de Geus Christa J C, Huysmans Maaike A, van Rijssen H Jolanda, de Maaker-Berkhof Marianne, Schoonmade Linda J, Anema Johannes R
Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
J Occup Rehabil. 2025 Jun;35(2):159-180. doi: 10.1007/s10926-024-10203-0. Epub 2024 Jun 7.
The aim of this systematic review is to identify vocational rehabilitation (VR) interventions that are effective to enhance return-to-work (RTW) for people on long-term sick leave (> 90 days) and to identify main elements of these interventions.
Six electronic databases were searched for peer-reviewed studies published up to February 2022. Each article was screened independently by two different reviewers. Thereafter, one author performed the data-extraction which was checked by another author. The EPHPP quality assessment tool was used to appraise the methodological quality of the studies.
11.837 articles were identified. 21 articles were included in the review, which described 25 interventions. Results showed that ten interventions were more effective than usual care on RTW. Two interventions had mixed results. The effective interventions varied widely in content, but were often more extensive than usual care. Common elements of the effective interventions were: coaching, counseling and motivational interviewing, planning return to work, placing the worker in work or teaching practical skills and advising at the workplace. However, these elements were also common in interventions that were not effective on RTW compared to usual care and can therefore not explain why certain interventions are effective and others are not.
The effective interventions included in this study were often quite extensive and aimed at multiple phases of the RTW-process of the worker. In the future, researchers need to describe the population and the content of the investigated interventions more elaborate to be able to better compare VR interventions and determine what elements make interventions effective.
本系统评价的目的是确定能有效提高长期病假(>90天)人员复工率的职业康复(VR)干预措施,并确定这些干预措施的主要要素。
检索了六个电子数据库,查找截至2022年2月发表的同行评审研究。每篇文章由两名不同的评审员独立筛选。此后,由一名作者进行数据提取,并由另一名作者进行核对。使用EPHPP质量评估工具评估研究的方法学质量。
共识别出11837篇文章。本评价纳入了21篇文章,描述了25种干预措施。结果表明,有10种干预措施在复工方面比常规护理更有效。两种干预措施的结果不一。有效的干预措施在内容上差异很大,但通常比常规护理更为广泛。有效干预措施的共同要素包括:指导、咨询和动机性访谈、规划复工、为员工安排工作或教授实用技能以及在工作场所提供建议。然而,与常规护理相比,这些要素在对复工无效的干预措施中也很常见,因此无法解释为什么某些干预措施有效而其他干预措施无效。
本研究中纳入的有效干预措施通常较为广泛,针对员工复工过程的多个阶段。未来,研究人员需要更详细地描述所研究干预措施的人群和内容,以便能够更好地比较VR干预措施,并确定哪些要素使干预措施有效。