Werner Erik L, Laerum Even, Wormgoor Marjon E A, Lindh Erik, Indahl Aage
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Occup Med (Lond). 2007 Dec;57(8):590-5. doi: 10.1093/occmed/kqm094. Epub 2007 Oct 4.
Low back pain (LBP) is among the most frequent causes of sickness absence in Norway, and it is thought that it could be reduced by 30-50% if present day knowledge was implemented in the workplace. Evidence-based interventions in occupational settings to prevent sickness absence are still lacking.
To evaluate whether peer support would be able to modify general beliefs about LBP, pain experiences, health care utilization and sickness absence due to back pain.
In addition to a media campaign in two Norwegian counties in 2002-05, aiming at improving beliefs about LBP in the general public, the 'Active Back' project trained a peer adviser in six participating workplaces. The task of this peer adviser was to provide information aimed at reducing fear of the pain, supportive advice and arrange for modifications of workloads, etc., for a limited period of time.
The prevalence of back pain remained constant throughout the study period, but self-reported intensity of LBP decreased at the end. There was a small decline in use of health care professionals and significant improvements in beliefs, in line with the messages of the campaign. Total sickness absence decreased by 27% and the LBP-related sickness absence by 49%.
The combination of peer support and modified workload seemed to have additional effects to the general media campaign, and resulted in decline in sickness absence and improvements in beliefs about back pain.
在挪威,腰痛是导致病假的最常见原因之一,据认为,如果将当今的知识应用于工作场所,腰痛病假可减少30%至50%。目前仍缺乏基于证据的职业环境干预措施来预防病假。
评估同伴支持是否能够改变对腰痛的一般认知、疼痛体验、医疗保健利用情况以及因腰痛导致的病假情况。
除了在2002年至2005年期间在挪威的两个县开展媒体宣传活动,旨在提高公众对腰痛的认知外,“积极背部”项目还在六个参与的工作场所培训了一名同伴顾问。该同伴顾问的任务是在有限的时间内提供旨在减轻对疼痛的恐惧的信息、支持性建议,并安排调整工作量等。
在整个研究期间,背痛的患病率保持不变,但在研究结束时,自我报告的腰痛强度有所下降。医疗保健专业人员的使用略有下降,认知方面有显著改善,与宣传活动的信息一致。总病假减少了27%,与腰痛相关的病假减少了49%。
同伴支持和调整工作量的结合似乎对一般媒体宣传活动有额外的效果,并导致病假减少以及对背痛认知的改善。