Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
Center for Health And Medical Psychology, Department of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden.
J Occup Rehabil. 2020 Mar;30(1):93-104. doi: 10.1007/s10926-019-09849-y.
Purpose To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care. Methods The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements. Results At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months. Conclusions The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.
评估针对软组织损伤患者重返工作岗位的心理社会风险因素的早期干预方案是否优于常规（递进式）护理。
该研究采用对照、非随机前瞻性设计，比较了两种病例管理方法。对于干预条件，在受伤后 1-3 周内通过 Örebro 肌肉骨骼疼痛筛查问卷短版（ÖMPSQ-SF）筛查出有延迟重返工作高风险的工人将接受心理评估和全面的方案，以解决确定的工作重返障碍。同样在控制条件下识别出的受伤工人按照常规（递进式）护理安排进行管理。
在 2 年的随访中，干预组的平均误工天数不到对照组的一半，其索赔费用降低了 30%，11 个月后成本的增长轨迹也更低。
研究结果支持以下假设：简短的心理风险因素筛查，结合关键利益相关者之间的积极协作方案，以解决确定的心理和工作场所因素，可实现比常规（递进式）护理更好的投资回报。
