Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands.
Occup Environ Med. 2014 Jan;71(1):21-9. doi: 10.1136/oemed-2013-101412. Epub 2013 Oct 24.
Workers with common mental disorders (CMDs) frequently experience recurrent sickness absence but interventions to prevent this are lacking. The goal of this study was to evaluate the effectiveness of the Stimulating Healthy participation And Relapse Prevention at work intervention in preventing recurrent sickness absence in workers who returned to work after sickness absence due to CMDs.
We performed a cluster-randomised controlled trial with 3 months, 6 months and 12 months follow-up. Treatment providers were randomised to either a 2-day training in the Stimulating Healthy participation And Relapse Prevention at work intervention, that is, a problem-solving intervention, or usual care. Primary outcome measures were the incidence of recurrent sickness absence and time to recurrent sickness absence. Secondary outcome measures were mental health complaints, work functioning and coping behaviour.
80 participants were randomised in the intervention group and 78 in the control group. The adjusted OR for the incidence of recurrent sickness absence was 0.40 (95% CI 0.20 to 0.81) and the adjusted HR for time to recurrent sickness absence was 0.53 (95% CI 0.33 to 0.86) for the intervention group compared with care as usual.
This study demonstrates the 12-month effectiveness of a problem-solving intervention for reducing recurrent sickness absence in workers with CMDs and emphasises the importance of continuous attention in the post return to work phase for workers who have been on sickness absence due to CMDs.
患有常见精神障碍（CMD）的工人经常经历反复的病假，但缺乏预防这种情况的干预措施。本研究的目的是评估“在工作中激发健康参与和防止复发”干预措施在预防因 CMD 而缺勤后重返工作岗位的工人反复病假的有效性。
我们进行了一项为期 3 个月、6 个月和 12 个月随访的集群随机对照试验。治疗提供者被随机分配接受为期 2 天的“在工作中激发健康参与和防止复发”干预措施培训，即解决问题的干预措施，或常规护理。主要结局指标是反复病假的发生率和反复病假的时间。次要结局指标是心理健康投诉、工作功能和应对行为。
80 名参与者被随机分配到干预组，78 名参与者被随机分配到对照组。与常规护理相比，干预组反复病假发生率的调整 OR 为 0.40（95%CI 0.20 至 0.81），反复病假时间的调整 HR 为 0.53（95%CI 0.33 至 0.86）。
本研究证明了针对 CMD 患者的解决问题干预措施在减少反复病假方面的 12 个月有效性，并强调了在因 CMD 而缺勤的工人重返工作岗位后阶段持续关注的重要性。
