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动机性访谈在长期病假中的应用:一项随机对照试验的研究方案,随后进行定性和经济研究。

Motivational interviewing in long-term sickness absence: study protocol of a randomized controlled trial followed by qualitative and economic studies.

机构信息

Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway.

Unicare Helsefort Rehabilitation Centre, Rissa, Norway.

出版信息

BMC Public Health. 2018 Jun 18;18(1):756. doi: 10.1186/s12889-018-5686-0.

Abstract

BACKGROUND

Motivational interviewing (MI), mainly used and shown effective in health care (substance abuse, smoking cessation, increasing exercise and other life style changes), is a collaborative conversation (style) about change that could be useful for individuals having problems related to return to work (RTW). The aim of this paper is to describe the design of a randomized controlled trial evaluating the effect of MI on RTW among sick listed persons compared to usual care, in a social security setting.

METHODS

The study is a randomized controlled trial with parallel group design. Individuals between 18 and 60 years who have been sick listed for more than 7 weeks, with a current sick leave status of 50-100%, are identified in the Norwegian National Social Security System and invited to participate in the study. Exclusion criteria are no employment and pregnancy. Included participants are randomly assigned to the MI intervention or one of two control groups. The MI intervention consists of two MI sessions offered by caseworkers at the Norwegian Labor and Welfare Service (NAV), while the comparative arms consist of a usual care group and a group that receives two extra sessions without MI content (to control for attentional bias). The primary outcome measure is the total number of sickness absence days during 12 months after inclusion, obtained from national registers. Secondary outcomes include time until full sustainable return to work, health-related quality of life and mental health status. In addition, a health economic evaluation, a feasibility/process evaluation and qualitative studies will be performed as part of the study.

DISCUSSION

A previous study has suggested an effect of MI on RTW for sick listed workers with musculoskeletal complaints. The present study will evaluate the effect of MI for all sick listed workers, regardless of diagnosis. The knowledge from this study will potentially be important for policy makers, clinicians and other professionals` practical work.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03212118 (registered July 11, 2017).

摘要

背景

动机性访谈(MI)主要用于医疗保健领域(药物滥用、戒烟、增加锻炼和其他生活方式改变),并已被证明有效,它是一种关于改变的协作对话(风格),对于与重返工作(RTW)相关的个体可能会有所帮助。本文的目的是描述一项随机对照试验的设计,该试验评估 MI 对在社会保障环境中列入名单的患者 RTW 的影响,与常规护理进行比较。

方法

该研究是一项平行组设计的随机对照试验。在挪威国家社会保障系统中,确定年龄在 18 至 60 岁之间、病假超过 7 周、目前病假状态为 50-100%的个体,并邀请他们参加研究。排除标准是没有就业和怀孕。纳入的参与者被随机分配到 MI 干预组或两个对照组之一。MI 干预由挪威劳动和福利局(NAV)的个案工作者提供两次 MI 课程,而对照组包括常规护理组和接受两次无 MI 内容的额外课程组(以控制注意力偏差)。主要结局指标是纳入后 12 个月内的总病假天数,通过国家登记获得。次要结局指标包括完全可持续返回工作的时间、健康相关生活质量和心理健康状况。此外,作为研究的一部分,还将进行健康经济学评估、可行性/过程评估和定性研究。

讨论

先前的研究表明 MI 对列入名单的肌肉骨骼投诉工人的 RTW 有影响。本研究将评估 MI 对所有列入名单的工人的效果,无论诊断如何。这项研究的知识对于决策者、临床医生和其他专业人员的实际工作可能非常重要。

试验注册

ClinicalTrials.gov:NCT03212118(2017 年 7 月 11 日注册)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1884/6007062/62a15e527a0a/12889_2018_5686_Fig1_HTML.jpg

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