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认知行为疗法在帮助请病假人员重返工作岗位方面的有效性:系统评价和荟萃分析。

The Effectiveness of Cognitive-Behavioral Therapy in Helping People on Sick Leave to Return to Work: A Systematic Review and Meta-analysis.

机构信息

School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia.

Centre for Work, Organisation and Wellbing, Griffith University, Nathan, Q4215, Australia.

出版信息

J Occup Rehabil. 2024 Mar;34(1):4-36. doi: 10.1007/s10926-023-10116-4. Epub 2023 Apr 17.


DOI:10.1007/s10926-023-10116-4
PMID:37067701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10899273/
Abstract

PURPOSE: Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. METHODS: Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). RESULTS: Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. CONCLUSIONS: The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.

摘要

目的:先前的研究系统地研究了基于认知行为疗法(CBT)的干预措施在管理慢性病的精神和身体症状方面的有效性,包括抑郁、与压力相关的精神障碍(SMD)和慢性疼痛,这些都是请病假的常见原因。然而,缺乏针对 CBT 促进重返工作岗位(RTW)效果的系统评价。本研究综述了利用基于 CBT 的干预措施帮助请病假的员工重返工作岗位的研究。

方法:检索了 MEDLINE、EMBASE、The Cochrane Library、Scopus、PsycINFO、Web of Science 和 PubMed 中 1990 年 1 月 1 日至 2022 年 6 月 27 日期间发表的随机对照试验(RCT)。主要结局变量包括重返工作岗位(RTW)措施和病假。次要结局包括心理状况(精神疾病、压力、焦虑和抑郁)和身体状况(工作能力、疲劳和身体功能)。

结果:纳入 34 项 RCT 进行分析。15 项 RCT(1727 名参与者)报告了病假情况。结果显示,完成 CBT 干预的参与者的病假天数减少(平均减少 -3.654;95%CI -5.253,-2.046;p<0.001),与对照组相比。16 篇论文(2298 名参与者)报告说,干预组提前 1.5 天重返工作岗位(95%CI 1.019,1.722;p<0.05)。基于 CBT 的干预措施在管理疲劳、精神疾病和抑郁方面有效,并改善身体功能,而在管理压力、焦虑和工作能力方面则没有效果。

结论:研究结果表明,基于 CBT 的干预措施可有效缩短病假时间,促进干预组员工重返工作岗位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cec/10899273/80ff1ccf25e1/10926_2023_10116_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cec/10899273/ae52c5559f10/10926_2023_10116_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cec/10899273/80ff1ccf25e1/10926_2023_10116_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cec/10899273/ae52c5559f10/10926_2023_10116_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cec/10899273/80ff1ccf25e1/10926_2023_10116_Fig2_HTML.jpg

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Costs and Outcomes of a Therapist-Guided Internet-Delivered Cognitive Behavioral Therapy: Multicenter Observational Study.

J Med Internet Res. 2025-7-28

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Internet Interv. 2025-7-1

[3]
Effect of Cognitive Behavioural Stress Management on Return-to-Work Amongst Sick-Listed Employees.

J Occup Rehabil. 2025-6-25

[4]
Effectiveness of clinical healthcare interventions for enhancing the work participation of patients with various health conditions: a synthesis of systematic reviews.

BMJ Open. 2025-2-20

[5]
Functional assertiveness with acceptance and commitment therapy for employees returning to work: a preliminary investigation.

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[6]
Effect of cognitive-behavioral therapy on fatigue in cancer patients: a systematic review and meta-analysis.

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[7]
Being Cynical Is Bad for Your Wellbeing: A Structural Equation Model of the Relationship Between Cynicism and Mental Health in First Responders in South Africa.

Int J Environ Res Public Health. 2024-12-17

[8]
Impact of fatigue on work productivity and health-related job loss.

Occup Med (Lond). 2024-9-23

本文引用的文献

[1]
Integrated Mental Healthcare and Vocational Rehabilitation for People on Sick Leave with Anxiety or Depression: 24-Month Follow-up of the Randomized IBBIS Trial.

J Occup Rehabil. 2023-9

[2]
The Impact of CBT on Sick Leave and Health.

Eval Rev. 2020-4

[3]
Interventions to improve return to work in depressed people.

Cochrane Database Syst Rev. 2020-10-13

[4]
Integration of a Return-to-Work Module in Cognitive Behavioral Therapy in Patients With Major Depressive Disorder and Long-Term Sick Leave-A Feasibility Study.

Front Psychiatry. 2020-6-3

[5]
Effect of Internet vs Face-to-Face Cognitive Behavior Therapy for Health Anxiety: A Randomized Noninferiority Clinical Trial.

JAMA Psychiatry. 2020-9-1

[6]
Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial.

Scand J Psychol. 2019-11-6

[7]
Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review.

Int J Environ Res Public Health. 2019-5-27

[8]
Resilience and return-to-work pain interventions: systematic review.

Occup Med (Lond). 2019-5-25

[9]
Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials.

Int Arch Occup Environ Health. 2018-11-24

[10]
Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample.

Int Arch Occup Environ Health. 2018-5-28

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