Oakman Jodi, Keegel Tessa, Kinsman Natasha, Briggs Andrew M
Centre for Ergonomics and Human Factors, La Trobe University, Melbourne, Victoria, Australia.
Centre for Ergonomics and Human Factors, La Trobe University, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
Occup Environ Med. 2016 Mar;73(3):206-14. doi: 10.1136/oemed-2015-103208. Epub 2016 Jan 6.
A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed.
对文献进行了系统分析，以确定工作场所干预的哪些特征在帮助患有持续性肌肉骨骼疼痛（PMP）的人保持有效就业方面最有效。使用医学主题词表（MeSH）和其他相关术语检索了Medline、PsychINFO、护理学与健康领域数据库（CINAHL）和Embase数据库。纳入了报告在工作场所进行或涉及工作场所干预的研究。干预措施被视为要么侧重于个体，要么是多层次的。评估的结果指标包括：失业、生产力、病假、疼痛和成本效益。使用GRADE标准进行质量评估，并制定影响陈述以综合结果。确定了18篇相关文章（14项研究）纳入综述。未发现工作场所干预措施帮助患有PMP的人的高级别证据。参与者数量少和研究有限导致证据降级。然而，侧重于个体的干预措施可能会减少失业和病假，但不太可能减轻疼痛。多层次的干预措施可能会减少病假并提供一定的成本效益。关于生产力的证据有限且质量较差。由于PMP患者的可持续就业很重要，并且了解哪些措施有效对于确保制定有效的工作场所干预措施是必要的，因此需要进一步研究。
