scholarly journals Self-reported sick leave following a brief preventive intervention on work-related stress

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
A-M Hultén ◽  
P Bjerkeli ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Brief Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background General practitioners (GPs) play an important role for early identification and prevention of sick leave among patients perceiving ill health due to work-relates stress. In order to fulfil the role, they need adequate methodologies and tools. This study aimed to evaluate the effectiveness of a brief intervention in primary health care including early identification of work-related stress combined with feedback at consultation on the number of self-reported sick leave days. Methods A randomised controlled trial was performed at seven primary health care centres in western Sweden. Self-reported sick leave data collected between November 2015 and January 2017 were analysed prospectively. The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual. Results At 6-month follow-up 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up the corresponding numbers were 61/119 (51%) and 57/122 (47%) respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported sick leave days. Conclusions The brief intervention showed no effect on the numbers of self-reported sick leave days. However, using sick leave as an outcome measure was difficult, as sick leave is multifactorial and the data has a non-normal distribution. In addition, sick leave might be used as an indicator as well as a possible treatment of ill health. Other actions and interventions to address patients perceiving ill health due to work-related stress should be explored. Key messages Sick leave is used as an indicator and as a treatment of ill health, which can complicate the evaluation of studies. The complexity of primary health care trials calls for other evaluation methods.

scholarly journals Early identification in primary health care of people at risk for sick leave due to work-related stress – study protocol of a randomized controlled trial (RCT)

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Kristina Holmgren ◽  
Christine Sandheimer ◽  
Ann-Charlotte Mårdby ◽  
Maria E. H. Larsson ◽  
Ute Bültmann ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Primary Health Care ◽  
Sick Leave ◽  
Sickness Absence ◽  
Early Identification ◽  
Work Related Stress ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project’s aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. Method/design The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Discussion Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient’s specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015

scholarly journals Does early identification of work-related stress in primary health care effect pharmacy dispensing?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Bjerkeli ◽  
I M Skoglund ◽  
K Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Pharmacological Treatment ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care were eligible participants. The intervention included general practitionerś (GP) training to use the WSQ, early identification of patientś work-related stress by the WSQ, and GPś feedback on the WSQ results during the consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for 12 months following the intervention were analysed using Mann Whitney U tests and chi-square tests. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). Conclusions Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Key messages Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. Patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics than controls.

scholarly journals Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pernilla J. Bjerkeli ◽  
Ingmarie Skoglund ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Work Related ◽  
Primary Health ◽  
Related Stress ◽  
Pharmacy Dispensing Data ◽  
Dispensing Data

Abstract Background The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group. Methods The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests. Results The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007). Conclusion Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

scholarly journals Positioning work related stress – GPs’ reasoning about using the WSQ combined with feedback at consultation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna-Maria Hultén ◽  
Synneve Dahlin-Ivanoff ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Assessment Tool ◽  
Work Related Stress ◽  
Daily Work ◽  
Work Related ◽  
Use Of Resources ◽  
Primary Health ◽  
Related Stress

Abstract Background General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs’ awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs’ reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave. Methods A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger. Results Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs’ regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress. Conclusions The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC’s responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated. Trial registration ClinicalTrials.gov, NCT02480855. Registered 20 May 2015.

scholarly journals Self-reported sick leave following a brief preventive intervention on work-related stress: a randomised controlled trial in primary health care

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041157
Author(s):  
Anna-Maria Hultén ◽  
Pernilla Bjerkeli ◽  
Kristina Holmgren
Keyword(s):  
Sick Leave ◽  
Brief Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Median Number ◽  
Control Group ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress

ObjectivesTo evaluate the effectiveness of a brief intervention about early identification of work-related stress combined with feedback at consultation with a general practitioner (GP) on the number of self-reported sick leave days.DesignRandomised controlled trial. Prospective analyses of self-reported sick leave data collected between November 2015 and January 2017.SettingSeven primary healthcare centres in western Sweden.ParticipantsThe study included 271 employed, non-sick-listed patients aged 18–64 years seeking care for mental and/or physical health complaints. Of these, 132 patients were allocated to intervention and 139 patients to control.InterventionsThe intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients’ work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual.Outcome measuresThe number of self-reported gross sick leave days and the number of self-reported net sick leave days, thereby also considering part-time sick leave.ResultsAt 6 months’ follow-up, 220/271 (81%) participants were assessed, while at 12 months’ follow-up, 241/271 (89%) participants were assessed. At 6-month follow-up, 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up, the corresponding numbers were 61/119 (51%) and 57/122 (47%), respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported gross sick leave days and the median number of self-reported net sick leave days.ConclusionsThe brief intervention showed no effect on the numbers of self-reported sick leave days for patients seeking care at the primary healthcare centres. Other actions and new types of interventions need to be explored to address patients’ perceiving of ill health due to work-related stress.Trial registration numberNCT02480855.

scholarly journals Does a brief work-stress intervention prevent sick-leave during the following 24 months? A randomized controlled trial in Swedish primary care

Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Jenny Hultqvist ◽  
Pernilla Bjerkeli ◽  
Gunnel Hensing ◽  
Kristina Holmgren
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Sick Leave ◽  
Early Identification ◽  
Controlled Trial ◽  
Intervention Group ◽  
Training Session ◽  
Control Group ◽  
Treatment As Usual ◽  
Primary Health

BACKGROUND: Work-related stress (WRS) presents a risk for sick leave. However, effective methods to identify people at risk for sick leave due to WRS at an early stage are lacking in primary health care. OBJECTIVE: To evaluate whether a systematic early identification of WRS can prevent sick leave over 24 months after the intervention. METHODS: Study participants (n = 132 intervention; n = 139 control) were employed, non-sick-listed persons seeking care at primary health care centres. The intervention included early identification of WRS by a validated instrument, general practitioner (GP) awareness supported by a brief training session, patients’ self-reflection by instrument completion, GP giving the patient feedback at consultation and GP identifying preventive measures. The control group received treatment as usual. Outcome data were retrieved from the Swedish Social Insurance Agency. RESULTS: The intervention group had less registered median sick leave days (n = 56) than the control group (n = 65) but the difference was not statistically significant. CONCLUSIONS: The brief intervention was not proven effective in preventing sick leave in the following 24 months compared to treatment as usual. Further research on how to identify, advice and treat those at high risk for sick leave in primary health care is needed.

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