scholarly journals Early identification of people at risk for sick-leave due to work-related stress – design of a RCT

2016 ◽  
Vol 26 (suppl_1) ◽  
Author(s):  
K Holmgren ◽  
C Sandheimer ◽  
A-C Mårdby ◽  
MEH Larsson ◽  
D Hange ◽  
...  
Keyword(s):  
At Risk ◽  
Sick Leave ◽  
Early Identification ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress

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 a work-stress intervention prevent sick leave? A randomized controlled trial in primary care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Hultqvist ◽  
P Bjerkeli ◽  
G Hensing ◽  
K Holmgren
Keyword(s):  
Sick Leave ◽  
Work Stress ◽  
Early Identification ◽  
Preventive Intervention ◽  
Control Group ◽  
Work Related Stress ◽  
Treatment As Usual ◽  
Work Related ◽  
Primary Health ◽  
Related Stress

Abstract Background Work-related stress (WRS) clearly presents a risk for sick-leave. A brief preventive intervention aiming to identify people at risk for WRS was tested in a RCT study in primary health-care centers (PHCC). At the 12-month follow-up there were differences regarding sick leave between the intervention and the control group, however they did not become statistically significant. Evaluating the intervention in a longer perspective is thus warranted. Purpose This study aims to evaluate whether a systematic early identification of work-related stress can prevent sickness absence over 18 to 24 months after the intervention. Methods The RCT-study had follow-ups at 18 and 24 months. The participants (N = 271) were employed, non-sick-listed women and men (18 to 64 years) seeking care at PHCCs for mental and physical health complaints. 132 patients were allocated to the intervention and 139 patients were allocated to treatment as usual. The preventive intervention included early identification of WRS by the Work Stress Questionnaire (WSQ), general practitioner (GP) awareness supported by a brief training session, patients' self-reflection by WSQ completion, GP giving the patient feedback at consultation, and identifying appropriate preventive measures. Sick leave data from the Swedish Social Insurance Agency register constituted the outcome comparing the preventive intervention by the GP versus treatment as usual. Results The preliminary results showed that there were differences in median sick days between the intervention group (68, 72) and the control group (80, 81) at 18 months and at 24 months, however these differences did not become statistically significant. Conclusions The WSQ brief intervention was not proven effective in preventing sick leave in the following 18 and 24 months compared to treatment as usual. The study may have been under-powered and the lack of statistical difference between the groups might be due to a type II error. Key messages Work-related stress is a predictor for sick-leave. Further research on how to identify those at high risk for sick-leave, give advice and treat this group in primary health care is needed. A study of the WSQ brief intervention with a larger sample seems warranted.

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 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.

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