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额外个性化干预对疲劳障碍患者病假和症状的影响:一项随机对照试验。

Effects of Additional Individually Tailored Interventions on Sick-Leave and Symptoms in Patients with Exhaustion Disorder: A Randomized Controlled Trial.

机构信息

Institute of Stress Medicine, Institute of Stress Medicine, Gothenburg, Sweden.

出版信息

J Rehabil Med. 2022 Aug 24;54:jrm00321. doi: 10.2340/jrm.v54.2941.

Abstract

OBJECTIVE

To evaluate the effects of adding individually tailored interventions to a standard treatment in patients with stress-related exhaustion disorder, with regard to sick-leave days and symptoms of burnout. The study design was a 2-armed randomized controlled intervention, with follow-up after 15 months. Data were obtained from patients referred to the Institute of Stress Medicine, and were collected between 2011 and 2014 in western Sweden.

METHODS

Inclusion criteria were scoring above cut-off in at least 1 of 4 dimensions; mental and physical exhaustion, disturbed sleep, reduced cognitive function and perceived poor self-esteem. The total study population comprised 142 patients (112 females, 30 males) allocated through block randomization to either the intervention group (n = 71) or the control group (n = 71). The intervention group received 1-4 individually tailored interventions (physical activity, cognitive behaviour therapy for insomnia, computerized memory training, cognitive behavioural therapy for self-esteem), based on the results of screening assessments. The interventions were additional to a standard treatment. The control group received solely the standard treatment. The primary outcome measure was the proportion of participants not sicklisted at the 15-month follow-up.

RESULTS

At the 15-month follow-up, 30% of subjects in the intervention group and 34% in the control group had 0% sick-listed (p = 0.58). No change between baseline and follow-up was seen in 42% of the intervention group and 39% of the control group, while an increased sick-leave rate was seen in 1% of the intervention group and 4% of the control group. However, no statistically significant difference was seen between groups.

CONCLUSION

Adding individually tailored interventions to a standard treatment in patients with stress-related exhaustion did not reduce sick-leave days or burnout symptoms.

摘要

目的

评估在应激相关耗竭障碍患者中,针对病假天数和倦怠症状,为标准治疗增加个性化干预的效果。该研究设计为 2 臂随机对照干预,随访时间为 15 个月。数据来自于瑞典西部压力医学研究所转诊的患者,于 2011 年至 2014 年期间收集。

方法

纳入标准为至少在 4 个维度中的 1 个维度得分高于临界值:心理和身体耗竭、睡眠障碍、认知功能减退和自我感觉不佳。总研究人群包括 142 名患者(112 名女性,30 名男性),通过区组随机分配至干预组(n = 71)或对照组(n = 71)。干预组根据筛查评估结果接受 1-4 种个性化干预(体力活动、失眠认知行为疗法、计算机记忆训练、自尊认知行为疗法)。干预是在标准治疗之外进行的。对照组仅接受标准治疗。主要结局指标为 15 个月随访时未请病假的参与者比例。

结果

在 15 个月的随访中,干预组有 30%的受试者和对照组有 34%的受试者 0%请病假(p = 0.58)。干预组的 42%和对照组的 39%在基线和随访之间没有变化,而干预组的 1%和对照组的 4%的病假率增加。然而,两组之间没有统计学上的显著差异。

结论

在应激相关耗竭障碍患者中,为标准治疗增加个性化干预并不能减少病假天数或倦怠症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4087/9422869/ce4e113bb2b4/JRM-54-2941-g001.jpg

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