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改善常见精神疾病患者重返工作岗位的干预措施:随机对照试验的系统评价和荟萃分析

Interventions for enhancing return to work in individuals with a common mental illness: systematic review and meta-analysis of randomized controlled trials.

作者信息

Nigatu Y T, Liu Y, Uppal M, McKinney S, Rao S, Gillis K, Wang J

机构信息

Department of Psychiatry,Cumming School of Medicine,University of Calgary,Alberta,Canada.

Department of Psychiatry,Faculty of Medicine,University of Ottawa,Ontario,Canada.

出版信息

Psychol Med. 2016 Dec;46(16):3263-3274. doi: 10.1017/S0033291716002269. Epub 2016 Sep 9.

Abstract

Common mental disorders (CMDs) are highly prevalent in the working population, and are associated with long-term sickness absence and disability. Workers on sick leave with CMDs would benefit from interventions that enable them to successfully return to work (RTW). However, the effectiveness of RTW interventions for workers with a CMD is not well studied. The objective of this review is to assess the effectiveness of existing workplace and clinical interventions that were aimed at enhancing RTW. A systematic review of studies of interventions for improving RTW in workers with a CMD was conducted. The main outcomes were proportion of RTW and sick-leave duration until RTW. Randomized controlled trials (RCTs) were identified from Medline/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource and management databases from January 1995 to 2016. Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently homogeneous in different comparison groups and assessed the overall quality of the evidence. We reviewed 2347 abstracts from which 136 full-text articles were reviewed and 16 RCTs were included in the analysis. Combined results from these studies suggested that the available interventions did not lead to improved RTW rates over the control group [pooled risk ratio 1.05, 95% confidence interval (CI) 0.97-1.12], but reduced the number of sick-leave days in the intervention group compared to the control group, with a mean difference of -13.38 days (95% CI -24.07 to -2.69).

摘要

常见精神障碍(CMDs)在工作人群中高度流行,且与长期病假和残疾相关。患有CMDs的病假员工将受益于能使其成功重返工作岗位(RTW)的干预措施。然而,针对患有CMDs的员工的RTW干预措施的有效性尚未得到充分研究。本综述的目的是评估旨在促进RTW的现有工作场所和临床干预措施的有效性。我们对改善患有CMDs的员工RTW的干预措施研究进行了系统综述。主要结局指标为RTW的比例以及直至RTW的病假时长。我们从1995年1月至2016年的Medline/PubMed、PsycINFO、EMBASE、SocINDEX以及人力资源与管理数据库中识别出随机对照试验(RCTs)。两位作者独立筛选研究、评估偏倚风险并提取数据。我们汇总了在不同比较组中我们认为足够同质的研究,并评估了证据的整体质量。我们审查了2347篇摘要,从中筛选出136篇全文文章进行评审,16项RCTs纳入分析。这些研究的综合结果表明,与对照组相比,现有干预措施并未提高RTW率[合并风险比1.05,95%置信区间(CI)0.97 - 1.12],但干预组的病假天数与对照组相比有所减少,平均差值为 - 13.38天(95% CI - 24.07至 - 2.69)。

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