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通过工作场所教育性腰痛干预措施减少病假:一项整群随机对照试验。

Reduction in sick leave by a workplace educational low back pain intervention: A cluster randomized controlled trial.

作者信息

Ree Eline, Lie Stein Atle, Eriksen Hege R, Malterud Kirsti, Indahl Aage, Samdal Oddrun, Harris Anette

机构信息

Uni Research Health, Uni Research, Norway Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Norway

Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway.

出版信息

Scand J Public Health. 2016 Aug;44(6):571-9. doi: 10.1177/1403494816653854. Epub 2016 Jun 15.

Abstract

AIMS

The aim of this study was to investigate whether a workplace educational low back pain intervention had an effect on sick leave at the individual level and to identify possible predictors of the effect of intervention.

METHODS

Work units in two municipalities were cluster randomized to (a) educational meetings and peer support (45 units), (b) educational meetings, peer support and access to an outpatient clinic if needed (48 units) or (c) a control group (42 units). Both intervention groups attended educational meetings with information about back pain based on a non-injury model. A peer adviser was selected from among their colleagues. The outcome was days of sick leave at the individual level at 3, 6, 9 and 12 months, adjusting for previous sick leave at the unit level. As a result of similar effects on sick leave, the two intervention groups were merged (n=646) and compared with the control group (n=211). The predictors were different levels of belief in back pain myths, pain-related fear, helplessness/hopelessness and low back pain.

RESULTS

The intervention group had significantly less days of sick leave at the three month (4.9 days, p=0.001) and six month (4.4 days, p=0.016) follow ups compared with the control group. At three months, a low level of pain-related fear was the only predictor for the intervention effect (8.0 less days of sick leave, p<0.001). CONCLUSIONS A WORKPLACE EDUCATIONAL BACK PAIN INTERVENTION HAD AN EFFECT ON SICK LEAVE FOR UP TO SIX MONTHS A LOW SCORE ON PAIN-RELATED FEAR WAS A PREDICTOR OF THE INTERVENTION EFFECT.

摘要

目的

本研究旨在调查工作场所的低腰痛教育干预在个体层面上对病假是否有影响,并确定干预效果的可能预测因素。

方法

两个城市的工作单位被整群随机分为:(a)教育会议和同伴支持组(45个单位),(b)教育会议、同伴支持以及必要时可使用门诊组(48个单位),或(c)对照组(42个单位)。两个干预组都参加了基于非损伤模型的有关背痛信息的教育会议。从同事中选出一名同伴顾问。结果是在3、6、9和12个月时个体层面的病假天数,并对单位层面之前的病假情况进行了调整。由于对病假有相似的影响,将两个干预组合并(n = 646)并与对照组(n = 211)进行比较。预测因素是对背痛神话的不同程度的信念、疼痛相关恐惧、无助感/绝望感和低腰痛。

结果

与对照组相比,干预组在三个月(4.9天,p = 0.001)和六个月(4.4天,p = 0.016)随访时的病假天数明显更少。在三个月时,低水平的疼痛相关恐惧是干预效果的唯一预测因素(病假天数少8.0天,p < 0.001)。结论:工作场所的低腰痛教育干预对病假长达六个月有影响,疼痛相关恐惧得分低是干预效果的一个预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca8b/4941097/efb10b1354ae/10.1177_1403494816653854-fig1.jpg

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