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抑郁、焦虑和压力患者休病假后重返工作岗位的预测因素:一项随机对照试验的二次分析。

Predictors of return to work for people on sick leave with depression, anxiety and stress: secondary analysis from a randomized controlled trial.

机构信息

Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark.

National Board of Social Services in Denmark, Edisonsvej 1, 5000, Odense, Denmark.

出版信息

Int Arch Occup Environ Health. 2023 Jul;96(5):715-734. doi: 10.1007/s00420-023-01968-7. Epub 2023 Mar 18.

Abstract

PURPOSE

Knowledge about predictors of return to work (RTW) in people on sick leave with common mental disorders (CMDs) may inform the development of effective vocational rehabilitation interventions for this target group. In this study, we investigated predictors of RTW at 6 and 12 months in people on sick leave with depression, anxiety disorders or stress-related disorders.

METHODS

We have performed a secondary analysis, utilizing data from two RCTs that evaluated the efficacy of an integrated health care and vocational rehabilitation intervention. Data were obtained from mental health assessments, questionnaires and registers. Using Cox regression analysis, the relationship between baseline variables and RTW was analysed at 6 and 12 months after randomization within the group of CMD as a whole and within the subgroups of depression, anxiety and stress-related disorders.

RESULTS

Symptom burden and employment status at baseline predicted RTW in the CMD group (n = 1245) and in the three diagnostic subgroups at both time points. RTW self-efficacy predicted RTW in the depression group but not in the anxiety or stress subgroups.

CONCLUSION

Many predictors of RTW were similar over time and, to some extent, across the CMD subgroups. Findings highlight the need not only to take health-related and psychological factors into account when developing vocational rehabilitation interventions but also to consider workplace strategies and options for support.

摘要

目的

了解导致请病假的常见精神障碍(CMD)人群重返工作岗位(RTW)的因素,可能有助于为这一目标群体制定有效的职业康复干预措施。本研究旨在探讨抑郁、焦虑障碍或应激相关障碍患者请病假时,6 个月和 12 个月 RTW 的预测因素。

方法

我们对两项评估综合医疗保健和职业康复干预效果的 RCT 的数据进行了二次分析。数据来自心理健康评估、问卷调查和登记处。使用 Cox 回归分析,在整个 CMD 组以及抑郁、焦虑和应激相关障碍亚组内,根据基线变量与随机分组后 6 个月和 12 个月 RTW 的关系进行分析。

结果

症状负担和基线时的就业状况是 CMD 组(n=1245)和三个诊断亚组在两个时间点 RTW 的预测因素。康复效能感预测了抑郁组的 RTW,但对焦虑或应激亚组没有预测作用。

结论

随着时间的推移,许多 RTW 的预测因素是相似的,在一定程度上,这些预测因素跨越了 CMD 亚组。研究结果强调,在制定职业康复干预措施时,不仅要考虑与健康相关的和心理因素,还要考虑工作场所的策略和支持选择。

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Interventions to improve return to work in depressed people.改善抑郁症患者重返工作岗位的干预措施。
Cochrane Database Syst Rev. 2020 Oct 13;10(10):CD006237. doi: 10.1002/14651858.CD006237.pub4.

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