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工作相关压力的恢复:一项针对临床样本的压力管理干预的随机对照试验。

Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample.

机构信息

Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.

出版信息

Int Arch Occup Environ Health. 2018 Aug;91(6):675-687. doi: 10.1007/s00420-018-1314-7. Epub 2018 May 28.

Abstract

PURPOSE

Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample.

METHODS

Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW.

RESULTS

Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was - 3.09 (- 5.47, - 0.72), while for GHQ it was - 3.91 (- 7.15, - 0.68). There were no group differences in RTW.

CONCLUSIONS

The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups.

摘要

目的

旨在减少工作相关压力的干预措施的随机对照试验(RCT)表明,认知行为疗法(CBT)比其他干预措施更有效。然而,研究人群的定义往往不明确,而且缺乏针对个人和工作场所的干预措施。本研究旨在确定在临床样本中,将个体 CBT 与工作场所重点相结合的压力管理干预措施是否优于不治疗,以减少感知压力和压力症状以及持久重返工作岗位(RTW)的时间。

方法

将患有工作相关应激反应或适应障碍的患者随机分配至干预组(n=57,84.2%女性)或对照组(n=80,83.8%女性)。通过问卷和登记数据对受试者进行随访。干预措施包括个体 CBT 和提供工作场所会议。我们通过分析感知压力量表(PSS-10)和一般健康问卷(GHQ-30)的评分变化来检验干预效果。我们还测试了干预是否导致更快的持久 RTW。

结果

干预组的 PSS 基线平均值为 24.79,对照组为 23.26,而 GHQ 的相应值分别为 21.3 和 20.27。存在时间的显著影响。在基线后 10 个月,两组均报告感知压力较小且心理健康状况改善。在基线后 4 个月,我们发现感知压力和心理健康均有显著的治疗效果。4 个月后 PSS 平均变化的差值为-3.09(-5.47,-0.72),而 GHQ 为-3.91(-7.15,-0.68)。两组在 RTW 方面没有差异。

结论

干预措施导致工作相关应激反应和适应障碍患者的感知压力和压力症状更快减轻。干预结束后 6 个月,两组之间不再存在差异。

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