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Kyndi M, Willert MV, Vestergaard JM, Andersen JH, Christiansen DH, Dalgaard VL. Long-term follow-up study of work status among patients with work-related mental disorders referred to departments of occupational medicine in Denmark. BMJ Open 2023; 13:e072217. [PMID: 37935518 PMCID: PMC10632875 DOI: 10.1136/bmjopen-2023-072217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVES To describe the 5 year work status in patients referred for suspected work-related common mental disorders. To develop a prognostic model. DESIGN Register-based nationwide longitudinal follow-up study. SETTING All departments of occupational medicine in Denmark. PARTICIPANTS 17 822 patients aged 18-67 years, seen for the first time at a Department of Occupational Medicine in Denmark from 2000 to 2013 and diagnosed with stress, depression, post-traumatic stress disorder, anxiety or other mental disorders. INTERVENTIONS All patients were seen for diagnostic assessment and causal evaluation of the work-relatedness of their disorders. Some departments offered patients with stress disorders psychological treatment, which, however, was not organised according to patient selection or type of treatment. PRIMARY AND SECONDARY OUTCOME MEASURES Register data were collected for 5 year periods before and after the patients' first assessment at a department. Weekly percentages of patients are presented according to work status. The outcome in the prognostic model was a high Work Participation Score (ie, working>75% of potential work weeks/year) at 5 year follow-up. RESULTS For all subgroups of patients, a high proportion were working (>75%) 1-5 years before assessment, and all experienced a large reduction in work status at time of assessment. At 1 year follow-up, almost 60% of patients with stress were working, whereas in the other patient subgroups, less than 40% were working. In the following years, practically no increase was observed in the percentage of patients working in any of the subgroups. Based on these 5 year follow-up data, we developed a work participation model with only moderate discrimination and calibration. CONCLUSIONS In Denmark, not all return to previous work status 5 years after a referral due to a suspected work-related common mental disorder. We developed a prognostic model with only moderate discrimination and calibration for long-term work participation after suggested work-related common mental disorders.
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Affiliation(s)
- Marianne Kyndi
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Occupational and Environmental Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Vejs Willert
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
| | - David Høyrup Christiansen
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Elective surgery centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Vita Ligaya Dalgaard
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Dalgaard VL, Willert MV, Kyndi M, Vestergaard JM, Andersen JH, Christiansen DH. Cohort Profile: The Danish Occupational Medicine Cohort-a nationwide cohort of patients with work-related disease. Int J Epidemiol 2023; 52:e201-e210. [PMID: 36869758 PMCID: PMC10396417 DOI: 10.1093/ije/dyad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Affiliation(s)
- Vita Ligaya Dalgaard
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus C, Denmark
| | - Morten Vejs Willert
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Marianne Kyndi
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
- Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
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Dalgaard VL, Gayed A, Hansen AKL, Grytnes R, Nielsen K, Kirkegaard T, Uldall L, Ingerslev K, Skakon J, Jacobsen CB. A study protocol outlining the development and evaluation of a training program for frontline managers on leading well-being and the psychosocial work environment in Danish hospital settings - a cluster randomized waitlist controlled trial. BMC Public Health 2023; 23:848. [PMID: 37165331 PMCID: PMC10170839 DOI: 10.1186/s12889-023-15728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/22/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Hospital staff are often exposed to stressful psychosocial working conditions and report high levels of stress and burnout, which may negatively impact the safety of employees and patients. Managers hold unique knowledge of workplace conditions and needs of employees, but leadership interventions to improve the well-being of managers and employees in hospital settings are scarce. This study evaluates the effects of a leadership intervention based on a health-oriented leadership approach on the well-being and psychosocial work environment aspects of managers and employees. METHODS/DESIGN The study is designed as a randomized, waitlist-controlled trial with two groups (intervention and waitlist control group) and measurements at baseline, 6- and 12-month follow-up. We aim to include 200 frontline managers in Danish hospital settings and their approximately 5,000 employees. The leadership training comprises five full day modules and four smaller group-training sessions over a period of 5 months. The main aim is to improve stress, burnout, self-care, and perceived level of staff-care among managers and employees. Sickness absence will also be assessed at both manager and employee level. In addition, several psychosocial factors will be assessed at the employee level. A quantitative and qualitative process evaluation will also be conducted. DISCUSSION Action towards supporting the mental health of hospital employees is important to maintain a strong healthcare system. There is increasing recognition that best practice in workplace mental health requires an integrated approach that prevents harm and promotes positive mental health. There is also increasing understanding of the key role managers' play in maintaining well-being within the workplace, however they often report a lack of knowledge and skills to promote employee mental health. The current leadership training program has been developed for frontline managers working in a hospital setting. The aim is to increase managers' application of strategies to facilitate a healthy psychosocial work environment to benefit well-being and mental health among staff and managers themselves. TRIAL REGISTRATION The study was retrospectively registered on November 21, 2022 in Clinical Trial.gov with identifier: NCT05623371.
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Affiliation(s)
- V L Dalgaard
- Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 9, 8000, Aarhus C, Denmark.
- Crown Prince Frederik Center for Public Leadership, Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark.
| | - A Gayed
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, 2031, Australia
| | - A K L Hansen
- Crown Prince Frederik Center for Public Leadership, Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark
| | - R Grytnes
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital Goedstrup, Moellegade 16, 7400, Herning, Denmark
| | - K Nielsen
- Sheffield University Management School, The University of Sheffield, Conduit Road, Sheffield, S10 1FL, UK
| | - T Kirkegaard
- Department of Psychology and Behavioural Sciences, Aarhus University, Bartholins Allé 9, 8000, Aarhus C, Denmark
| | - L Uldall
- Central Denmark Region, Corporate Human Resource Development, Oluf Palmes Allé 32, 8200, Aarhus N, Denmark
| | - K Ingerslev
- Central Denmark Region, Corporate Human Resource Development, Oluf Palmes Allé 32, 8200, Aarhus N, Denmark
| | - J Skakon
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2a, 1353, Copenhagen K, Denmark
| | - C B Jacobsen
- Crown Prince Frederik Center for Public Leadership, Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark
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Ladegaard Y, Dalgaard VL, Conway PM, Eller NH, Skakon J, Maltesen T, Scheike T, Netterstrøm B. Notified occupational mental disorders: associations with health and income. Occup Med (Lond) 2023; 73:66-72. [PMID: 36738447 DOI: 10.1093/occmed/kqad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Studies indicate that workers' compensation claim processes may affect patients' health negatively. However, few studies focus on patients with mental health claims, and the claim process varies between countries. AIMS The aims of this study were to examine whether being notified to the Danish Labour Market Insurance with an occupational mental health condition was associated with changes in visits to the general practitioner (GP), use of medicine and annual income. METHODS Study participants were 965 patients with a mental disorder examined at a department of occupational medicine. Of these, 669 patients were notified with an occupational mental disorder, 296 were not. Health-related outcomes, including GP visits and prescriptions of psychotropic drugs, were estimated at baseline during the year of medical examination, while annual income was estimated a year before the examination. The follow-up was the year after the year of examination for all outcomes. Outcomes were collected from the Danish National Bureau of Statistics. Analyses were conducted using Poisson regression and conditional logistic regression. RESULTS All measured outcomes decreased from baseline to follow-up in both groups. These changes were not significantly different depending on notification status at baseline. CONCLUSIONS This study suggests that being notified with an occupational mental disorder does not significantly affect health-related outcomes. A significant decrease in annual income over time was seen in both groups, the notified and the unnotified group, highlighting the importance of providing support to all employees with a mental disorder.
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Affiliation(s)
- Y Ladegaard
- Department of Psychology, University of Copenhagen, Copenhagen K, Denmark
- The Foundation for Mental Health, Valby, Denmark
| | - V L Dalgaard
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - P M Conway
- Department of Psychology, University of Copenhagen, Copenhagen K, Denmark
| | - N H Eller
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Skakon
- Department of Psychology, University of Copenhagen, Copenhagen K, Denmark
| | - T Maltesen
- Institute of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - T Scheike
- Institute of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - B Netterstrøm
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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Ladegaard Y, Skakon J, Dalgaard VL, Ståhl C, Slot Thomsen ST, Netterstrøm B. Employees with mental disorders seeking support from the workers compensation system - experiences from Denmark. Work 2023; 75:1361-1377. [PMID: 36710695 DOI: 10.3233/wor-211315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In Europe it is commonly accepted that psychosocial hazards may influence the mental health of employees. However, mental disorders such as depression are generally not acknowledged as an occupational disease covered by the workers compensation system. Studies indicate that workers compensation claim processes may affect employee's health negatively due to a demanding case process. If filing a workers' compensation claim can harm the employees' health, it is highly relevant to pay attention to employees with mental health claims, as they are most likely vulnerable and face a very low chance of compensation. OBJECTIVE This study investigates how employees with work-related mental disorders experience the process of seeking workers compensation from the Danish Workers' Compensation System. METHOD Interview (N = 13) and questionnaire (N = 436) data from claimants were analysed. RESULTS Analysis showed that even though many employees wished for the claim to influence the conditions at the workplace, there seemed to be a lack of preventive health and safety initiatives in the workplaces. Central stakeholders such as health and safety representatives were often not involved. Management involvement was often experienced negatively, and the Danish Working Environment Authority rarely conducted workplace inspections. Employees experienced inadequate information about the workers' compensation process and experienced a lack of coordination between stakeholders. CONCLUSION A more supportive and coordinated approach in the Workers' Compensation System is recommendable. The processes in the system could be evaluated using the Social Insurance Literacy concept, to ensure sufficient support of the claimants and reduce potential harmful aspects of the process.
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Affiliation(s)
- Yun Ladegaard
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Foundation for Mental Health, Copenhagen, Denmark
| | - Janne Skakon
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Vita Ligaya Dalgaard
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Christian Ståhl
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- HELIX Competence Centre, Linköping University, Linköping, Sweden
| | | | - Bo Netterstrøm
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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Abstract
Patients on sick leave due to work-related stress often present with cognitive complaints. The primary aim of this prospective cohort study was to examine potential long-term consequences of previous ongoing work-related stress in terms of cognitive functioning four years after initial professional care seeking. We tested a group of patients with work-related stress complaints with a comprehensive neuropsychological test battery. Patients were examined at a department of occupational medicine and tested at baseline, one-year follow-up and four-year follow-up. At each time point, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the four-year follow-up. Patients improved on their neuropsychological test performance during the four years but the main improvements took place during the first year. At baseline, the main impairments in the patient group concerned executive function and mental speed. At four-year follow-up, patients displayed slightly lower scores on the neuropsychological tests relative to controls but only the difference on immediate memory was significant corresponding to a small effect size (Cohen's d). More than half of the patients who participated in the four-year follow-up reported that they felt only slightly or partially recovered. The level of work participation among the former patients improved considerably during the four-year follow-up period.Lay SummaryThis study examines the long-term consequences of work-related stress in terms of cognitive functioning and recovery four years after initial professional care seeking. After four years, patients continued to display significantly lower memory scores than controls but no other significant differences between the groups were found on neuropsychological tests. Levels of work participation among patients improved considerably over time, yet, more than half of the former patients who participated in the four-year follow-up did not feel completely recovered.
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Affiliation(s)
- Vita Ligaya Dalgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus C, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
| | | | - Lars Peter Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
| | - Anita Eskildsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
- Department of Affective Disorders, Aarhus University Hospital - Skejby, Aarhus N, Denmark
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Glasscock DJ, Carstensen O, Dalgaard VL. Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample. Int Arch Occup Environ Health 2018; 91:675-687. [PMID: 29808433 DOI: 10.1007/s00420-018-1314-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/22/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample. METHODS Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW. RESULTS Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was - 3.09 (- 5.47, - 0.72), while for GHQ it was - 3.91 (- 7.15, - 0.68). There were no group differences in RTW. CONCLUSIONS The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups.
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Affiliation(s)
- David J Glasscock
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Ole Carstensen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Vita Ligaya Dalgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
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Dalgaard VL, Andersen LPS, Andersen JH, Willert MV, Carstensen O, Glasscock DJ. Work-focused cognitive behavioral intervention for psychological complaints in patients on sick leave due to work-related stress: Results from a randomized controlled trial. J Negat Results Biomed 2017; 16:13. [PMID: 28830555 PMCID: PMC5567478 DOI: 10.1186/s12952-017-0078-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Work-related stress is a global problem with negative implications for individuals and society. The purpose of the current study was to evaluate a stress management intervention for patients on sick leave due to work-related stress complaints using a three-armed randomized controlled design. METHODS Participants were patients referred from three municipalities to the regional Department of Occupational Medicine. Inclusion criteria were: 1) sick leave due to work-related stress complaints, 2) a diagnosis of adjustment disorder or reactions to severe stress (ICD 10 code: F43,2 - F 43,9 not PTSD) or mild depressive episode (F 32.0). Through a double randomization procedure patients (n = 163) were randomized to either an intervention group (n = 58), a 'control group A' receiving a clinical examination (n = 56), or 'control group B' (n = 49) receiving no offers at the department. The intervention comprised six sessions of individual cognitive behavioral therapy and the offer of a small workplace intervention. Questionnaire data were analyzed with multivariate repeated measurements analysis. Primary outcomes assessed were perceived stress and general mental health. Secondary outcomes were sleep quality and cognitive failures. Follow-up was at four and 10 months after baseline. RESULTS Complaints were significantly reduced in all groups over time. No group effects were observed between the intervention group and control group A that was clinically assessed. Significant group effects were found for perceived stress and memory when comparing the intervention group to group B, but most likely not due to an intervention effect. CONCLUSION Psychological complaints improved substantially over time in all groups, but there was no significant treatment effect on any outcomes when the intervention group was compared to control group A that received a clinical assessment. TRIAL REGISTRATION ISRCTN ISRCTN91404229. Registered 03 August 2012 (retrospectively registered).
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Affiliation(s)
- Vita Ligaya Dalgaard
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark.
| | - Lars Peter Sønderbo Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Morten Vejs Willert
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Carstensen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - David John Glasscock
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
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Dalgaard VL, Aschbacher K, Andersen JH, Glasscock DJ, Willert MV, Carstensen O, Biering K. Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention. Scand J Work Environ Health 2017. [PMID: 28650513 DOI: 10.5271/sjweh.3655] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to evaluate the effect of a stress management intervention (SMI) on lasting return to work (RTW) among patients with work-related stress complaints. Methods Sickness benefit departments from three local municipalities referred patients on sick leave with work-related adjustment disorders or mild depression to the Department of Occupational Medicine, Regional Hospital West Jutland. A 2× randomization procedure allocated patients into one of three groups: intervention (N=58), control A (which received a clinical assessment; N=56), or control B (no assessment; N=49). Treatment comprised individual work-focused cognitive behavioral therapy (CBT) with an optional workplace intervention. The outcome was time until lasting RTW (16 and 44 weeks follow-up) using register data. Results Median number of weeks until lasting RTW was 15, 19, and 32 for the intervention group, control A, and control B respectively. However, for group B, clinical assessment was not part of the inclusion process, which may have introduced selection bias. In the fully-adjusted Cox regression model, the intervention group exhibited significantly faster lasting RTW at 44 weeks; hazard ratio (HR) 1.57 [95% confidence interval (95% CI) 1.01-2.44] relative to control group A, with a non-significant trend evident at 16 weeks; HR 1.70 (95% CI 0.94-3.10), when controlling for age, gender, occupation, sick leave during previous year, full or partial sick leave, and diagnosis. Unadjusted analyses remained directionally consistent but were reduced to marginal significance. Conclusions There was a tendency towards faster lasting RTW in the intervention group compared to control A, which received clinical assessment, in all analyses. The intervention group returned to work about 4 weeks earlier than control A, which could translate into substantial financial gains.
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Affiliation(s)
- Vita Ligaya Dalgaard
- Danish Ramazzini Centre, Dept. of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
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Eskildsen A, Dalgaard VL, Nielsen KJ, Andersen JH, Zachariae R, Olsen LR, Jørgensen A, Christiansen DHÃ. Cross-cultural adaptation and validation of the Danish consensus version of the 10-item Perceived
Stress Scale. Scand J Work Environ Health 2015; 41:486-90. [DOI: 10.5271/sjweh.3510] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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