一项关于心理健康问题/精神疾病患者再就业的污名意识干预措施的效果：一项整群随机对照试验。
Effectiveness of a Stigma Awareness Intervention on Reemployment of People with Mental Health Issues/Mental Illness: A Cluster Randomised Controlled Trial.
机构信息
Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK.
出版信息
J Occup Rehabil. 2024 Mar;34(1):87-99. doi: 10.1007/s10926-023-10129-z. Epub 2023 Jul 13.
PURPOSE
A barrier for reemployment of people with mental health issues/mental illness (MHI) is workplace stigma and discrimination. In this RCT the effectiveness of a stigma-awareness intervention addressing finding work, retaining work and decisional stress were evaluated.
METHODS
A cluster RCT was conducted in 8 Dutch municipal practices. Randomisation took place at practice level. Participants were unemployed people with MHI, receiving social benefits. The intervention consisted of a decision aid for workplace disclosure for participants and a 2 × 3 h stigma-awareness training for their employment specialists. Primary outcomes were measured at baseline, 3-, 6- and 12-months. Multilevel analyses, containing random intercepts of participants nested in organizations, were conducted to analyse the effects of the intervention.
RESULTS
Participants (N = 153) were randomized to an experimental (n = 76) or control group (n = 77). At six months, significantly more participants of the experimental group (51%) had found work compared to the control group (26%). At twelve months, significantly more participants of the experimental group (49%) had retained work compared to the control group (23%). Intention-to-treat analyses showed that randomization to the experimental group was associated with finding (OR(95%CI) = 7.78(1.33-45.53), p = 0.02) and retaining (OR(95%CI) = 12.15(2.81-52.63), p < 0.01) work more often at twelve months. Analyses showed that the experimental and control group did not differ in decisional stress.
CONCLUSIONS
Our stigma awareness intervention was effective for finding and retaining work. As the percentage of people who found and retained work almost doubled, this suggests that on a societal level, a vast number of unemployed people could be reemployed with a relatively simple intervention.
TRIAL REGISTRATION
The study was retrospectively registered at the Dutch Trial Register (TRN: NL7798, date: 04-06-2019).
目的
精神健康问题/精神疾病（MHI）患者重新就业的一个障碍是工作场所的耻辱和歧视。在这项随机对照试验中，评估了一项针对寻找工作、保留工作和决策压力的耻辱感意识干预措施的效果。
方法
在 8 家荷兰市立诊所进行了一项集群随机对照试验。在诊所层面进行随机分组。参与者是失业的 MHI 患者，领取社会福利。该干预措施包括参与者的工作场所披露决策辅助工具和就业专家的 2×3 小时耻辱感意识培训。主要结果在基线、3 个月、6 个月和 12 个月时进行测量。采用包含参与者在组织内嵌套的随机截距的多级分析来分析干预的效果。
结果
参与者（N=153）被随机分配到实验组（n=76）或对照组（n=77）。在 6 个月时，实验组（51%）有更多的参与者找到工作，而对照组（26%）则较少。在 12 个月时，实验组（49%）有更多的参与者保留工作，而对照组（23%）则较少。意向治疗分析表明，实验组的随机分组与 12 个月时找到（OR（95%CI）=7.78（1.33-45.53），p=0.02）和保留（OR（95%CI）=12.15（2.81-52.63），p<0.01）工作的相关性更高。分析表明，实验组和对照组在决策压力方面没有差异。
结论
我们的耻辱感意识干预措施对于寻找和保留工作是有效的。由于找到和保留工作的人数增加了近一倍，这表明在社会层面上，通过一项相对简单的干预措施，大量失业人员可以重新就业。
试验注册
该研究在荷兰试验注册中心（TRN：NL7798，日期：2019 年 6 月 4 日）进行了回顾性注册。
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