Ebert David Daniel, Lehr Dirk, Heber Elena, Riper Heleen, Cuijpers Pim, Berking Matthias
Friedrich-Alexander University Erlangen-Nuremberg, Clinical Psychology and Psychotherapy, 90453 Erlangen, Germany.
Scand J Work Environ Health. 2016 Sep 1;42(5):382-94. doi: 10.5271/sjweh.3573. Epub 2016 Jun 1.
This randomized controlled trial (RCT) aimed to evaluate the efficacy of an internet-based stress management intervention (iSMI) among employees compared to a 6-month waitlist control group (WLC) with full access to treatment-as-usual.
A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was assigned to either the iSMI or WLC group. The iSMI consisted of seven sessions and one booster session including problem-solving and emotion regulation techniques. Participants received guidance from an e-coach that focused on improving the adherence to the intervention. Self-report data were assessed at baseline, seven weeks, and six months following randomization. The primary outcome was perceived stress (PSS-10). The secondary outcomes included other relevant mental and work-related health outcomes.
The iSMI participants showed a significantly higher reduction in perceived stress from baseline to seven weeks [d=0.79, 95% confidence interval (95% CI) 0.54-1.04] and the 6-month follow up (d=0.85, 95% CI 0.59-1.10) compared to controls. Significant moderate-to-large effect sizes were also found for depression, anxiety, emotional exhaustion, sleeping problems, worrying, quality of life (mental health), psychological detachment and emotion regulation skills. Work engagement, quality of life (physical health), absenteeism and presenteeism were not found to significantly differ between the iSMI and WLC groups. Changes in emotion regulation regarding general distress mediated changes in perceived stress.
The iSMI investigated in this study was found to be effective in reducing typical symptoms of stress. However, several important work-related health symptoms were not significantly affected by the intervention. Internet-based guided self-help interventions could be an acceptable, effective approach to reduce a range of negative consequences associated with work-related stress. Future studies should investigate the comparative (cost-) effectiveness of guided and unguided stress management interventions.
本随机对照试验（RCT）旨在评估基于互联网的压力管理干预措施（iSMI）对员工的疗效，并与可全面接受常规治疗的6个月等候名单对照组（WLC）进行比较。
选取264名感知压力症状较高（感知压力量表，PSS-10≥22）的员工，将其分为iSMI组或WLC组。iSMI包括七个疗程和一个强化疗程，涵盖解决问题和情绪调节技巧。参与者接受电子教练的指导，重点是提高对干预措施的依从性。在随机分组后的基线、七周和六个月时评估自我报告数据。主要结果是感知压力（PSS-10）。次要结果包括其他相关的心理和与工作相关的健康结果。
与对照组相比，iSMI参与者从基线到七周[效应量d=0.79，95%置信区间（95%CI）0.54-1.04]以及6个月随访时（效应量d=0.85，95%CI 0.59-1.10）的感知压力显著降低。在抑郁、焦虑、情绪耗竭、睡眠问题、担忧、生活质量（心理健康）、心理脱离和情绪调节技能方面也发现了显著的中等到大的效应量。iSMI组和WLC组在工作投入、生活质量（身体健康）、旷工和出勤主义方面没有显著差异。一般困扰方面的情绪调节变化介导了感知压力的变化。
本研究中调查的iSMI被发现可有效减轻典型的压力症状。然而，一些重要的与工作相关的健康症状并未受到该干预措施的显著影响。基于互联网的引导式自助干预可能是一种可接受的、有效的方法，以减少与工作相关压力相关的一系列负面后果。未来的研究应调查引导式和非引导式压力管理干预措施的比较（成本）效益。
