一项针对手臂、颈部或肩部有不适症状员工的自我管理计划的效果评估：一项随机对照试验。

Effect evaluation of a self-management programme for employees with complaints of the arm, neck or shoulder: a randomised controlled trial.

作者信息

Hutting Nathan, Staal J Bart, Engels Josephine A, Heerkens Yvonne F, Detaille Sarah I, Nijhuis-van der Sanden Maria W G

机构信息

Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands Faculty of Health and Social Studies, HAN University of Applied Sciences, Research Group Occupation & Health, Nijmegen, The Netherlands.

出版信息

Occup Environ Med. 2015 Dec;72(12):852-61. doi: 10.1136/oemed-2015-103089. Epub 2015 Sep 10.

DOI:10.1136/oemed-2015-103089

PMID:26359220

Abstract

OBJECTIVE

To evaluate the effectiveness of a self-management intervention (including an eHealth module), compared with usual care, in employees with chronic non-specific complaints of the arm, neck or shoulder (persisting >3 months).

METHODS

Participants were randomised into the self-management group (SG) or usual care group (UCG). The SG participated in 6 self-management sessions and could use an eHealth module; the UCG could use all available usual care. The primary outcome of the study was score on the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes included: absenteeism, pain in the previous week, quality of life, pain catastrophising, self-efficacy, work style, presenteeism, fatigue, and limitations experienced during work. Data were analysed using generalised estimating equations (GEE) linear regression and Mann-Whitney U tests, and were collected at baseline, 3-month, 6-month, and 12-month follow-up.

RESULTS

On the general module of the DASH, no significant difference between SG and the UCG was detected. On most of the other outcome measures, there were no significant between-group differences. In the DASH work module, the between-group effect was -3.82 (95% CI -7.46 to -0.19, p=0.04). For limitations experienced in job-related activities the between-group effect was -1.01 (95% CI -1.97 to -0.04, p=0.04). The mean hours of sport activities in the past 3 months, measured at 12 months, was 1.00 h (95% CI -1.90 to -0.12 h, p=0.03) less in the SG compared with the UCG.

CONCLUSIONS

The self-management intervention improved the participants' perceived disability during work. Since no significant between-group differences were found on most outcome measures, the results of this study should be interpreted with caution.

TRIAL REGISTRATION NUMBER

Dutch Trial Registration number NTR 3816.

摘要

目的

评估自我管理干预措施（包括一个电子健康模块）相较于常规护理，对患有手臂、颈部或肩部慢性非特异性疼痛（持续超过3个月）的员工的有效性。

方法

参与者被随机分为自我管理组（SG）或常规护理组（UCG）。自我管理组参加6次自我管理课程，并可使用电子健康模块；常规护理组可使用所有可用的常规护理。该研究的主要结局是手臂、肩部和手部功能障碍问卷（DASH）的得分。次要结局包括：缺勤率、前一周的疼痛、生活质量、疼痛灾难化、自我效能感、工作方式、出勤主义、疲劳以及工作期间经历的限制。使用广义估计方程（GEE）线性回归和曼-惠特尼U检验对数据进行分析，并在基线、3个月、6个月和12个月随访时收集数据。

结果

在DASH的总体模块上，未检测到自我管理组和常规护理组之间存在显著差异。在大多数其他结局指标上，组间无显著差异。在DASH工作模块中，组间效应为-3.82（95%CI -7.46至-0.19，p=0.04）。对于与工作相关活动中经历的限制，组间效应为-1.01（95%CI -1.97至-0.04，p=0.04）。在12个月时测量的过去3个月的平均体育活动时长，自我管理组比常规护理组少1.00小时（95%CI -1.90至-0.12小时，p=0.03）。