Linge Anita Dyb, Jensen Chris, Laake Petter, Bjørkly Stål Kapstø
Institute of Social Sciences, Volda University College, Mailbox 500, 6101, Volda, Norway.
Norwegian National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Norway.
BMC Public Health. 2021 May 17;21(1):936. doi: 10.1186/s12889-021-10954-y.
People on or at risk of sick leave from work due to obesity or obesity-related problems participated in a new vocational rehabilitation (VR). The study aimed to examine the outcome changes in the participants' health-related quality of life (HRQoL), body mass index (BMI), return to work self-efficacy (RTWSE), work ability scale (WAS) and degree of work participation (DWP) after their participation in the 12-month VR programme. The secondary aim was to examine associations between the outcome changes and HRQoL at 12-month follow-up, measured with the HRQoL 15D instrument (15D).
This prospective observational study included 95 participants. The one-year multidisciplinary VR programme with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by 5 meetings. A paired sample t-test was used to examine changes in HRQoL, BMI, RTWSE, WAS, and DWP between baseline and the 12-month follow-up. Multiple linear regression analyses explored associations between changes in HRQoL and the outcome variables.
The participants achieved statistically significant changes in HRQoL (2.57, 95% CI: 1.35 to 3.79), BMI (- 2.33, 95% CI: - 3.10 to - 1.56), RTWSE (15.89, 95% CI: 4.07 to 27.71), WAS (1.51, 95% CI: 0.83 to 2.20) and DWP (18.69, 95% CI: 8.35 to 29.02). At 12 months, a significant association was found between HRQoL and BMI (B = - 0.34, 95% CI: - 0.65 to - 0.04), RTWSE (B = 0.02, 95% CI: 0.004 to 0.04), WAS (B = 0.91, 95% CI: 0.55 to 1.28), DWP (B = - 0.02, 95% CI: - 0.04 to 0.001) and work absence (B = - 0.01, 95% CI: - 0.02 to - 0.002). The regression model explained 71.8% of the HRQoL variance.
The results indicated positive changes in HRQoL, BMI, RTWSE, WAS and DWP from baseline to the 12-month follow-up. Factors associated with HRQoL at the 12-month follow-up were decreased BMI, increased RTWSE, improved WAS and reduced work absence. Future studies examining VR programmes with lifestyle interventions for people with obesity are recommended.
Norwegian Regional Committee for Medical and Health Research Ethics (REC) 2017/573, Clinical Trials NCT03286374 , registered 18. September 2017. https://clinicaltrials.gov/ct2/results?cond=Obesity&term=Anita+Dyb+Linge&cntry=NO&state=&city=&dist=.
因肥胖或肥胖相关问题面临工作病假风险或正在休病假的人参与了一项新的职业康复（VR）项目。该研究旨在考察参与者在参加为期12个月的VR项目后，其健康相关生活质量（HRQoL）、体重指数（BMI）、重返工作自我效能感（RTWSE）、工作能力量表（WAS）和工作参与度（DWP）的结果变化。次要目的是使用HRQoL 15D工具（15D）考察12个月随访时结果变化与HRQoL之间的关联。
这项前瞻性观察性研究纳入了95名参与者。为期一年的多学科VR项目包括综合工作和生活方式干预，其中有4周住院治疗，之后进行5次会面。采用配对样本t检验考察基线与12个月随访之间HRQoL、BMI、RTWSE、WAS和DWP的变化。多元线性回归分析探讨HRQoL变化与结果变量之间的关联。
参与者在HRQoL（2.57，95%置信区间：1.35至3.79）、BMI（-2.33，95%置信区间：-3.10至-1.56）、RTWSE（15.89，95%置信区间：4.07至27.71）、WAS（1.51，95%置信区间：0.83至2.20）和DWP（18.69，95%置信区间：8.35至29.02）方面取得了具有统计学意义的变化。在12个月时，发现HRQoL与BMI（B = -0.34，95%置信区间：-0.65至-0.04）、RTWSE（B = 0.02，95%置信区间：0.004至0.04）、WAS（B = 0.91，95%置信区间：0.55至1.28）、DWP（B = -0.02，95%置信区间：-0.04至0.001）以及缺勤（B = -0.01，95%置信区间：-0.02至-0.002）之间存在显著关联。回归模型解释了HRQoL方差的71.8%。
结果表明从基线到12个月随访，HRQoL、BMI、RTWSE、WAS和DWP有积极变化。12个月随访时与HRQoL相关的因素包括BMI降低、RTWSE增加、WAS改善和缺勤减少。建议未来开展针对肥胖人群的采用生活方式干预的VR项目研究。
挪威医学与健康研究伦理区域委员会（REC）2017/573，临床试验NCT03286374，于2017年9月18日注册。https://clinicaltrials.gov/ct2/results?cond=Obesity&term=Anita+Dyb+Linge&cntry=NO&state=&city=&dist=.
