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 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 Promoting recovery in daily life: study protocol for a randomized controlled trial

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Dorota Reis ◽  
Alexander Hart ◽  
Dirk Lehr ◽  
Malte Friese
Keyword(s):  
Training Programs ◽  
Controlled Trial ◽  
Online Training ◽  
Cognitive Behavioral ◽  
Main Mechanism ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress ◽  
Underlying Mechanisms

Abstract Background Work-related stress shows steadily increasing prevalence rates and has tangible consequences for individual workers, their organizations, and society as a whole. One mechanism that may help offset the negative outcomes of work-related stress on employees’ well-being is recovery. Recovery refers to the experience of unwinding from one's job when not at work. However, employees who experience high levels of work-related stress and are thus particularly in need of recovery tend to struggle to switch-off. Due to the detrimental effects of this prolonged and sustained mental representation of job stressors, interventions promoting recovery may contribute to improvements in employees' mental health. Methods In this randomized, waitlist controlled trial, we will investigate the effectiveness of two 6-week online training programs (cognitive behavioral and mindfulness-based). The sample will include employees working at least part-time during regular work hours. Besides the pre-post-follow-up assessments, the trial will include measurement bursts with the goal of examining the underlying mechanisms. We expect that both interventions will reduce work-related perseverative thinking (PT) compared with the waitlist control groups (primary outcome). Also, we expect that both interventions will result in similar improvements, but the underlying mechanisms will differ (process outcomes). In the cognitive-behavioral intervention group, we expect that the main mechanism responsible for lower PT levels will be an increase in recovery experiences across time. In the mindfulness-based group, we expect that the main mechanism responsible for lower PT levels will be an increase in facets of mindfulness across time. Discussion In the present study, we will investigate mechanisms underlying assumed changes in work-related PT in great detail. Besides evaluating the overall effectiveness of the two interventions in terms of pre-post-follow-up changes, we will look at the underlying processes at different levels—that is, within days, within weeks, across weeks, and between individuals. Accordingly, our study will offer a fine-grained approach to investigating potential determinants, mediators, and moderators of the processes that may, in the end, be responsible for work-related strain. From a public health perspective, if effective, the online training programs may offer valuable, low-threshold, and low-intensity interventions for a broad range of occupations. Trial registration German Clinical Trials Registration: DRKS00024933. Registered prospectively 7 April 2021. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024933

scholarly journals Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

2019 ◽  
Vol 76 (10) ◽  
pp. 705-711 ◽  
Author(s):  
Michelle Lilly ◽  
Rebecca Calhoun ◽  
Ian Painter ◽  
Randal Beaton ◽  
Scott Stangenes ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Intervention Group ◽  
Future Research ◽  
Control Group ◽  
Post Intervention ◽  
Work Related ◽  
Emergency Medical ◽  
Emergency Medical Dispatchers

ObjectivesEmergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce.MethodsActive-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness.ResultsDifferences between the intervention group and control group in pre–post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of −10.0 (95% CI: −14.9, −5.2, p<0.001) for change from baseline to post intervention, and a difference of −6.5 (95% CI: −11.9, −1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=−0.53, p<0.001).ConclusionsDevelopment of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.

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 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.

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

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