Hitt David, Tahir Tayyeb, Davies Lyndon, Delahay Jo, Kelson Mark
Cognitive Behaviour Therapy Nurse Therapist, Cardiff and Vale University Health Board, Cardiff, UK.
Professor of Psychiatry, Cardiff and Vale University Health Board, Cardiff, UK.
J Res Nurs. 2018 Jun;23(4):360-372. doi: 10.1177/1744987117745580. Epub 2018 Feb 5.
The National Institute for Health and Clinical Excellence (NICE) guidance recommends Cognitive Behavioural Therapy (CBT) as part of multidisciplinary occupational mental health interventions for people with long-term or recurrent short-term sickness absence from work (NICE, 2009). Despite this, there is a paucity of data for both randomised trials for CBT and literature that supports the transferability of CBT into occupational environments.
This service evaluation aimed to evaluate the clinical effectiveness of CBT by analysing data from a partnership scheme between a local authority and a local heath board using a routine employee population.
A clinical cohort of 81 employees referred through the partnership scheme completed CBT over a 5-year period via a CBT nurse therapist. A sample of 76 employees was included in the evaluation who completed pre-/post-measures to establish outcome. Of these, 30 were followed up at a 3-year point, completing the same measures.
Each of the clinical measures yielded significant outcomes at 95% confidence intervals, and large effect sizes using Cohen's both at post-test and follow-up. No significant difference was shown between post-treatment and follow-up outcomes. CBT was demonstrated to be clinically effective within an occupational mental health setting.
In conclusion, partnership schemes with a focus on mental health between public sector agencies can have a positive outcome for the funding agency as well as individual employees.
英国国家卫生与临床优化研究所(NICE)的指南推荐认知行为疗法(CBT)作为针对长期或反复短期缺勤的员工进行多学科职业心理健康干预的一部分(NICE,2009)。尽管如此,关于CBT的随机试验数据以及支持将CBT应用于职业环境的文献都很匮乏。
本服务评估旨在通过分析地方当局与地方卫生委员会合作计划中使用常规员工群体的数据,评估CBT的临床效果。
通过合作计划转介的81名员工的临床队列在5年时间里通过一名CBT护士治疗师完成了CBT。评估纳入了76名完成前后测量以确定结果的员工样本。其中,30名员工在3年时接受了随访,完成了相同的测量。
每项临床测量在95%置信区间均产生了显著结果,在测试后和随访时使用科恩效应量均显示出较大效应大小。治疗后和随访结果之间未显示出显著差异。CBT在职业心理健康环境中被证明具有临床效果。
总之,公共部门机构之间以心理健康为重点的合作计划对资助机构和员工个人都能产生积极结果。