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基于网络的干预措施对受伤索赔者的有效性:一项随机对照试验。

Effectiveness of a web-based intervention for injured claimants: a randomized controlled trial.

作者信息

Elbers Nieke A, Akkermans Arno J, Cuijpers Pim, Bruinvels David J

出版信息

Trials. 2013 Jul 20;14:227. doi: 10.1186/1745-6215-14-227.

Abstract

BACKGROUND

There is considerable evidence showing that injured people who are involved in a compensation process show poorer physical and mental recovery than those with similar injuries who are not involved in a compensation process. One explanation for this reduced recovery is that the legal process and the associated retraumatization are very stressful for the claimant. The aim of this study was to empower injured claimants in order to facilitate recovery.

METHODS

Participants were recruited by three Dutch claims settlement offices. The participants had all been injured in a traffic crash and were involved in a compensation process. The study design was a randomized controlled trial. An intervention website was developed with (1) information about the compensation process, and (2) an evidence-based, therapist-assisted problem-solving course. The control website contained a few links to already existing websites. Outcome measures were empowerment, self-efficacy, health status (including depression, anxiety, and somatic symptoms), perceived fairness, ability to work, claims knowledge and extent of burden. The outcomes were self-reported through online questionnaires and were measured four times: at baseline, and at 3, 6, and 12 months.

RESULTS

In total, 176 participants completed the baseline questionnaire after which they were randomized into either the intervention group (n=88) or the control group (n=88). During the study, 35 participants (20%) dropped out. The intervention website was used by 55 participants (63%). The health outcomes of the intervention group were no different to those of the control group. However, the intervention group considered the received compensation to be fairer (P<0.01). The subgroup analysis of intervention users versus nonusers did not reveal significant results. The intervention website was evaluated positively.

CONCLUSIONS

Although the web-based intervention was not used enough to improve the health of injured claimants in compensation processes, it increased the perceived fairness of the compensation amount.

TRIAL REGISTRATION

Netherlands Trial Register NTR2360.

摘要

背景

有大量证据表明,卷入赔偿程序的受伤者在身体和心理恢复方面比未卷入赔偿程序的类似伤者更差。这种恢复情况不佳的一种解释是,法律程序以及相关的再次创伤对索赔人来说压力极大。本研究的目的是增强受伤索赔人的能力以促进恢复。

方法

参与者由荷兰的三个理赔办公室招募。参与者均在交通事故中受伤且卷入了赔偿程序。研究设计为随机对照试验。开发了一个干预网站,其中包含(1)关于赔偿程序的信息,以及(2)一个基于证据、由治疗师协助的问题解决课程。对照网站包含一些指向现有网站的链接。结果测量指标包括赋权、自我效能感、健康状况(包括抑郁、焦虑和躯体症状)、感知公平性、工作能力、索赔知识和负担程度。结果通过在线问卷进行自我报告,并在基线时以及3个月、6个月和12个月时进行测量。

结果

共有176名参与者完成了基线问卷,之后他们被随机分为干预组(n = 88)或对照组(n = 88)。在研究期间,35名参与者(20%)退出。55名参与者(63%)使用了干预网站。干预组的健康结果与对照组无异。然而,干预组认为所获得的赔偿更公平(P < 0.01)。干预使用者与非使用者的亚组分析未得出显著结果。干预网站得到了积极评价。

结论

尽管基于网络的干预措施使用得还不足以改善赔偿程序中受伤索赔人的健康状况,但它提高了对赔偿金额的感知公平性。

试验注册

荷兰试验注册NTR2360 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f573/3722043/df750cd4c3ed/1745-6215-14-227-1.jpg

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