Nystuen Pål, Hagen Kåre B
Norwegian Directorate for Health and Social Welfare, Department of Social Services Research, Norway.
BMC Public Health. 2003 Jun 3;3:19. doi: 10.1186/1471-2458-3-19.
Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the feasibility and effectiveness of offering a voluntary, solution-focused follow-up to sick-listed employees.
Employees on long-term sick leave due to psychological problems or muscle skeletal pain were randomly allocated to be offered a solution-focused follow-up (n = 122) or "treatment as usual" (n = 106). The intervention was integrated within 2 social security offices' regular follow-up. The intervention group was informed about the offer with letters, telephone calls and information meetings. Feasibility was measured by rate of uptake to the intervention, and effectiveness by number of days on sick leave.
In general, few were reached with the different information elements. While the letter was sent to all, only 31% were reached by telephone and 15% attended the information meetings. Thirteen employees (11.5%) in the intervention group participated in the solution-focused follow-up. Intention to treat analysis showed no difference in mean length of sick leave between the intervention group (217 days) and the control group (189 days) (p = 0,101).
Even if the information strategy might be improved, it is not likely that a voluntary solution-focused follow-up offered by the social security offices would result in measurable reduction in length of sick leave on a population level. However, the efficacy of a solution-focused follow-up for the persons reporting a need for this approach should be further investigated.
多年来,长期病假一直是挪威政界人士和决策者关注的问题。在本研究中,我们评估了为列入病假名单的员工提供以解决问题为重点的自愿后续跟进措施的可行性和有效性。
因心理问题或肌肉骨骼疼痛而长期病假的员工被随机分配接受以解决问题为重点的后续跟进措施(n = 122)或“照常治疗”(n = 106)。干预措施整合在两个社会保障办公室的常规跟进工作中。通过信件、电话和信息会议向干预组通报了这一措施。通过干预措施的接受率来衡量可行性,通过病假天数来衡量有效性。
总体而言,很少有人接收到不同的信息内容。虽然信件已发送给所有人,但只有31%的人接到了电话,15%的人参加了信息会议。干预组中有13名员工(11.5%)参与了以解决问题为重点的后续跟进措施。意向性分析显示,干预组(217天)和对照组(189天)的平均病假时长没有差异(p = 0.101)。
即使信息策略可能需要改进,但社会保障办公室提供的以解决问题为重点的自愿后续跟进措施在总体层面上不太可能使病假时长得到可衡量的减少。然而,对于那些表示需要这种方法的人,以解决问题为重点的后续跟进措施的效果应进一步研究。