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一项针对德国医护人员的群组随机参与式组织干预的结果和过程评估。

Outcomes and process evaluation of a cluster-randomised participatory organisational intervention among German healthcare workers.

机构信息

Department of Population-Based Medicine, University of Tübingen, Hoppe-Seyler-Str. 9, Tübingen, 72076, Germany.

Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Parktstr. 11, Ulm, 89073, Germany.

出版信息

BMC Health Serv Res. 2023 Mar 16;23(1):260. doi: 10.1186/s12913-023-09240-x.

Abstract

BACKGROUND

In the present investigation the results of the outcome and process evaluation of a participatory workplace intervention are reported. The intervention aimed to increase the workers' self-assessed physical and mental work ability.

METHODS

The intervention was a two-arm, cluster-randomised trial with healthcare workers in 10 hospitals and one elderly care centre in Germany. Outcome data on workers were collected in questionnaires at baseline, and two follow-ups between 2019 and 2021. The intervention consisted of interviews and workshops, in which employees proposed measures for reducing the physical and psychosocial load and strengthening resources at work. Outcome data were analysed with linear-mixed regression models. The process evaluation was based on the thematic criteria proposed in previous literature and the collection of the type of intervention measures and their implementation status.

RESULTS

The regression analysis did not provide evidence of treatment differences or reductions of psychosocial load in the intervention wards. The process evaluation suggested that the measures did not address specifically the self-assessed work ability. In addition, there was no indication that the intervention measures were causally related to the intended goals.

CONCLUSIONS

The planning and implementation of organisational interventions require a careful consideration of the definition of intervention goals, the theoretical rationale of the intervention and a project-oriented action plan during the delivery phase.

摘要

背景

本研究报告了一项参与式工作场所干预的结果和过程评估的结果。该干预旨在提高工人自我评估的身体和心理工作能力。

方法

该干预是一项在德国 10 家医院和 1 家老年护理中心进行的双臂、整群随机试验。在 2019 年至 2021 年期间,通过问卷调查收集了工人的基线和两次随访的结果数据。干预措施包括访谈和研讨会,员工在其中提出了减少身体和心理社会负担以及加强工作资源的措施。使用线性混合回归模型分析结果数据。过程评估基于以前文献中提出的主题标准以及干预措施的类型和实施情况的收集。

结果

回归分析并未提供干预病房治疗差异或心理社会负担减轻的证据。过程评估表明,这些措施并未特别针对自我评估的工作能力。此外,没有迹象表明干预措施与预期目标有因果关系。

结论

组织干预的规划和实施需要仔细考虑干预目标的定义、干预的理论基础以及实施阶段的项目导向行动计划。

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