预测因抑郁障碍而复发性病假的因素——一项涉及科学家和医生的德尔菲法研究。
Predictors of recurrent sickness absence due to depressive disorders--a Delphi approach involving scientists and physicians.
机构信息
365/Occupational Health Service Utrecht, Utrecht, The Netherlands.
出版信息
PLoS One. 2012;7(12):e51792. doi: 10.1371/journal.pone.0051792. Epub 2012 Dec 20.
BACKGROUND
Depression is a common and highly recurrent mental disorder that is accompanied by poor functioning at home and at work. Not all depressed employees report sick and little is known about variables associated with sickness absence (SA) due to depression. Recurrent SA due to depression tends to marginalize employees from the workforce and exclude them from social participation. Therefore, this study sought group consensus on factors predicting recurrent SA due to depression.
METHODOLOGY/PRINCIPAL FINDINGS: 23 scientists in the field of work and mental health and 23 physicians with expertise in assessing work disability were invited for a Delphi study. Sixty-seven factors retrieved from the literature were scored for their impact on the recurrence of SA due to depression, range 1 (no impact) to 10 (very high impact) in two Delphi rounds. The third Delphi round addressed the assessability and modifiability of elected predictors. Group consensus was defined as 75% agreement. In the first round (response 78%), group consensus was reached on a high impact of 13 factors on recurrent SA due to depression. The second round (response 79%) added another 8 factors with high impact on recurrent SA due to depression. The panelists were of the opinion that stressful life and work events, age at first diagnosis, duration of the last depressive episode, anxiety, lifetime number of depressive episodes, and psychological work demands were readily assessable in consultation with patients. Furthermore, work factors, particularly decision latitude, psychological job demands, and commitment to work, were recognized as modifiable.
CONCLUSIONS/SIGNIFICANCE: Although results have to be validated with further quantitative research, physicians may identify employees at risk of recurrent SA due to depression and may support them to adjust their work aimed at increasing commitment to work and preventing future SA due to depression.
背景
抑郁症是一种常见且高度复发性的精神障碍，其特点是在家和工作中功能不佳。并非所有抑郁的员工都会请病假，而与抑郁导致的病假（SA）相关的变量知之甚少。由于抑郁导致的反复 SA 往往会使员工边缘化，使他们无法参与社会活动。因此，本研究旨在就预测抑郁导致的反复 SA 的因素达成专家组共识。
方法/主要发现：邀请了 23 名工作和心理健康领域的科学家以及 23 名评估工作残疾的专家医生参加德尔菲研究。从文献中检索到的 67 个因素根据其对抑郁导致的 SA 复发的影响进行评分，范围为 1（无影响）到 10（影响非常高），在两轮德尔菲研究中进行评分。第三轮德尔菲研究探讨了所选预测因素的可评估性和可修改性。 75%的一致性被定义为专家组共识。在第一轮（回应率为 78%）中，专家组就 13 个对抑郁导致的 SA 复发有高度影响的因素达成了共识。第二轮（回应率为 79%）又增加了另外 8 个对抑郁导致的 SA 复发有高度影响的因素。小组成员认为，通过与患者协商，可以评估压力性生活和工作事件、首次诊断时的年龄、上次抑郁发作的持续时间、焦虑、一生中抑郁发作的次数以及心理工作要求等因素，并且可以修改工作因素，特别是决策自主权、心理工作要求和对工作的投入。
结论/意义：尽管还需要进一步的定量研究来验证结果，但医生可以识别出有复发性抑郁导致 SA 风险的员工，并支持他们调整工作，以增加对工作的投入，并预防未来因抑郁导致的 SA。
Zotero 插件