临时工作调整对与肌肉骨骼疼痛或抑郁症状相关的残疾的疗效——一项对照试验的研究方案

Efficacy of temporary work modifications on disability related to musculoskeletal pain or depressive symptoms--study protocol for a controlled trial.

作者信息

Haukka Eija, Martimo Kari-Pekka, Kivekäs Teija, Horppu Ritva, Lallukka Tea, Solovieva Svetlana, Shiri Rahman, Pehkonen Irmeli, Takala Esa-Pekka, MacEachen Ellen, Viikari-Juntura Eira

机构信息

Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.

Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland Client Services, Occupational Health Collaboration, Finnish Institute of Occupational Health, Helsinki, Finland.

出版信息

BMJ Open. 2015 May 18;5(5):e008300. doi: 10.1136/bmjopen-2015-008300.

DOI:10.1136/bmjopen-2015-008300

PMID:25986643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4442237/

Abstract

INTRODUCTION

Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms.

METHODS AND ANALYSIS

A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0-10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days during a 12-month follow-up. Secondary outcomes are intensity of musculoskeletal pain (scale 0-10), pain interference with work or sleep (scale 0-10) and severity of depressive symptoms (Patient Health Questionnaire, PHQ-9), inquired via online questionnaires at baseline and 3, 6, 9 and 12 months after recruitment. Information on SA days will be collected from the medical records of the OHSs over 12 months, before and after recruitment. The findings will give new information about the possibilities of training physicians to initiate work modifications and their effects on RTW in employees with work disability due to musculoskeletal pain or depressive symptoms.

ETHICS AND DISSEMINATION

The Coordinating Ethics Committee of Hospital District of Helsinki and Uusimaa has granted approval for this study. The results will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ISRCTN74743666.

摘要

引言

先前的研究表明，从事工作量适宜的工作可能会促进残疾人的健康并使其继续工作。本研究将考察在工作致残早期进行临时工作调整，对于提高患有肌肉骨骼疾病或抑郁症状的员工恢复工作（RTW）或继续工作的效果。

方法与分析

将在芬兰九个城市的八家企业及其职业健康服务机构（OHS）开展一项采用改良阶梯楔形设计的单中心对照试验。因肌肉骨骼疼痛（0至10分制中≥4分）或抑郁症状（对2个筛查问题有≥1个肯定回答）寻求医疗建议且符合其他纳入标准的患者符合条件。该研究包括对职业医生进行教育干预，以加强工作调整的启动。主要结局指标为持续恢复工作（连续工作≥4周且无新的病假（SA））以及12个月随访期间的病假总天数。次要结局指标包括肌肉骨骼疼痛强度（0至10分制）、疼痛对工作或睡眠的干扰（0至10分制）以及抑郁症状严重程度（患者健康问卷，PHQ - 9），在基线以及招募后3、6、9和12个月通过在线问卷进行询问。病假天数信息将从OHS的病历中收集，涵盖招募前后的12个月。研究结果将为培训医生启动工作调整的可能性及其对因肌肉骨骼疼痛或抑郁症状导致工作致残的员工恢复工作的影响提供新信息。