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针对与工作相关的压力投诉和病假的个体及团体认知行为疗法:一项随机对照试验。

Individual and group cognitive-behavioral treatment for work-related stress complaints and sickness absence: a randomized controlled trial.

作者信息

de Vente Wieke, Kamphuis Jan H, Emmelkamp Paul M G, Blonk Roland W B

机构信息

Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

J Occup Health Psychol. 2008 Jul;13(3):214-31. doi: 10.1037/1076-8998.13.3.214.

Abstract

Work-related stress is widespread and can lead to long-term absenteeism and work disability. Cognitive-behavioral treatment (CBT) has demonstrated effectiveness in treating psychopathology but has only rarely been tested in clinical samples with work-related stress. A randomized controlled trial was conducted to investigate the efficacy of CBT-based stress management training (SMT). Eighty-two patients on sickness leave with work-related stress were randomly assigned to (a) individual SMT, (b) group SMT, or (c) care as usual (CAU). The SMT comprised 12 sessions conducted by a psychologist. Complaints of burnout and distress were measured at baseline, and at 4, 7, and 10 months. Absenteeism was measured during the whole research period. Across treatment conditions, complaints and sickness absence reduced considerably between baseline and 4 months. Thereafter, complaints remained approximately stable, whereas sickness absence further reduced. Hardly any significant group difference emerged, and no consistent pattern could be discerned in favor of any treatment condition. In subgroups with low depressive complaints, though, individual SMT resulted in larger reductions of some complaints than CAU. In conclusion, this study adds to the evidence that CBT-based interventions as currently practiced are not successful in treating patients with clinical levels of work-related stress.

摘要

工作相关压力普遍存在,可能导致长期旷工和工作能力丧失。认知行为疗法(CBT)已证明在治疗精神病理学方面有效,但在有工作相关压力的临床样本中很少进行测试。进行了一项随机对照试验,以研究基于CBT的压力管理培训(SMT)的疗效。82名因工作相关压力而休病假的患者被随机分配到(a)个体SMT、(b)团体SMT或(c)常规护理(CAU)。SMT由一名心理学家进行12次治疗。在基线时以及第4、7和10个月测量倦怠和痛苦的主诉。在整个研究期间测量旷工情况。在所有治疗条件下,基线和4个月之间,主诉和病假情况大幅减少。此后,主诉大致保持稳定,而病假情况进一步减少。几乎没有出现任何显著的组间差异,也没有发现有利于任何治疗条件的一致模式。然而,在抑郁主诉较低的亚组中,个体SMT导致某些主诉的减少幅度大于常规护理。总之,本研究进一步证明,目前实施的基于CBT的干预措施在治疗具有临床水平工作相关压力的患者方面并不成功。

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