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Bosma AR, Boot CRL, Schaafsma FG, Kok G, Anema JR. Development of an Intervention to Create a Supportive Work Environment for Employees with Chronic Conditions: An Intervention Mapping Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:624-634. [PMID: 32200483 PMCID: PMC7716852 DOI: 10.1007/s10926-020-09885-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Purpose This study describes the development of an evidence-based intervention to create a supportive work environment for employees with chronic conditions. Occupational physicians (OPs) play an important role in guiding organizations in this process of organizational change. Supportive work environments can aid in preventing work-related problems and facilitate sustainable employment. Current workplace interventions for employees with chronic conditions are mainly focused on return to work or a reduction in sick leave at the individual worker's level. This study contributes to the literature an organizational-level intervention which utilizes a preventive approach. Methods Intervention mapping (IM) is a six-step, structured protocol that was used to develop this intervention. In step 1, a needs assessment was conducted to define the problem and explore the perspectives of all stakeholders involved. The program outcomes and the performance objectives of employees with chronic conditions and occupational physicians were specified in step 2. In step 3, appropriate methods and practical applications were chosen. Step 4 describes the actual development of the intervention, consisting of (1) a training for occupational physicians to teach them how to guide organizations in creating a supportive work environment; (2) a practical assignment; and (3) a follow-up meeting. The intervention will be implemented in a pilot study in which occupational physicians will put their acquired knowledge and skills into practice within one of their organizations, which is delineated in step 5. Conclusions IM proved to be a valuable and practical tool for the development of this intervention, aiming to facilitate sustainable employment for employees with chronic conditions.
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Affiliation(s)
- A. R. Bosma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - C. R. L. Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - F. G. Schaafsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - G. Kok
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - J. R. Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
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De Wit M, Horreh B, Daams JG, Hulshof CTJ, Wind H, de Boer AGEM. Interventions on cognitions and perceptions that influence work participation of employees with chronic health problems: a scoping review. BMC Public Health 2020; 20:1610. [PMID: 33109123 PMCID: PMC7590449 DOI: 10.1186/s12889-020-09621-5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cognitions and perceptions, such as motivation and return to work (RTW) expectations, can influence work participation of employees with chronic health problems. This makes these cognitions and perceptions important factors for occupational health professionals to intervene upon in order to increase work participation. There is, however, no overview of interventions that influence these factors and are aimed at increasing work participation. Therefore, the purpose of this scoping review is to explore available interventions that are focused on cognitions and perceptions of employees with chronic health problems and aimed at increasing work participation. METHODS A scoping review was carried out following the framework of Arksey and O'Malley. Ovid MEDLINE and PsycINFO were searched for original papers published between January 2013 and June 2020. We included studies that describe interventions that focus on at least one of ten cognitions and perceptions and on work participation. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. RESULTS In total, 29 studies were identified that studied interventions aimed at changing at least one of ten cognitions and perceptions in order to change work participation. The interventions that were included mainly focused on changing recovery and RTW expectations, self-efficacy, feelings of control, perceived health, fear-avoidance beliefs, perceived work-relatedness of the health problem, coping strategies and catastrophizing. No interventions were found that focused on changing motivation or on optimism/pessimism. Four interventions were judged as effective in changing coping, self-efficacy, fear-avoidance beliefs, or perceived work-relatedness and work participation according to results of randomized controlled trials. CONCLUSIONS This review provides an overview of interventions that focus on changing cognitions and perceptions and work participation. Evidence was found for four effective interventions focused on changing these factors and increasing work participation. Occupational health professionals may use the overview of interventions to help employees with chronic health problems to increase their work participation.
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Affiliation(s)
- Mariska De Wit
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands.
| | - Bedra Horreh
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Joost G Daams
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Haije Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
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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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Bolinski F, Boumparis N, Kleiboer A, Cuijpers P, Ebert D, Riper H. The effect of e-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials. Internet Interv 2020; 20:100321. [PMID: 32382515 PMCID: PMC7201188 DOI: 10.1016/j.invent.2020.100321] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Mental health symptoms are common among college and university students and these can affect their academic performance. E-mental health interventions have proven effective in addressing mental health complaints but their effect on academic performance has not been synthesized yet. OBJECTIVES To synthesize the evidence from randomized controlled trials for the effectiveness of e-mental health interventions on academic performance in college and university students compared to inactive controls. DATA SOURCES AND ELIGIBILITY CRITERIA We searched six databases (PubMed, Cochrane library, CINAHL, ERIC, PsycINFO, Web of Science) during the period January 2000 until September 2019 for randomized controlled trials that reported on e-mental health interventions (guided or unguided) for college and university students and measured academic performance (e.g. grade point average). STUDY APPRAISAL AND SYNTHESIS METHODS Study and participant characteristics and the academic performance measures at post-intervention were extracted. The latter were pooled and Hedges' g was calculated as the effect size. Heterogeneity and publication bias were investigated. RESULTS Six studies containing 2428 participants were included in the meta-analysis. These focussed on either mood and anxiety or alcohol and tobacco use. The pooling of data resulted in a small but non-significant effect of g = 0.26 (95% CI, -0.00, 0.52; p = .05) on academic performance, favouring e-mental health interventions over inactive controls. Interventions had positive effects on depression (g = -0.24) and anxiety (g = -0.2). Heterogeneity was high. DISCUSSION Despite the small and non-significant effect, our meta-analysis points to a promising direction for the effectiveness of e-mental health interventions on academic performance. Yet, these results must be interpreted with caution, as heterogeneity was high and few studies on the effectiveness of e-mental health interventions for students reported academic performance measures.
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Affiliation(s)
- F. Bolinski
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - N. Boumparis
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - A. Kleiboer
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - P. Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - D.D. Ebert
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Germany
| | - H. Riper
- Department of Clinical, Neuro-, and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
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Zaprutko T, Göder R, Rybakowski F, Kus K, Kopciuch D, Paczkowska A, Ratajczak P, Nowakowska E. Non-pharmacological treatments of inpatients with major depression - The case of Polish (Poznan) and German (Kiel) hospital. Complement Ther Clin Pract 2020; 39:101129. [PMID: 32379644 DOI: 10.1016/j.ctcp.2020.101129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Although the treatment of depression should be comprehensive, there is insufficient information about non-pharmacological interventions used during hospitalization. Hence, the aim was to compare non-pharmacological interventions used in psychiatry clinics in Kiel (Germany) and Poznan (Poland). METHODS AND MATERIALS The retrospective study covered all patients hospitalized in 2016 (F32 or F33). Out of 545 patients hospitalized in 2016 in both centers, the analysis concerns 322 records from Kiel and 168 from Poznan. RESULTS Non-pharmacological treatments were used in both centers. However, in Kiel there were more therapeutic options. Contrary to Poznan, patients in Kiel used therapies like "Kneippen", Qigong, and light therapy. CONCLUSIONS Implementing Tai Chi in Kiel would be interesting to develop the scope of used interventions. Investment in non-pharmacological treatment should be a priority for healthcare decision-makers in Poland. The wide range of non-pharmacological interventions should be commonly accessible to provide the most comprehensive treatment.
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Affiliation(s)
- Tomasz Zaprutko
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland.
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University of Kiel, 24105, Kiel, Germany
| | - Filip Rybakowski
- Department of Adult Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St, 60-572, Poznań, Poland
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland
| | - Dorota Kopciuch
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland
| | - Piotr Ratajczak
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland
| | - Elżbieta Nowakowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Rokietnicka 7 St, 60-806, Poznań, Poland
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7
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Wisenthal A, Krupa T, Kirsh B, Lysaght R. Insights into cognitive work hardening for return-to-work following depression: Qualitative findings from an intervention study. Work 2019; 62:599-613. [DOI: 10.3233/wor-192893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Terry Krupa
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Rosemary Lysaght
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
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8
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Thisted CN, Labriola M, Vinther Nielsen C, Kristiansen ST, Strøm J, Bjerrum MB. Managing employees' depression from the employees', co-workers' and employers' perspectives. An integrative review. Disabil Rehabil 2018; 42:445-459. [PMID: 30384779 DOI: 10.1080/09638288.2018.1499823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To synthesize evidence on factors promoting or hindering work participation (WP) of employees with depression from the employees', co-workers' and employers' perspectives, as well as an additional focus on the influence of the employee's occupation.Methods: An integrative review was conducted. Pre-defined eligibility criteria guided study selection. Articles were critically appraised using tools developed by Joanna Briggs and Mixed Methods Appraisal Tool. Findings were analysed and synthesised using qualitative inductive content analysis.Results: Seventeen studies were included: 12 quantitative studies, three qualitative studies and two mixed methods studies. From these, 144 findings were extracted and combined into six categories from which two syntheses were developed. One synthesis demonstrated that employees, co-workers and employers hold different perspectives on rehabilitation stakeholders' responsibilities hindering WP. The other synthesis revealed that WP is influenced by interactions between individual and occupational factors.Conclusions: Sufficient treatment from health professionals promotes WP. Employees' fear of stigmatization hinders WP. Co-workers and employers find that open communication is important, however, employers are concerned about entering employees' private sphere. When managing employees with depression, employers intervene at the individual level. There is a need for structural interventions to promote WP among employees with depression.Implications for RehabilitationThe responsibilities of rehabilitation stakeholders should be clarified to promote collaboration.Structural workplace interventions should be initiated to supplement individual level interventions.Workplace interventions may focus on more open communication and awareness towards mental illness.Interactions between the occupational factors and individual factors should be carefully considered.
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Affiliation(s)
- Cecilie N Thisted
- Department of Public Health, Section for Nursing Science, Aarhus University, Aarhus, Denmark
| | - Merete Labriola
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Sanne T Kristiansen
- Department of Affective Disorders, Aarhus University Hospital, Risskov, Central Denmark Region, Aarhus, Denmark
| | - Janni Strøm
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark.,Spine Unit, Elective Surgery Centre, Regional Hospital Central Jutland, Silkeborg, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Section for Nursing Science, Aarhus University, Aarhus, Denmark.,Danish Centre of Systematic Reviews: A Joanna Briggs Institute Centre of Excellence, Department of Medicine and Technology, University of Aalborg, Aalborg, Denmark
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9
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Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, Hogg-Johnson S, Kristman V, Laberge M, McKenzie D, Newnam S, Palagyi A, Ruseckaite R, Sheppard DM, Shourie S, Steenstra I, Van Eerd D, Amick BC. Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:1-15. [PMID: 28224415 PMCID: PMC5820404 DOI: 10.1007/s10926-016-9690-x] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.
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Affiliation(s)
- K L Cullen
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.
| | - E Irvin
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - A Collie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - F Clay
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - U Gensby
- National Centre for Occupational Rehabilitation, Rauland, Norway
- Team WorkingLife ApS, Copenhagen, Denmark
| | - P A Jennings
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
| | - S Hogg-Johnson
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - V Kristman
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Lakehead University, Thunder Bay, ON, Canada
| | - M Laberge
- University of Montreal and CHU Ste-Justine Research Centre, Montreal, QC, Canada
| | - D McKenzie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - S Newnam
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - A Palagyi
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - R Ruseckaite
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - D M Sheppard
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - S Shourie
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - I Steenstra
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - D Van Eerd
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - B C Amick
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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10
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Wisenthal A, Krupa T, Kirsh BH, Lysaght R. Cognitive work hardening for return to work following depression: An intervention study: Le réentraînement cognitif au travail pour favoriser le retour au travail à la suite d'une dépression : étude d'intervention. The Canadian Journal of Occupational Therapy 2018; 85:21-32. [PMID: 29334790 DOI: 10.1177/0008417417733275] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. PURPOSE This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention. METHOD A single group ( n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data. FINDINGS Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements. IMPLICATIONS Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.
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11
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Williams-Whitt K, Bültmann U, Amick B, Munir F, Tveito TH, Anema JR. Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:417-433. [PMID: 27614465 PMCID: PMC5104758 DOI: 10.1007/s10926-016-9664-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.
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Affiliation(s)
- Kelly Williams-Whitt
- University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Ute Bültmann
- University Medical Center Groningen, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - Benjamin Amick
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Institute for Work and Health, Toronto, Canada
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Torill H Tveito
- Uni Research Health, Bergen, Norway
- Department of Health Promotion, University College of Southeast Norway, Horten, Norway
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Clark M, DiBenedetti D, Perez V. Cognitive dysfunction and work productivity in major depressive disorder. Expert Rev Pharmacoecon Outcomes Res 2016; 16:455-63. [DOI: 10.1080/14737167.2016.1195688] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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de Vries G, Koeter MWJ, Nieuwenhuijsen K, Hees HL, Schene AH. Predictors of impaired work functioning in employees with major depression in remission. J Affect Disord 2015; 185:180-7. [PMID: 26188379 DOI: 10.1016/j.jad.2015.07.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 07/03/2015] [Accepted: 07/08/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aims to (i) assess work functioning in employees returning to work with a major depression in remission, (ii) study the predictors of impaired work functioning. METHODS Participants diagnosed with major depressive disorder (MDD), on long term sick leave (mean 27 weeks) and treated in a specialized mental healthcare setting, were selected from an intervention study sample. They were eligible for this study if they were remitted from their depression and had returned to work for at least 50% of their contract hours at 18 month follow-up. Work functioning was assessed with the Work Limitations Questionnaire (WLQ) and the Need For Recovery scale (NFR). Potential predictors of impaired work functioning were demographic characteristics (assessed at baseline), health characteristics (assessed at baseline, six and twelve month follow-up), and personality- and work characteristics (assessed at 18 month follow-up). RESULTS After their return to work with MDD in remission, employees were on average still impaired in their work functioning. Personality characteristics were the strongest predictor of this impaired work functioning, followed by health and work characteristics. In the final prediction model, only a passive reaction coping style remained as predictor. LIMITATIONS We used self-report data with respect to work functioning and work characteristics and not an assessment by a supervisor. CONCLUSIONS Personality trait, coping style, and ability to manage the work environment should be addressed in mental health and return-to-work interventions. Subsequent improved work functioning may be beneficial for mental health and may reduce societal costs.
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Affiliation(s)
- Gabe de Vries
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin/Roads, Amsterdam, The Netherlands.
| | - Maarten W J Koeter
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Hiske L Hees
- Program for Mood Disorders, Pro Persona, Arnhem, The Netherlands
| | - Aart H Schene
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
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Dewa CS, Loong D, Bonato S, Joosen MCW. The effectiveness of return-to-work interventions that incorporate work-focused problem-solving skills for workers with sickness absences related to mental disorders: a systematic literature review. BMJ Open 2015; 5:e007122. [PMID: 26078309 PMCID: PMC4480016 DOI: 10.1136/bmjopen-2014-007122] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This paper reviews the current state of the published peer-reviewed literature related to return-to-work (RTW) interventions that incorporate work-related problem-solving skills for workers with sickness absences related to mental disorders. It addresses the question: What is the evidence for the effectiveness of these RTW interventions? DESIGN Using a multiphase screening process, this systematic literature review was based on publically available peer-reviewed studies. Five electronic databases were searched: (1) Medline Current, (2) Medline In-process, (3) PsycINFO, (4) Econlit and (5) Web of Science. SETTING The focus was on RTW interventions for workers with medically certified sickness absences related to mental disorders. PARTICIPANTS Workers with medically certified sickness absences related to mental disorders. INTERVENTIONS RTW intervention included work-focused problem-solving skills. PRIMARY AND SECONDARY OUTCOME MEASURES RTW rates and length of sickness absences. RESULTS There were 4709 unique citations identified. Of these, eight articles representing a total of six studies were included in the review. In terms of bias avoidance, two of the six studies were rated as excellent, two as good and two as weak. Five studies were from the Netherlands; one was from Norway. There was variability among the studies with regard to RTW findings. Two of three studies reported significant differences in RTW rates between the intervention and control groups. One of six studies observed a significant difference in sickness absence duration between intervention and control groups. CONCLUSIONS There is limited evidence that combinations of interventions that include work-related problem-solving skills are effective in RTW outcomes. The evidence could be strengthened if future studies included more detailed examinations of intervention adherence and changes in problem-solving skills. Future studies should also examine the long-term effects of problem-solving skills on sickness absence recurrence and work productivity.
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Affiliation(s)
- Carolyn S Dewa
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Desmond Loong
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Margot C W Joosen
- Tilburg University, School of Social and Behavioral Sciences, Tranzo, Tilburg, Tranzo, The Netherlands
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Clemente M, Reig-Botella A, Prados JC. Alterations in psychosocial health of people affected by asbestos poisoning. Rev Saude Publica 2015; 49:24. [PMID: 25902564 PMCID: PMC4390070 DOI: 10.1590/s0034-8910.2015049005445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the state of psychosocial and mental health of professionals affected by asbestos. METHODS A cross-sectional study was conducted with 110 professionals working in the Ferrolterra region of Spain, who were affected by asbestos poisoning. This group was compared with a group of 70 shipyard workers with no manifestation of work-related diseases. All the participants were male with a mean age of 67 years. This study was conducted in 2013, between January and June, and used the SCL-90 questionnaire by Derogatis as its primary measure for research. This questionnaire consists of 9 variables that measure psychosomatic symptoms. In addition, an overall index of psychosomatic gravity was calculated. The participants were also asked two questions concerning their overall perception of feeling good. Data were analyzed by ANOVA and logistic regression. RESULTS Participants affected by asbestos poisoning showed high occurrence rates of psychological health variables such as somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and global severity index. CONCLUSIONS Social interaction as a differentiating factor between workers affected by work-related chronic syndromes as compared to healthy participants will possibly aid in the development of intervention programs by improving the social network of affected individuals.
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[Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part III: Treatment of Resistant Depression and Psychotic Depression, Occupational Therapy and Day Hospital Treatment]. ACTA ACUST UNITED AC 2014; 41:774-86. [PMID: 26572265 DOI: 10.1016/s0034-7450(14)60046-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 11/06/2012] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. METHODOLOGY A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. RESULTS Recommendations 23-25 corresponding to the management of depression are presented.
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Adaptation of the questionnaire of Hahn, Cella, Bode, and Hanrahan in Spanish patients affected by asbestos poisoning. SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E66. [PMID: 24230929 DOI: 10.1017/sjp.2013.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to assess whether or not the questionnaire developed by Hahn, Cella, Bode, and Hanharan (2010) for use with cancer patients accurately measures the social well-being of individuals suffering from chronic illnesses associated with asbestos poisoning. One hundred ten male patients with asbestos poisoning were age-matched in blocks to a comparison group of 70 "healthy" controls, all of whom were current or retired employees of the largest naval company in Spain. The results indicate very high reliability of the Hahn et al. (2010) test to assess social well-being in these chronically ill patients, and a high concurrent validity of the measured outcomes with regard to results of the SCL-90 Derogatis questionnaire, especially on the social well-being dimensions of negative emotional support, negative social companionship, and satisfaction. Limitations of the study and possible future directions are discussed.
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Hees HL, Koeter MWJ, Schene AH. Longitudinal relationship between depressive symptoms and work outcomes in clinically treated patients with long-term sickness absence related to major depressive disorder. J Affect Disord 2013; 148:272-7. [PMID: 23332643 DOI: 10.1016/j.jad.2012.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/03/2012] [Accepted: 12/05/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) negatively affects a wide range of work outcomes (absenteeism, work productivity, work limitations). However, the exact longitudinal relationship between depressive symptoms and work outcomes in MDD patients with long-term sickness absence is still unclear. Therefore, the present study aimed to examine the temporal and directional relationship between depressive symptoms and various work outcomes in these patients. METHODS Patients (n = 117) were diagnosed with MDD according to DSM-IV criteria, had a median duration of MDD-related sickness absence of 4.8 months (IQR = 2.6-10.1 months) at baseline, and were referred by occupational physicians. All patients received outpatient treatment for their MDD. Depressive symptoms and work outcomes were examined during baseline, and 6-, 12- and 18-month follow-ups. RESULTS Within-subject changes in the severity of depressive symptoms were significantly related to within-subject changes in all work outcomes (all scales: p < 0.001). Earlier reduction in depressive symptoms predicted subsequent improvements in all work outcomes (all scales: p < 0.05). Conversely, only earlier improvement in Time Management (p = 0.007) and Mental/Interpersonal (p < 0.001) work limitations predicted a subsequent reduction in depressive symptoms. LIMITATIONS All work outcomes were assessed through self-report. Work limitations at the start of absenteeism were retrospectively assessed. CONCLUSIONS Symptom reduction remains crucial for improving adverse work outcomes in MDD patients with long-term sickness absence. In addition, a treatment focus on qualitative functioning in the workplace may accelerate depression recovery.
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Affiliation(s)
- Hiske L Hees
- Program for Mood Disorders (PA 3.223), Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
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Arends I, Bruinvels DJ, Rebergen DS, Nieuwenhuijsen K, Madan I, Neumeyer-Gromen A, Bültmann U, Verbeek JH. Interventions to facilitate return to work in adults with adjustment disorders. Cochrane Database Syst Rev 2012; 12:CD006389. [PMID: 23235630 DOI: 10.1002/14651858.cd006389.pub2] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Adjustment disorders are a frequent cause of sick leave and various interventions have been developed to expedite the return to work (RTW) of individuals on sick leave due to adjustment disorders. OBJECTIVES To assess the effects of interventions facilitating RTW for workers with acute or chronic adjustment disorders. SEARCH METHODS We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to October 2011; the Cochrane Central Register of Controlled Trials (CENTRAL) to Issue 4, 2011; MEDLINE, EMBASE, PsycINFO and ISI Web of Science, all years to February 2011; the WHO trials portal (ICTRP) and ClinicalTrials.gov in March 2011. We also screened reference lists of included studies and relevant reviews. SELECTION CRITERIA We selected randomised controlled trials (RCTs) evaluating the effectiveness of interventions to facilitate RTW of workers with adjustment disorders compared to no or other treatment. Eligible interventions were pharmacological interventions, psychological interventions (such as cognitive behavioural therapy (CBT) and problem solving therapy), relaxation techniques, exercise programmes, employee assistance programmes or combinations of these interventions. The primary outcomes were time to partial and time to full RTW, and secondary outcomes were severity of symptoms of adjustment disorder, work functioning, generic functional status (i.e. the overall functional capabilities of an individual, such as physical functioning, social function, general mental health) and quality of life. DATA COLLECTION AND ANALYSIS Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently clinically homogeneous in different comparison groups, and assessed the overall quality of the evidence using the GRADE approach. MAIN RESULTS We included nine studies reporting on 10 psychological interventions and one combined intervention. The studies included 1546 participants. No RCTs were found of pharmacological interventions, exercise programmes or employee assistance programmes. We assessed seven studies as having low risk of bias and the studies that were pooled together were comparable. For those who received no treatment, compared with CBT, the assumed time to partial and full RTW was 88 and 252 days respectively. Based on two studies with a total of 159 participants, moderate-quality evidence showed that CBT had similar results for time (measured in days) until partial RTW compared to no treatment at one-year follow-up (mean difference (MD) -8.78, 95% confidence interval (CI) -23.26 to 5.71). We found low-quality evidence of similar results for CBT and no treatment on the reduction of days until full RTW at one-year follow-up (MD -35.73, 95% CI -113.15 to 41.69) (one study with 105 participants included in the analysis). Based on moderate-quality evidence, problem solving therapy (PST) significantly reduced time until partial RTW at one-year follow-up compared to non-guideline based care (MD -17.00, 95% CI -26.48 to -7.52) (one study with 192 participants clustered among 33 treatment providers included in the analysis), but we found moderate-quality evidence of no significant effect on reducing days until full RTW at one-year follow-up (MD -17.73, 95% CI -37.35 to 1.90) (two studies with 342 participants included in the analysis). AUTHORS' CONCLUSIONS We found moderate-quality evidence that CBT did not significantly reduce time until partial RTW and low-quality evidence that it did not significantly reduce time to full RTW compared with no treatment. Moderate-quality evidence showed that PST significantly enhanced partial RTW at one-year follow-up compared to non-guideline based care but did not significantly enhance time to full RTW at one-year follow-up. An important limitation was the small number of studies included in the meta-analyses and the small number of participants, which lowered the power of the analyses.
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Affiliation(s)
- Iris Arends
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University ofGroningen, Groningen,
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Interpretability of change in the Nurses Work Functioning Questionnaire: minimal important change and smallest detectable change. J Clin Epidemiol 2012; 65:1337-47. [DOI: 10.1016/j.jclinepi.2012.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 06/05/2012] [Accepted: 06/19/2012] [Indexed: 11/20/2022]
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Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev 2012; 10:CD006525. [PMID: 23076925 DOI: 10.1002/14651858.cd006525.pub2] [Citation(s) in RCA: 465] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Common mental health problems, such as depression and anxiety, are estimated to affect up to 15% of the UK population at any one time, and health care systems worldwide need to implement interventions to reduce the impact and burden of these conditions. Collaborative care is a complex intervention based on chronic disease management models that may be effective in the management of these common mental health problems. OBJECTIVES To assess the effectiveness of collaborative care for patients with depression or anxiety. SEARCH METHODS We searched the following databases to February 2012: The Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDAN) trials registers (CCDANCTR-References and CCDANCTR-Studies) which include relevant randomised controlled trials (RCTs) from MEDLINE (1950 to present), EMBASE (1974 to present), PsycINFO (1967 to present) and the Cochrane Central Register of Controlled Trials (CENTRAL, all years); the World Health Organization (WHO) trials portal (ICTRP); ClinicalTrials.gov; and CINAHL (to November 2010 only). We screened the reference lists of reports of all included studies and published systematic reviews for reports of additional studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of collaborative care for participants of all ages with depression or anxiety. DATA COLLECTION AND ANALYSIS Two independent researchers extracted data using a standardised data extraction sheet. Two independent researchers made 'Risk of bias' assessments using criteria from The Cochrane Collaboration. We combined continuous measures of outcome using standardised mean differences (SMDs) with 95% confidence intervals (CIs). We combined dichotomous measures using risk ratios (RRs) with 95% CIs. Sensitivity analyses tested the robustness of the results. MAIN RESULTS We included seventy-nine RCTs (including 90 relevant comparisons) involving 24,308 participants in the review. Studies varied in terms of risk of bias.The results of primary analyses demonstrated significantly greater improvement in depression outcomes for adults with depression treated with the collaborative care model in the short-term (SMD -0.34, 95% CI -0.41 to -0.27; RR 1.32, 95% CI 1.22 to 1.43), medium-term (SMD -0.28, 95% CI -0.41 to -0.15; RR 1.31, 95% CI 1.17 to 1.48), and long-term (SMD -0.35, 95% CI -0.46 to -0.24; RR 1.29, 95% CI 1.18 to 1.41). However, these significant benefits were not demonstrated into the very long-term (RR 1.12, 95% CI 0.98 to 1.27).The results also demonstrated significantly greater improvement in anxiety outcomes for adults with anxiety treated with the collaborative care model in the short-term (SMD -0.30, 95% CI -0.44 to -0.17; RR 1.50, 95% CI 1.21 to 1.87), medium-term (SMD -0.33, 95% CI -0.47 to -0.19; RR 1.41, 95% CI 1.18 to 1.69), and long-term (SMD -0.20, 95% CI -0.34 to -0.06; RR 1.26, 95% CI 1.11 to 1.42). No comparisons examined the effects of the intervention on anxiety outcomes in the very long-term.There was evidence of benefit in secondary outcomes including medication use, mental health quality of life, and patient satisfaction, although there was less evidence of benefit in physical quality of life. AUTHORS' CONCLUSIONS Collaborative care is associated with significant improvement in depression and anxiety outcomes compared with usual care, and represents a useful addition to clinical pathways for adult patients with depression and anxiety.
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Affiliation(s)
- Janine Archer
- School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK.
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Towards a new definition of return-to-work outcomes in common mental disorders from a multi-stakeholder perspective. PLoS One 2012; 7:e39947. [PMID: 22768180 PMCID: PMC3386986 DOI: 10.1371/journal.pone.0039947] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 05/29/2012] [Indexed: 11/19/2022] Open
Abstract
Objectives To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD’s). Methods A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. Results A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded “Sustainability” and “At-work functioning” most important, while employees regarded “Sustainability,” “Job satisfaction,” “Work-home balance,” and “Mental Functioning” most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Conclusions Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly.
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