and Health Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Nöldnerstr, 40-42 10317, Berlin, Germany
| | - Ralf Stegmann
- Federal Institute for Occupational Safety and Health (BAuA) Division 3 Work and Health Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Nöldnerstr, 40-42 10317, Berlin, Germany
| | - Uta Wegewitz
- Federal Institute for Occupational Safety and Health (BAuA) Division 3 Work and Health Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Nöldnerstr, 40-42 10317, Berlin, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Kristin Herrmann
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
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20
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Behrens-Wittenberg E, Wedegaertner F. A Return-to-Work Intervention for Prematurely Retired Depression or Anxiety Disorder Patients. Front Psychiatry 2021; 12:662158. [PMID: 34149480 PMCID: PMC8206491 DOI: 10.3389/fpsyt.2021.662158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Depression and anxiety disorders are the most common cause for premature retirement of people of middle age. These people are expelled from the workforce. The following social disintegration can have an additional detrimental effect on subjects' psychological well-being which further reduces the chance to re-enter the workforce. Depression and anxiety in general need not be regarded as irreversible causes of disability. Therefore, long-term disability should be avoidable in many cases. This two-arm prospective controlled study tests a novel approach for those who have become economically inactive due to their illness with the goal to improve psychological well-being and return to work. Forty-one subjects were followed-up on over a period of 12 months and compared to 41 control cases. ANOVA for repeated measures showed that experimental subjects' psychological well-being and work ability was much better after the intervention than in the control group. These findings show that an individually tailored return-to-work intervention can be a useful therapeutic tool even after retirement.
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Affiliation(s)
| | - Felix Wedegaertner
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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21
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Standal MI, Aasdahl L, Jensen C, Foldal VS, Hagen R, Fors EA, Solbjør M, Hjemdal O, Grotle M, Meisingset I. Subgroups of Long-Term Sick-Listed Based on Prognostic Return to Work Factors Across Diagnoses: A Cross-Sectional Latent Class Analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:383-392. [PMID: 33052511 PMCID: PMC8172395 DOI: 10.1007/s10926-020-09928-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
Comorbidity is common among long-term sick-listed and many prognostic factors for return to work (RTW) are shared across diagnoses. RTW interventions have small effects, possibly due to being averaged across heterogeneous samples. Identifying subgroups based on prognostic RTW factors independent of diagnoses might help stratify interventions. The aim of this study was to identify and describe subgroups of long-term sick-listed workers, independent of diagnoses, based on prognostic factors for RTW. Latent class analysis of 532 workers sick-listed for eight weeks was used to identify subgroups based on seven prognostic RTW factors (self-reported health, anxiety and depressive symptoms, pain, self-efficacy, work ability, RTW expectations) and four covariates (age, gender, education, physical work). Four classes were identified: Class 1 (45% of participants) was characterized by favorable scores on the prognostic factors; Class 2 (22%) by high anxiety and depressive symptoms, younger age and higher education; Class 3 (16%) by overall poor scores including high pain levels; Class 4 (17%) by physical work and lack of workplace adjustments. Class 2 included more individuals with a psychological diagnosis, while diagnoses were distributed more proportionate to the sample in the other classes. The identified classes illustrate common subgroups of RTW prognosis among long-term sick-listed individuals largely independent of diagnosis. These classes could in the future assist RTW services to provide appropriate type and extent of follow-up, however more research is needed to validate the class structure and examine how these classes predict outcomes and respond to interventions.
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Affiliation(s)
- Martin Inge Standal
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Chris Jensen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- National Center for Occupational Rehabilitation, Rauland, Norway
| | - Vegard Stolsmo Foldal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roger Hagen
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Egil Andreas Fors
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Solbjør
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department for Research of Musculoskeletal Disorders (FORMI), Oslo University Hospital, Oslo, Norway
| | - Ingebrigt Meisingset
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Eskilsson T, Norlund S, Lehti A, Wiklund M. Enhanced Capacity to Act: Managers' Perspectives When Participating in a Dialogue-Based Workplace Intervention for Employee Return to Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:263-274. [PMID: 32737671 PMCID: PMC8172407 DOI: 10.1007/s10926-020-09914-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process, where the managers strengthened their agential capacity in three levels (categories). These levels were building competence, making adjustments, and sharing responsibility with the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.
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Affiliation(s)
- Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden.
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Sofia Norlund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Arja Lehti
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Section of Professional Development, Umeå University, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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23
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Shafi R, Colantonio A. Assessing the effectiveness of workplace accommodations in facilitating return to work after traumatic brain injury: a systematic review protocol. BMJ Open 2021; 11:e041581. [PMID: 34011579 PMCID: PMC8137232 DOI: 10.1136/bmjopen-2020-041581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Returning to work and sustaining employment can be a significant challenge for traumatic brain injury (TBI) survivors. Within the literature, there is recurring support for the role of workplace accommodations in effective and early return-to-work (RTW). To date, however, there has been a lack of systematic reviews exploring the specific role of workplace accommodations within the context of RTW after TBI. The primary objective of this protocol is to outline the methodological approach that will be undertaken to systematically review the literature and to assess the effectiveness of workplace accommodations in facilitating RTW. METHODS AND ANALYSIS A total of nine databases will be searched systematically using the concepts 'Brain injury,' 'RTW' and 'Job Accommodations.' Study selection will be performed independently by three reviewers, based on predetermined eligibility criteria through two rounds of screening using, first, the title and abstract, followed by a full-text search. Extracted information will include the study's purpose, design, and setting; the data source and type; the severity of TBI and the diagnostic criterion used; a comprehensive description of the intervention provided; the RTW outcome variables and the statistical methods used, etc. The data will be tabulated and narratively synthesised. Systematic review registration: This protocol has been registered with International Prospective Register of Systematic Reviews. ETHICS AND DISSEMINATION As this review intends to use pre-existing published studies hence research ethics board approvals will not be required. Nevertheless, this review will follow the ethical and governance standards in the data management and presentation of results. The findings from this review will potentially be published in a peer-reviewed scientific journal (electronically and in print). The results of this review will be presented at both national/international conferences and shared with stakeholders influencing RTW practices. PROSPERO REGISTRATION NUMBER CRD42016043517.
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Affiliation(s)
- Reema Shafi
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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24
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Hoaki Y, Terao T. Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance. Front Psychiatry 2021; 12:620520. [PMID: 34054592 PMCID: PMC8160237 DOI: 10.3389/fpsyt.2021.620520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Several predictors for work restoration and maintenance of restoration have been examined among employees with mood and/or anxiety disorders, but whether frequency of participation in a return-to-work (RTW) program can predict successful work restoration and maintenance remains unclear. In the present study, we attempted to investigate the hypothesis that the frequency of RTW program participation can predict successful work restoration and maintenance. Among seventy-seven patients attending an RTW program, the frequency of participation was positively associated with work restoration but not with maintenance. The result was in partial agreement (restoration) and partial disagreement (maintenance of restoration) with our hypothesis. Thus, the present study suggests that the frequency of participation in an RTW program can predict successful work restoration but not maintenance.
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Affiliation(s)
- Yuriko Hoaki
- Department of Psychiatry, Oita Okanoue Hospital, Oita, Japan
| | - Takeshi Terao
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan
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25
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Abstract
Depression is a common and debilitating condition that adversely affects functioning and the capacity to work and establish economic stability. Women are disproportionately burdened by depression, and low-income pregnant and parenting women have particularly high rates of depression and often lack access to treatment. As depression can be treated, it is a modifiable risk factor for poor economic outcomes for women, and thus for children and families. Recent national and state health care policy changes offer the opportunity for community-based psychological and economic interventions that can reduce the number of pregnant and parenting women with clinically significant depressive symptoms. Moreover, there is strong evidence that in addition to benefiting women's well-being, such reforms bolster children's emotional and social development and learning and help families rise out of poverty. This review summarizes the mental health and economic literature regarding how maternal depression perpetuates intergenerational poverty and discusses recommendations regarding policies to treat maternal depression in large-scale social services systems.
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Affiliation(s)
- Megan V Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA; .,The Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06519, USA.,Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut 06510, USA.,Women's Health Research at Yale, Yale University School of Medicine, New Haven, Connecticut 06510, USA
| | - Carolyn M Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA; .,Women's Health Research at Yale, Yale University School of Medicine, New Haven, Connecticut 06510, USA.,Department of Psychology, Yale University, New Haven, Connecticut 06511, USA
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26
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Markus M, Gabriel N, Bassler M, Bethge M. Work-related medical rehabilitation in patients with mental disorders: the protocol of a randomized controlled trial (WMR-P, DRKS00023175). BMC Psychiatry 2021; 21:225. [PMID: 33941123 PMCID: PMC8091693 DOI: 10.1186/s12888-021-03181-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various rehabilitation services and return-to-work programs have been developed in order to reduce sickness absence and increase sustainable return-to-work. To ensure that people with a high risk of not returning to work can participate in working life, the model of work-related medical rehabilitation was developed in Germany. The efficacy of these programs in patients with mental disorders has been tested in only a few trials with very specific intervention approaches. To date, there is no clear evidence of the effectiveness of work-related medical rehabilitation implemented in real-care practice. METHODS/DESIGN Our randomized controlled trial will be conducted in six rehabilitation centers across Germany. Within 15 months, 1800 patients with mental disorders (300 per rehabilitation center) will be recruited and assigned one-to-one either to a work-related medical rehabilitation program or to a conventional psychosomatic rehabilitation program. Participants will be aged 18-60 years. The control group will receive a conventional psychosomatic rehabilitation program without additional work-related components. The intervention group will receive a work-related medical rehabilitation program that contains at least 11 h of work-related treatment modules. Follow-up data will be assessed at the end of the rehabilitation and 3 and 12 months after completing the rehabilitation program. The primary outcome is a stable return to work. Secondary outcomes cover several dimensions of health, functioning and coping strategies. Focus groups and individual interviews supplement our study with qualitative data. DISCUSSION This study will determine the relative effectiveness of a complex and newly implemented work-related rehabilitation strategy for patients with mental disorders. TRIAL REGISTRATION German Clinical Trials Register ( DRKS00023175 , September 29 2020).
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Affiliation(s)
- Miriam Markus
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Nina Gabriel
- Rehabilitation Sciences and Health Services Research, Institute for Social Medicine, Nordhausen University of Applied Sciences, Weinberghof 4, Nordhausen, 99734 Germany
| | - Markus Bassler
- Rehabilitation Sciences and Health Services Research, Institute for Social Medicine, Nordhausen University of Applied Sciences, Weinberghof 4, Nordhausen, 99734 Germany
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
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27
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Audhoe SS, Hoving JL, Zijlstra BJH, Frings-Dresen MHW, Nieuwenhuijsen K. Is the "Brainwork Intervention" effective in reducing sick leave for non-permanent workers with psychological problems? Results of a controlled clinical trial. BMC Public Health 2021; 21:698. [PMID: 33836711 PMCID: PMC8034165 DOI: 10.1186/s12889-021-10704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 03/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background Both the presence of psychological problems and the absence of an employment contract are related to long-term sickness absence, prolonged work disability and unemployment. Studies researching the effectiveness of return-to-work interventions on these non-permanent workers, including unemployed and temporary agency workers and workers with an expired fixed-term contract, are lagging behind. Therefore, a return-to-work intervention called “Brainwork” was developed. The aim of this study was to assess the effectiveness of the ‘Brainwork Intervention’ in reducing the duration of sick leave compared to usual care over a 12-month follow-up. Methods In a multicenter controlled clinical trial, using a quasi-randomization procedure, we compared the Brainwork Intervention (n = 164) to usual care (n = 156). The primary outcome was the duration of sick leave. Secondary outcomes were the duration of sick leave starting from Social Security Agency transfer; the proportion of workers returned to work; the number of hours of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. Protocol adherence (Brainwork Intervention) was considered sufficient when at least three of the five protocol steps were followed. Cox regressions, linear and ordinal regression, and Mixed Model analyses were performed. Results All 320 participants were analyzed. The Brainwork Intervention resulted in a non-significant reduction of the duration of sick leave compared to usual care (269 days versus 296 days; HR = 1.29; 95% CI 0.94–1.76; p = 0.11). For those working (46%) during the 12-month follow-up, the mean number of hours of paid employment was non-significantly higher in the usual care group (682 h versus 493 h; p = 0.053). No significant differences were found for other secondary outcomes. Protocol adherence was 10%. Conclusions The Brainwork Intervention as performed with a low protocol adherence did not result in a significant reduction of the duration of sick leave compared to usual care. It remains unclear what the results would have been if the Brainwork Intervention had been executed according to protocol. Trial registration The Netherlands Trial Register (NTR); NTR3976 (old registration number NTR4190). Registered September 27th 2013. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10704-0.
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Affiliation(s)
- Selwin S Audhoe
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Jan L Hoving
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Bonne J H Zijlstra
- Faculty of Behavioral and Social Sciences, University of Amsterdam, Research Institute of Child Development and Education, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health/Research Center for Insurance Medicine, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
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28
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Sandheimer C, Björkelund C, Hensing G, Mehlig K, Hedenrud T. Implementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden. BMJ Open 2021; 11:e044959. [PMID: 33674375 PMCID: PMC7938985 DOI: 10.1136/bmjopen-2020-044959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/28/2021] [Accepted: 02/19/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines. DESIGN Register-based study on PCC level. SETTING Primary care in Region Västra Götaland, Sweden. PARTICIPANTS All PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42). OUTCOME MEASURES Proportion of inadequate medication users, defined as number of patients >18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1-179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model. RESULTS Overall, all PCCs had about 30%-34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (-6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01). CONCLUSIONS Public PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.
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Affiliation(s)
- Christine Sandheimer
- Social medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Cecilia Björkelund
- Social medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Goteborg, Sweden
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Gunnel Hensing
- Social medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Kirsten Mehlig
- Social medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Goteborg, Sweden
- Lifecourse Epidemiology, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tove Hedenrud
- Social medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgenska Academy, University of Gothenburg, Goteborg, Sweden
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29
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Eftedal M, Tveito TH, Gensby U, Islam MK, Lie SA, Aasland G, Kostveit S, Jensen C. Comparing two interdisciplinary occupational rehabilitation programs for employees on sick leave: a mixed-method design study protocol. BMC Musculoskelet Disord 2021; 22:158. [PMID: 33563250 PMCID: PMC7871619 DOI: 10.1186/s12891-021-03994-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) and common mental disorders (CMDs) are the most frequent reasons for long-term sick leave and work disability. Occupational rehabilitation programs are used to help employees return to work (RTW). However, knowledge regarding the effect of these programs is scarce, and even less is known about which programs are best suited for which patients. This study aims to compare the RTW results of two interdisciplinary occupational rehabilitation programs in Norway, as well as to examine the delivery and reception of the two programs and explore the active mechanisms of the participants' RTW processes. METHODS/DESIGN We will use a mixed-method convergent design to study the main outcome. Approximately 600 participants will be included in the study. Eligible study participants will be aged 18-60 years old and have been on sick leave due to MSDs, CMDs, or both for at least 6 weeks. Interdisciplinary teams at both participating clinics will deliver complex occupational rehabilitation programs. The inpatient rehabilitation program has a duration of 4 weeks and is full time. The outpatient program has a duration of 3 months and involves weekly sessions. The primary outcome is RTW. Secondary outcomes are differences in the incremental cost for an averted sick leave day, cost utility/benefit, and differences between the programs regarding improvements in known modifiable obstacles to RTW. Subgroup analyses are planned. The researchers will be blinded to the intervention groups when analyzing the quantitative RTW data. DISCUSSION This study aims to provide new insights regarding occupational rehabilitation interventions, treatment targets, and outcomes for different subgroups of sick-listed employees and to inform discussions on the active working mechanisms of occupational rehabilitation and the influence of context in the return-to-work process. TRIAL REGISTRATION Current controlled trials ISRCTN12033424 , 15.10.2014, retrospectively registered.
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Affiliation(s)
- Monica Eftedal
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
| | - Torill H. Tveito
- NORCE Norwegian Research Centre, Bergen, Norway
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Horten, Norway
| | - Ulrik Gensby
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
- Team Working Life Aps, Copenhagen, Denmark
- Adjunct Scientist, Institute for Work and Health, Toronto, Canada
| | - M. Kamrul Islam
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Gro Aasland
- Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Tønsberg, Norway
| | | | - Chris Jensen
- National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864 Rauland, Norway
- NORCE Norwegian Research Centre, Bergen, Norway
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30
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Parsons V, Juszczyk D, Gilworth G, Ntani G, McCrone P, Hatch S, Shannon R, Henderson M, Coggon D, Molokhia M, Smedley J, Griffiths A, Walker-Bone K, Madan I. A case management occupational health model to facilitate earlier return to work of NHS staff with common mental health disorders: a feasibility study. Health Technol Assess 2021; 25:1-94. [PMID: 33641712 PMCID: PMC7957455 DOI: 10.3310/hta25120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The NHS is the biggest employer in the UK. Depression and anxiety are common reasons for sickness absence among staff. Evidence suggests that an intervention based on a case management model using a biopsychosocial approach could be cost-effective and lead to earlier return to work for staff with common mental health disorders. OBJECTIVE The objective was to assess the feasibility and acceptability of conducting a trial of the clinical effectiveness and cost-effectiveness of an early occupational health referral and case management intervention to facilitate the return to work of NHS staff on sick leave with any common mental health disorder (e.g. depression or anxiety). DESIGN A multicentre mixed-methods feasibility study with embedded process evaluation and economic analyses. The study comprised an updated systematic review, survey of care as usual, and development of an intervention in consultation with key stakeholders. Although this was not a randomised controlled trial, the study design comprised two arms where participants received either the intervention or care as usual. PARTICIPANTS Participants were NHS staff on sick leave for 7 or more consecutive days but less than 90 consecutive days, with a common mental health disorder. INTERVENTION The intervention involved early referral to occupational health combined with standardised work-focused case management. CONTROL/COMPARATOR Participants in the control arm received care as usual. PRIMARY OUTCOME The primary outcome was the feasibility and acceptability of the intervention, study processes (including methods of recruiting participants) and data collection tools to measure return to work, episodes of sickness absence, workability (a worker's functional ability to perform their job), occupational functioning, symptomatology and cost-effectiveness proposed for use in a main trial. RESULTS Forty articles and two guidelines were included in an updated systematic review. A total of 49 of the 126 (39%) occupational health providers who were approached participated in a national survey of care as usual. Selected multidisciplinary stakeholders contributed to the development of the work-focused case management intervention (including a training workshop). Six NHS trusts (occupational health departments) agreed to take part in the study, although one trust withdrew prior to participant recruitment, citing staff shortages. At mixed intervention sites, participants were sequentially allocated to each arm, where possible. Approximately 1938 (3.9%) NHS staff from the participating sites were on sick leave with a common mental health disorder during the study period. Forty-two sick-listed NHS staff were screened for eligibility on receipt of occupational health management referrals. Twenty-four (57%) participants were consented: 11 (46%) received the case management intervention and 13 (54%) received care as usual. Follow-up data were collected from 11 out of 24 (46%) participants at 3 months and 10 out of 24 (42%) participants at 6 months. The case management intervention and case manager training were found to be acceptable and inexpensive to deliver. Possible contamination issues are likely in a future trial if participants are individually randomised at mixed intervention sites. HARMS No adverse events were reported. LIMITATIONS The method of identification and recruitment of eligible sick-listed staff was ineffective in practice because uptake of referral to occupational health was low, but a new targeted method has been devised. CONCLUSION All study questions were addressed. Difficulties raising organisational awareness of the study coupled with a lack of change in occupational health referral practices by line managers affected the identification and recruitment of participants. Strategies to overcome these barriers in a main trial were identified. The case management intervention was fit for purpose and acceptable to deliver in the NHS. TRIAL REGISTRATION Current Controlled Trials ISRCTN14621901. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 12. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Vaughan Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Dorota Juszczyk
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Gill Gilworth
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Paul McCrone
- King's Health Economics, King's College London, London, UK
| | - Stephani Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robert Shannon
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Max Henderson
- Liaison Psychiatry, Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mariam Molokhia
- Population Health Sciences, King's College London, London, UK
| | - Julia Smedley
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Amanda Griffiths
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- National Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Ira Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
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Petersson EL, Törnbom K, Hange D, Nejati S, Jerlock M, Wikberg C, Björkelund C, Svenningsson I. The experiences of care managers and rehabilitation coordinators of a primary care intervention to promote return to work for patients with common mental disorders: a qualitative study. BMC FAMILY PRACTICE 2020; 21:272. [PMID: 33339512 PMCID: PMC7749497 DOI: 10.1186/s12875-020-01348-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/07/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND In an earlier study, PRIM-CARE RCT, a care manager implementation at the primary care centre showed improved return to work and reduced sick leave for patients with CMD. To further improve return to work, the project Co-Work-Care added a person-centered dialogue meeting between the patient, the employer and the rehabilitation coordinator, preceded by an increased collaboration between care manager, rehabilitation coordinator and GP. In this first qualitative study of the Co-Work-Care project, we explored how care managers and rehabilitation coordinators experienced the Co-Work-Care model. The purpose of this study was to explore care managers' and rehabilitation coordinators' perceptions and experiences of a close collaboration and the use of the person-centred dialogue meeting. METHODS From an ongoing RCT with 20 primary care centres, care managers (CMs) (n = 13) and rehabilitation coordinators (RCs) (n = 12) participated in a qualitative study with focus groups. The study was conducted in the primary health care in a Swedish region. The data was analysed with Systematic Text Condensation by Malterud. RESULTS Seven codes describing the participants' experiences of the Co-Work-Care model were identified: 1) The importance of collaboration at the primary care centre, 2) Collaboration and division of roles between the RC and the CM, 3) Collaboration with the General practitioner (GP), 4) The person-centred dialogue meeting, 5) Initiating the person-centred dialogue meeting, 6) The person-centred dialogue meeting to improve collaboration with the employer, and 7) The person-centred dialogue meeting to teach about the return to work process. CONCLUSION The increased collaboration within the Co-Work-Care model created a common picture and understanding of the patient's situation. The person-centred dialogue meeting in the rehabilitation process became a bridge between the employer and the patient. TRIAL REGISTRATION NCT03250026 (registered August 15, 2017).
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Affiliation(s)
- Eva-Lisa Petersson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Göteborg, Sweden
| | - Karin Törnbom
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Dominique Hange
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Göteborg, Sweden
| | - Shabnam Nejati
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margareta Jerlock
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl Wikberg
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Björkelund
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Göteborg, Sweden
| | - Irene Svenningsson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Göteborg, Sweden
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Blank D, Brieger P, Hamann J. [Return to Work after Mental Disorders - A Scoping Review]. PSYCHIATRISCHE PRAXIS 2020; 48:119-126. [PMID: 33271622 DOI: 10.1055/a-1310-2591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Workers on sick-leave due to a mental disorder have enormous problems to return to work. The main objective of this review is to examine different return-to-work (RTW) interventions. METHODS We conduct a systematic literature research. RESULTS 88 articles were screened and 29 studies included. The included RTW-interventions build on different approaches: 1) individual, 2) workplace, 3) mental health services. The majority of the interventions showed positive effects on the return-to-work process. CONCLUSION Even if not all interventions could be readily transferred to the German context, the findings indicate ways improving the transition from the mental health system to the workplace.
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Affiliation(s)
- Daniela Blank
- kbo-Isar-Amper-Klinikum gGmbH, Akademisches Lehrkrankenhaus der LMU München, Akademisches Lehrkrankenhaus der LMU München
| | - Peter Brieger
- kbo-Isar-Amper-Klinikum gGmbH, Akademisches Lehrkrankenhaus der LMU München, Akademisches Lehrkrankenhaus der LMU München
| | - Johannes Hamann
- Klinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
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Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, McGill K, Elders A, Hagen S, McClurg D, Torrens C, Maxwell M. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev 2020; 11:CD013779. [PMID: 33150970 PMCID: PMC8226433 DOI: 10.1002/14651858.cd013779] [Citation(s) in RCA: 207] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence from disease epidemics shows that healthcare workers are at risk of developing short- and long-term mental health problems. The World Health Organization (WHO) has warned about the potential negative impact of the COVID-19 crisis on the mental well-being of health and social care professionals. Symptoms of mental health problems commonly include depression, anxiety, stress, and additional cognitive and social problems; these can impact on function in the workplace. The mental health and resilience (ability to cope with the negative effects of stress) of frontline health and social care professionals ('frontline workers' in this review) could be supported during disease epidemics by workplace interventions, interventions to support basic daily needs, psychological support interventions, pharmacological interventions, or a combination of any or all of these. OBJECTIVES Objective 1: to assess the effects of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. Objective 2: to identify barriers and facilitators that may impact on the implementation of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. SEARCH METHODS On 28 May 2020 we searched the Cochrane Database of Systematic Reviews, CENTRAL, MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Global Index Medicus databases and WHO Institutional Repository for Information Sharing. We also searched ongoing trials registers and Google Scholar. We ran all searches from the year 2002 onwards, with no language restrictions. SELECTION CRITERIA We included studies in which participants were health and social care professionals working at the front line during infectious disease outbreaks, categorised as epidemics or pandemics by WHO, from 2002 onwards. For objective 1 we included quantitative evidence from randomised trials, non-randomised trials, controlled before-after studies and interrupted time series studies, which investigated the effect of any intervention to support mental health or resilience, compared to no intervention, standard care, placebo or attention control intervention, or other active interventions. For objective 2 we included qualitative evidence from studies that described barriers and facilitators to the implementation of interventions. Outcomes critical to this review were general mental health and resilience. Additional outcomes included psychological symptoms of anxiety, depression or stress; burnout; other mental health disorders; workplace staffing; and adverse events arising from interventions. DATA COLLECTION AND ANALYSIS Pairs of review authors independently applied selection criteria to abstracts and full papers, with disagreements resolved through discussion. One review author systematically extracted data, cross-checked by a second review author. For objective 1, we assessed risk of bias of studies of effectiveness using the Cochrane 'Risk of bias' tool. For objective 2, we assessed methodological limitations using either the CASP (Critical Appraisal Skills Programme) qualitative study tool, for qualitative studies, or WEIRD (Ways of Evaluating Important and Relevant Data) tool, for descriptive studies. We planned meta-analyses of pairwise comparisons for outcomes if direct evidence were available. Two review authors extracted evidence relating to barriers and facilitators to implementation, organised these around the domains of the Consolidated Framework of Implementation Research, and used the GRADE-CERQual approach to assess confidence in each finding. We planned to produce an overarching synthesis, bringing quantitative and qualitative findings together. MAIN RESULTS We included 16 studies that reported implementation of an intervention aimed at supporting the resilience or mental health of frontline workers during disease outbreaks (severe acute respiratory syndrome (SARS): 2; Ebola: 9; Middle East respiratory syndrome (MERS): 1; COVID-19: 4). Interventions studied included workplace interventions, such as training, structure and communication (6 studies); psychological support interventions, such as counselling and psychology services (8 studies); and multifaceted interventions (2 studies). Objective 1: a mixed-methods study that incorporated a cluster-randomised trial, investigating the effect of a work-based intervention, provided very low-certainty evidence about the effect of training frontline healthcare workers to deliver psychological first aid on a measure of burnout. Objective 2: we included all 16 studies in our qualitative evidence synthesis; we classified seven as qualitative and nine as descriptive studies. We identified 17 key findings from multiple barriers and facilitators reported in studies. We did not have high confidence in any of the findings; we had moderate confidence in six findings and low to very low confidence in 11 findings. We are moderately confident that the following two factors were barriers to intervention implementation: frontline workers, or the organisations in which they worked, not being fully aware of what they needed to support their mental well-being; and a lack of equipment, staff time or skills needed for an intervention. We are moderately confident that the following three factors were facilitators of intervention implementation: interventions that could be adapted for local needs; having effective communication, both formally and socially; and having positive, safe and supportive learning environments for frontline workers. We are moderately confident that the knowledge or beliefs, or both, that people have about an intervention can act as either barriers or facilitators to implementation of the intervention. AUTHORS' CONCLUSIONS There is a lack of both quantitative and qualitative evidence from studies carried out during or after disease epidemics and pandemics that can inform the selection of interventions that are beneficial to the resilience and mental health of frontline workers. Alternative sources of evidence (e.g. from other healthcare crises, and general evidence about interventions that support mental well-being) could therefore be used to inform decision making. When selecting interventions aimed at supporting frontline workers' mental health, organisational, social, personal, and psychological factors may all be important. Research to determine the effectiveness of interventions is a high priority. The COVID-19 pandemic provides unique opportunities for robust evaluation of interventions. Future studies must be developed with appropriately rigorous planning, including development, peer review and transparent reporting of research protocols, following guidance and standards for best practice, and with appropriate length of follow-up. Factors that may act as barriers and facilitators to implementation of interventions should be considered during the planning of future research and when selecting interventions to deliver within local settings.
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Affiliation(s)
- Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Joshua Cheyne
- Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | - Julie Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Bridget Davis
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Jacqueline McCallum
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Suzanne Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Claire Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
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Physical activity and ability to meet different work requirements among adult working men with or without current depressive symptoms. Int Arch Occup Environ Health 2020; 94:451-458. [PMID: 33125526 PMCID: PMC8032589 DOI: 10.1007/s00420-020-01595-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 10/13/2020] [Indexed: 11/24/2022]
Abstract
Purpose To examine the relationship between leisure-time physical activity (LTPA) and ability to meet different work requirements among adult working men with or without current depressive symptoms. Methods We measured LTPA with the long version of the International Physical Activity Questionnaire (IPAQ). The Work Ability Index (WAI) and Beck Depression Inventory (BDI) were used to assess the work ability and depression of 921 Finnish employed male volunteers. Participants were divided into three groups according to the WAI for their work requirements: mental (MENT), physical (PHYS), and an equal amount of mental and physical work (BTH). Results When adjusted for age, BMI and employment years, there was a significant difference in weekly LTPA between WAI groups {p = 0.003, [F (2902) = 5.58]}, but not for depression. It appeared that participants with depressive symptoms scored lower WAI in each group regardless of LTPA. In addition, a linear relationship was found between higher LTPA and WAI in nondepressed workers in the PHYS [p = 0.011, β = 0.10 (95% CI 0.03–0.18)] and BTH [p = 0.027, β = 0.19 (95% CI 0.03–0.34)] groups. Among workers with depressive symptoms, similar linearity was found in BTH [p = 0.003, β = 0.20 (95% CI 0.03–0.55)]. In group-wise comparison, work requirements {p = 0.001, [F (2902) = 11.2]} and depressive symptoms {p < 0.001, [F (1902) = 177.0]} related with lower WAI. Conclusion Depressive symptoms were associated with lower work ability regardless of the job description. Therefore, higher levels of weekly LTPA was linked with better work ability among nondepressed working men. Workers with depressive symptoms in jobs that require extensive mental or physical work might need more than exercise to improve work ability. Electronic supplementary material The online version of this article (10.1007/s00420-020-01595-6) contains supplementary material, which is available to authorized users.
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Abstract
The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.
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Affiliation(s)
- Deepak Jayarajan
- Psychiatric Rehabilitation Services, Dept. Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Thanapal Sivakumar
- Psychiatric Rehabilitation Services, Dept. Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - John B Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Jagadisha Thirthalli
- Psychiatric Rehabilitation Services, Dept. Psychiatry, NIMHANS, Bengaluru, Karnataka, India
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Return to Work after Common Mental Disorders: A Qualitative Study Exploring the Expectations of the Involved Stakeholders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186635. [PMID: 32932972 PMCID: PMC7558125 DOI: 10.3390/ijerph17186635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 12/14/2022]
Abstract
Common mental disorders (CMDs) are risk factors for long-term sickness absence and unemployment. Therefore, return-to-work (RTW) processes have been introduced to facilitate the return of employees. As the success of RTW processes is considered to be determined by the cooperativeness of the involved stakeholders, we aimed to investigate the views of those stakeholders to disclose potentially diverging expectations. Qualitative interviews were conducted (08/2018-04/2019) among five stakeholder groups: returnees with a diagnosed CMD who were eligible for a RTW process; health care professionals nominated by the returnees; supervisors, colleagues and occupational physicians (the latter three groups were not nominated by the returnees). In total, 24 returnees, 13 health care professionals, 13 occupational physicians, 9 supervisors and 9 colleagues were interviewed (68 interviews in total). Potentially diverging expectations of the stakeholders related to whether diagnoses need to be disclosed by returnees. Agreement existed in terms of the need for a trustful relationship between employees and occupational physicians to initiate a RTW process early. As the understanding of all stakeholders' viewpoints is one of the main factors promoting a successful RTW, we explored the expectations of those involved in the RTW process. One implication of our findings is to strengthen the role of occupational physicians, who could coordinate the return process.
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Cederberg M, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE). BMJ Open 2020; 10:e037515. [PMID: 32873675 PMCID: PMC7467509 DOI: 10.1136/bmjopen-2020-037515] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/27/2020] [Accepted: 07/31/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context. METHODS AND ANALYSIS This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted. ETHICS AND DISSEMINATION This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC. TRIAL REGISTRATION NUMBER NCT03404583.
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Affiliation(s)
- Matilda Cederberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Psychiatric department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine and Geriatrics, Sahlgrenska University Hospital Östra, Gothenburg, Sweden
| | - Kristina Glise
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Karl Swedberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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Corbière M, Mazaniello-Chézol M, Bastien MF, Wathieu E, Bouchard R, Panaccio A, Guay S, Lecomte T. Stakeholders' Role and Actions in the Return-to-Work Process of Workers on Sick-Leave Due to Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:381-419. [PMID: 31673934 DOI: 10.1007/s10926-019-09861-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The lack of knowledge regarding the roles and actions of return to work (RTW) stakeholders create confusion and uncertainty about how and when to RTW after experiencing a common mental disorder (CMD). Purpose The purpose of this scoping review is to disentangle the various stakeholders' role and actions in the RTW process of workers on sick-leave due to CMDs. The research question is: What is documented in the existing literature regarding the roles and actions of the identified stakeholders involved in the RTW process of workers on sick-leave due to CMDs? Methods In conducting this scoping review, we followed Arksey and O'Malley's (Int J Soc Res Methodol 8:19-32, 2005) methodology, consisting of different stages (e.g., charting the data by categorizing key results). Results 3709 articles were screened for inclusion, 243 of which were included for qualitative synthesis. Several RTW stakeholders (n=11) were identified (e.g., workers on sick leave due to CMDs, managers, union representatives, rehabilitation professionals, insurers, return to work coordinators). RTW stakeholders' roles and actions inter- and intra-system were recommended, either general (e.g., know and understand the perspectives of all RTW stakeholders) or specific to an actor (e.g., the return to work coordinator needs to create and maintain a working alliance between all RTW stakeholders). Furthermore, close to 200 stakeholders' actions, spread out on different RTW phases, were recommended for facilitating the RTW process. Conclusions Eleven RTW stakeholders from the work, heath and insurance systems have been identified, as well as their respective roles and actions. Thanks to these results, RTW stakeholders and policy makers will be able to build practical relationships and collaboration regarding the RTW of workers on sick leave due to CMDs.
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Affiliation(s)
- Marc Corbière
- Department of Education, Career counselling, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada.
| | - Maud Mazaniello-Chézol
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Marie-France Bastien
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Estelle Wathieu
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Art History, Concordia University, Montreal, QC, Canada
| | | | - Alexandra Panaccio
- John Molson School of Business, Concordia University, Montréal, QC, Canada
| | - Stéphane Guay
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychiatry and Addictology, Université de Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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Zhao J, Jiang W, Wang X, Cai Z, Liu Z, Liu G. Exercise, brain plasticity, and depression. CNS Neurosci Ther 2020; 26:885-895. [PMID: 32491278 PMCID: PMC7415205 DOI: 10.1111/cns.13385] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/25/2022] Open
Abstract
Depression is a common mental disorder characterized by high incidence, high disability, and high fatality, causing great burden to the society, families, and individuals. The changes in brain plasticity may be a main reason for depression. Recent studies have shown that exercise plays a positive role in depression, but systematic and comprehensive studies are lacking on brain plasticity changes in depression. To further understand the antidepressive effect of exercise and the changes in brain plasticity, we retrieved related literatures using key words "depression," "depressive disorder," "exercise," "brain plasticity," "brain structure," and "brain function" from the database of Web of Science, PubMed, EBSCO host, and CNKI, hoping to provide evidence for exercise in preventing and treating depression. Increase in exercise has been found negatively correlated with the risk of depression. Randomized controlled experiments have shown that aerobic exercise, resistance exercise, and mind-body exercise can improve depressive symptoms and levels. The intensity and long-term effect of exercise are now topical research issues. Exercise has been proven to reshape the brain structure of depression patients, activate the function of related brain areas, promote behavioral adaptation changes, and maintain the integrity of hippocampal and white matter volume, thus improving the brain neuroprocessing and delaying cognitive degradation in depression patients. Future studies are urgently needed to establish accurate exercise prescriptions for improving depressive symptoms, and studies on different depressive populations and studies using multimodal brain imaging combined with multiple analytical methods are also needed.
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Affiliation(s)
- Jin‐Lei Zhao
- School of Physical Education and HealthShanghai Lixin University of Accounting and FinanceShanghaiChina
| | - Wan‐Ting Jiang
- Department of Physical Education and Sport TrainingShanghai University of SportShanghaiChina
| | - Xing Wang
- Department of Physical Education and Sport TrainingShanghai University of SportShanghaiChina
| | - Zhi‐Dong Cai
- Department of Physical Education and Sport TrainingShanghai University of SportShanghaiChina
| | - Zu‐Hong Liu
- Department of Physical Education and Sport TrainingShanghai University of SportShanghaiChina
| | - Guo‐Rong Liu
- School of Physical Education and HealthShanghai Lixin University of Accounting and FinanceShanghaiChina
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Strömbäck M, Fjellman-Wiklund A, Keisu S, Sturesson M, Eskilsson T. Restoring confidence in return to work: A qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention. PLoS One 2020; 15:e0234897. [PMID: 32735586 PMCID: PMC7394387 DOI: 10.1371/journal.pone.0234897] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 06/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator. Methods A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory. Results The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW. Conclusions The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED.
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Affiliation(s)
- Maria Strömbäck
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Clinical Science, Psychiatry, Umeå University, Umeå, Sweden
- * E-mail:
| | | | - Sara Keisu
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Marine Sturesson
- Department of Community Medicine and Rehabilitation, Occupational therapy, Umeå University, Umeå, Sweden
| | - Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
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Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145234. [PMID: 32698470 PMCID: PMC7400406 DOI: 10.3390/ijerph17145234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 02/03/2023]
Abstract
The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.
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Keus van de Poll M, Nybergh L, Lornudd C, Hagberg J, Bodin L, Kwak L, Jensen I, Lohela-Karlsson M, Torgén M, Bergstrom G. Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services. Occup Environ Med 2020; 77:454-461. [PMID: 32291291 PMCID: PMC7306872 DOI: 10.1136/oemed-2019-106353] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/20/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Common mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms. METHODS Randomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee's manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health. RESULTS A statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences. CONCLUSION PSI was effective in reducing sickness absence which was the primary outcome in this study.
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Affiliation(s)
- Marijke Keus van de Poll
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Lotta Nybergh
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Caroline Lornudd
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden
| | - Jan Hagberg
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Lennart Bodin
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Lydia Kwak
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Irene Jensen
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Margareta Torgén
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnar Bergstrom
- Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
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Augustsson P, Holst A, Svenningsson I, Petersson EL, Björkelund C, Björk Brämberg E. Implementation of care managers for patients with depression: a cross-sectional study in Swedish primary care. BMJ Open 2020; 10:e035629. [PMID: 32371517 PMCID: PMC7228530 DOI: 10.1136/bmjopen-2019-035629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/03/2020] [Accepted: 04/06/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To perform an analysis of collaborative care with a care manager implementation in a primary healthcare setting. The study has a twofold aim: (1) to examine clinicians' and directors' perceptions of implementing collaborative care with a care manager for patients with depression at the primary care centre (PCC), and (2) to identify barriers and facilitators that influenced this implementation. DESIGN A cross-sectional study was performed in 2016-2017 in parallel with a cluster-randomised controlled trial. SETTING 36 PCCs in south-west Sweden. PARTICIPANTS PCCs' directors and clinicians. OUTCOME Data regarding the study's aims were collected by two web-based questionnaires (directors, clinicians). Descriptive statistics and qualitative content analysis were used for analysis. RESULTS Among the 36 PCCs, 461 (59%) clinicians and 36 (100%) directors participated. Fifty-two per cent of clinicians could cooperate with the care manager without problems. Forty per cent regarded to their knowledge of the care manager assignment as insufficient. Around two-thirds perceived that collaborating with the care manager was part of their duty as PCC staff. Almost 90% of the PCCs' directors considered that the assignment of the care manager was clearly designed, around 70% considered the priority of the implementation to be high and around 90% were positive to the implementation. Facilitators consisted of support from colleagues and directors, cooperative skills and positive attitudes. Barriers were high workload, shortage of staff and extensive requirements and demands from healthcare management. CONCLUSIONS Our study confirms that the care manager puts collaborative care into practice. Facilitators and barriers of the implementation, such as time, information, soft values and attitudes, financial structure need to be considered when implementing care managers at PCCs.
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Affiliation(s)
- Pia Augustsson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Anna Holst
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Irene Svenningsson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Eva-Lisa Petersson
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Cecilia Björkelund
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
| | - Elisabeth Björk Brämberg
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Development, Primary Health Care, Region Västra Götaland, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Riedl L, Blank D, Kohl M, Lang A, Kehl V, Brieger P, Hamann J. Return-to-work-experts for inpatient treatment of patients with mental illnesses- a proof-of-concept-study (RETURN): the study protocol. BMC Psychiatry 2020; 20:177. [PMID: 32306925 PMCID: PMC7168961 DOI: 10.1186/s12888-020-02504-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/17/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patients with mental illnesses often have massive difficulties returning to work after inpatient treatment at a psychiatric clinic and are often at risk of losing their jobs. The psychosocial support for this patient group at the interface of clinic/outpatient care is often insufficient. METHODS/DESIGN The RETURN-study prospectively assesses and surveys 200 patients with mental disorders in a cluster randomized intervention study, i.e. treatment teams and patients from intervention wards receive a return-to-work (RTW) intervention. Patients in control wards obtain treatment as usual (TAU). Pairs of comparable wards (similar patient population, similar staff density) have been identified and then randomized for control and intervention (n = 14 for each condition). On intervention wards return-to-work experts (RTW experts) who focus treatment on the workplace-related needs of patients with mental illnesses have been established. These RTW experts ensure the use of available resources within the framework of work-related discharge management and should lead to a more successful return to the workplace. The days at work in the year after release will be evaluated in a mixed methods approach as well as the return rate in the year after release, disability days in the year after return, relapse rate after 12 months, cost-benefit ratio of the intervention, analysis of the predictors / barriers for a successful return to the workplace (e.g. psychopathology, cognition, stigma, social-psychiatric support, company support, etc.), possibilities to implement the concept of RTW experts in standard psychiatric care (TAU - treatment as usual), the impact of the RTW experts' approach on the treatment process in standard psychiatric care. DISCUSSION This approach is already internationally established in the field of somatic rehabilitation and supported employment [Am J Psychiatry 171:1183-90, 2014; Lancet 370:1146-52, 2007; Cochrane Database Syst Rev, doi:10.1002/14651858.CD006237.pub3, 2014]; the innovative aspect of this project is to implement and evaluate it in standard psychiatric care in Germany. This project requires no new interventions to be developed and tested, as the techniques of the case manager/job coach is applied to the field of return to work. TRIAL REGISTRATION The study was registered in Deutsches Register Klinische Studien searchable via its Meta-registry (http://apps.who.int/trialsearch/), Trial registration number: DRKS00016037, Date of registration: 21/12/2018, URL of trial registry record.
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Affiliation(s)
- Lina Riedl
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany.
| | - Daniela Blank
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Monika Kohl
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany
| | - Anne Lang
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Victoria Kehl
- Department of Psychiatry and Psychotherapie, Technische Universität München, School of Medicine, Munich, Germany
| | - Peter Brieger
- kbo-Isar-Amper-Klinikum, Academic Teaching Hospital LMU Munich, Munich-Haar, Germany
- Academic Teaching Hospital LMU, Munich, Germany
| | - Johannes Hamann
- Department of Psychiatry and Psychotherapy of Technische Universität München, School of Medicine, Ismaninger Str.22, 81675, Munich, Germany
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Axén I, Björk Brämberg E, Vaez M, Lundin A, Bergström G. Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis. Int Arch Occup Environ Health 2020; 93:823-838. [PMID: 32246230 PMCID: PMC7452923 DOI: 10.1007/s00420-020-01535-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/12/2020] [Indexed: 12/14/2022]
Abstract
Introduction Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health. Objective To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis. Data sources The literature search was performed in four electronic databases in two searches, in 2014 and in 2017. Eligibility criteria (using PICO) Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included. Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof. Results Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect. Limitations Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common. Conclusions and implication of key findings Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions. Further, interventions for CMD administered through the occupational health service require further study. Rehabilitative and preventive strategies should be evaluated with scientifically robust methods, to examine the effectiveness of such interventions.
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Affiliation(s)
- Iben Axén
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Elisabeth Björk Brämberg
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden
| | - Marjan Vaez
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Andreas Lundin
- Department for Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnar Bergström
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of Occupational Health Sciences and Psychology, University of Gävle Centre for Musculoskeletal Research, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
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[Psychosocial vocational rehabilitation in a world of work 4.0-Between demands and needs]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2020; 34:5-14. [PMID: 31270695 DOI: 10.1007/s40211-019-0316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND This study provides insights into the work demands associated with the "world of work 4.0" as well as employee needs from the perspectives of clients, staff, and executives of an Austrian work integration social enterprise (WISE). The WISE offers two main types of rehabilitation and support programs for individuals with psychological health conditions: 1) counselling and assistance programs, and 2) training and employment programs. METHODS The study employed a mixed-method design, using both quantitative (online survey) and qualitative methods (semi-structured interviews). N = 620 clients and N = 188 employees from of the rehabilitation programs were invited to take part in an online survey on work demands and employee needs. The response rates were 40.81% (n = 253) among clients and 54.79% (n = 103) among employees. Additionally, semi-structured interviews were conducted among six executives. RESULTS The results demonstrate that, with respect to the future labour market, participants feel that it is important to develop competences related to new technologies and resilience, but also to train social competences. Employees and clients in counselling and advice programs evaluated the support (provided by the WISE) in achieving methodological competences, resilience, and social competences more positively as compared with employees and clients in training and employment programs. The latter, however, evaluated the support in achieving manual skills more positively. CONCLUSIONS FOR PRACTICE In general, the rehabilitation programs do well in fostering social competences and resilience among their clients, but need to improve their promotion of media competences. Participants' needs can hardly be satisfied through the future labour market, especially the need for low-demand work and the needs for autonomy and personal growth. Additionally, the executives noted that in the future labour market, many jobs in the production sector would be cut, jobs would become more complex, and high technical know-how would be required. They feel that these trends will make it more difficult to place participants into first labour market employment. Accordingly, it would be especially important to secure the second labour market.
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Foldal VS, Standal MI, Aasdahl L, Hagen R, Bagøien G, Fors EA, Johnsen R, Solbjør M. Sick-listed workers' experiences with motivational interviewing in the return to work process: a qualitative interview study. BMC Public Health 2020; 20:276. [PMID: 32111199 PMCID: PMC7048031 DOI: 10.1186/s12889-020-8382-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/20/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND When returning to work after being on long-term sick leave, individuals may experience varying levels of motivation and self-efficacy. Motivational interviewing (MI) is a counseling style that aims to increase motivation towards change, and it may be useful in the return to work (RTW) process. The aim of this study was to explore sick-listed workers' experiences with MI in the RTW process. METHODS This qualitative study was part of a randomized controlled trial evaluating the effects of MI on the RTW process, and it was administered by caseworkers at the Norwegian Labor and Welfare Administration. Sixteen sick-listed individuals, aged 33-60, participated in semi-structured interviews. All had a sick leave status of 50-100% for at least 8 weeks when interviewed and all had completed 2 MI sessions. The data was analyzed with systematic text condensation. RESULTS Participants' experiences of the MI sessions were categorized into three themes: (1) relationship with the MI caseworker, (2) normalizing sick leave, and (3) adjusting RTW strategies. The MI sessions were experienced as a positive encounter due to the supportive relationship that was built between the MI caseworker and the sick-listed worker. Being sick listed led to feelings of guilt and stigmatization, but acceptance and support from the MI caseworkers helped normalize the situation for the sick-listed workers. Furthermore, MI sessions allowed for personalized feedback and discussions on adjustments to their RTW strategies. CONCLUSION Sick-listed workers experienced MI as positive due to the good relationship that developed with the MI caseworker, how this normalized sick leave, and the help they received with adjusting their RTW strategies. Professionals working with individuals attempting to RTW may benefit from using MI as a method for helping sick-listed workers to RTW. TRIAL REGISTRATION ClinicalTrials.gov: NCT03212118 (registered July 11, 2017).
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Affiliation(s)
- Vegard Stolsmo Foldal
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.
| | - Martin Inge Standal
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Roger Hagen
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnhild Bagøien
- Tiller Community Mental Health Centre, Division of Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Egil Andreas Fors
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Marit Solbjør
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway
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48
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Knapstad M, Sæther SMM, Hensing G, Smith ORF. Prompt Mental Health Care (PMHC): work participation and functional status at 12 months post-treatment. BMC Health Serv Res 2020; 20:85. [PMID: 32019521 PMCID: PMC7001227 DOI: 10.1186/s12913-020-4932-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anxiety and depression are associated with substantial functional impairment. Prompt Mental Health Care (PMHC), the Norwegian adaptation of IAPT is currently piloted across Norway, as a means to improve access to evidence-based care for adults with anxiety disorders (including subthreshold cases) and minor to moderate depression. The aims of the current paper were to examine the change in work status and functional status from pre- to post-treatment and 12 months post-treatment among clients at the first 12 PMHC pilot sites, and whether degree of change differed across sociodemographic characteristics. METHODS A prospective cohort design was used, including working age clients receiving treatment between October 2014 and December 2016 (n = 1446, participation rate = 61%). Work status and functional status were self-reported, the latter by the Work and Social Adjustment Scale (WSAS). Changes in work status and WSAS score were examined through multilevel models based on maximum likelihood estimation. Likelihood ratio tests were performed to determine whether the interaction between time and the respective background variables were statistically significant. RESULTS A substantial increase in regular work participation was observed from pre- to post-treatment, which further had increased at 12 months post-treatment. The increase was driven by a corresponding reduction in proportion of clients working and receiving benefits (OR 0.38 [0.29-0.50] baseline to final treatment, OR = 0.19 [0.12-0.32] final treatment to 12-months post-treatment), while no statistically significant change was observed in proportion out of work. Large improvement (ES = - 0.89) in WSAS score was observed from pre- to post treatment. WSAS score at 12 months post-treatment remained at the post-treatment level. CONCLUSIONS Previous research has shown substantial symptom improvement among clients receiving treatment in PMHC. The current findings indicate that PMHC might also be able to aid adults struggling with mild to moderate anxiety and depression in returning to usual level of functioning. The degree to which the observed improvements are attributable to the treatment need nonetheless to be confirmed in a trial including a control group and with more complete follow-up data from registries.
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Affiliation(s)
- Marit Knapstad
- Department of Clinical Psychology, University of Bergen, P.B. 7807, N-5020 Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gate 7, N-5015 Bergen, Norway
| | | | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Otto Robert Frans Smith
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gate 7, N-5015 Bergen, Norway
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49
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Behrens-Wittenberg E, Wedegaertner F. Identifying Individuals at High Risk for Permanent Disability From Depression and Anxiety. Front Psychiatry 2020; 11:740. [PMID: 32848920 PMCID: PMC7411999 DOI: 10.3389/fpsyt.2020.00740] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/14/2020] [Indexed: 11/23/2022] Open
Abstract
Mental illnesses, among which depression and anxiety are most common, are the leading cause for permanent disability. It is of interest to know what case characteristics determine if a person returns to the work force in spite of mental illness to tailor specific interventions. So far, there has been little research into this field. In the present study a sample of 202 workers who had permanent disability due to depression/anxiety were followed-up on. 22% started some kind of work during follow-up in a period of 30 to 75 months. Logistic regression analyses showed that quick progression into disability, short period of disability, younger age, adequacy of income replacement through insurance benefits and no previous disability predicted return to work. These findings also allow to identify individuals at high risk for progression into permanent disability that can benefit from supporting interventions.
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Affiliation(s)
- Eva Behrens-Wittenberg
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Felix Wedegaertner
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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50
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Ohki Y, Igarashi Y, Yamauchi K. Re-work Program in Japan-Overview and Outcome of the Program. Front Psychiatry 2020; 11:616223. [PMID: 33584377 PMCID: PMC7874090 DOI: 10.3389/fpsyt.2020.616223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/03/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The objective of this study was to examine the effect of the Japanese re-work program (RP) to aid in recurrent sick leave prevention. Methods: A multicenter retrospective cohort research was conducted for workers who returned to work (RTW) after sick leave due to mood disorder. Work continuation for subjects who RTW after RP participation and treatment as usual (TAU) and subjects who received TAU only were compared. The Kaplan-Meier method and Cox proportional hazard models were utilized. Additionally, propensity score matching was conducted to control for possible confounds. Results: Log-rank test of overall cohort (n = 323) showed that work continuation of RP + TAU subjects was significantly better compared to that of TAU-only subjects (p = 0.001). Multivariate analysis found a hazard rate of recurrent sick leave for TAU-only subjects of 2.121 (p = 0.001, 95% CI: 1.360-3.309). Additionally, the propensity score-matched cohort (n = 100) had similar differences (p = 0.008), with a hazard ratio of recurrent sick leave of 2.871 (p = 0.009, 95% CI: 1.302-6.331) for TAU-only subjects. Limitations: Only workers who RTW after sick leave were targeted, and no examination was made considering cases who dropped out from RP or TAU. Moreover, the sample was a non-randomized controlled trial, with propensity score matching performed. However, there was an inability to retrieve and adjust for working environment background factors after RTW. Conclusions: Work continuation of subjects with RP was observed to be significantly better, suggesting that the RP was effective for recurrent sick leave prevention.
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Affiliation(s)
- Yoko Ohki
- Keio Research Institute at SFC, Fujisawa, Japan.,Tokyo Institute of Rework for Depression, Tokyo, Japan
| | - Yoshio Igarashi
- Tokyo Institute of Rework for Depression, Tokyo, Japan.,Medical Care Ohtemachi Clinic, Tokyo, Japan.,Japanese Association of Rework for Depression, Tokyo, Japan
| | - Keita Yamauchi
- Graduate School of Health Management, Keio University, Tokyo, Japan
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