Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
BMC Public Health. 2024 Aug 22;24(1):2288. doi: 10.1186/s12889-024-19773-3.
Common mental health problems, such as stress, anxiety and depression, are highly prevalent among workers and often lead to long-term absenteeism and work disability. Effective elements found in previous researched interventions were to explicitly focus on return to work (RTW) and not solely on symptom reduction, to take into account the employees' cognition towards RTW and to include the workplace environment. Based on these elements, a stepped-care approach was developed. The aim of this paper is to present the study design of a randomized controlled trial (RESTART), evaluating the effectiveness of the stepped-care approach on lasting RTW and the implementation process.
RESTART is a randomized controlled trial with a 2 × 2 factorial design and a follow-up of one year. Employees eligible for this study are those who reported sick within 2 to 8 weeks with psychological distress based on a distress screener. Participants will be randomized to a group receiving a tailored e-Health app or usual care, as well as randomized to a group receiving a Participatory Approach (PA; conversational method) in the workplace or usual care. The PA will however only be provided in case of persistent sickness absence at 8 weeks. Measurements take place at baseline, after the e-Health intervention period (3 months), and after the PA intervention period (6 months) and 12 months. Primary outcome is lasting RTW, defined as full RTW in previous or equal work for at least four consecutive weeks. Secondary outcomes are (the severity of) stress-related symptoms, total number of sickness absence days, self-efficacy for RTW and self-reported health. A process evaluation including a realist evaluation will also be conducted.
Early intervention that focuses on RTW, the cognition towards RTW despite symptoms and involves the workplace environment, plays a crucial role in managing sickness absence among employees with psychological distress. If effective, the stepped-care approach is relevant for employees, employers and society as a whole.
ISRCTN: 90663076. Registered on 5 October 2023.
常见的心理健康问题，如压力、焦虑和抑郁，在工作人群中普遍存在，且常导致长期缺勤和工作残疾。先前研究干预中发现的有效元素是明确关注重返工作岗位（RTW），而不仅仅是减轻症状，要考虑员工对 RTW 的认知，并将工作场所环境纳入其中。基于这些元素，开发了一种阶梯式护理方法。本文旨在介绍一项随机对照试验（RESTART）的研究设计，评估阶梯式护理方法对持久 RTW 的有效性以及实施过程。
RESTART 是一项随机对照试验，采用 2×2 析因设计，随访时间为 1 年。有资格参加这项研究的员工是那些在心理困扰的困扰筛查中报告在 2 至 8 周内因心理困扰而请病假的员工。参与者将被随机分配到接受定制电子健康应用程序或常规护理的组，以及随机分配到在工作场所接受参与式方法（PA；对话方法）或常规护理的组。只有在 8 周时持续病假的情况下才会提供 PA。测量在基线时、电子健康干预期（3 个月）后以及 PA 干预期（6 个月）和 12 个月后进行。主要结局是持久 RTW，定义为至少连续四周完全 RTW 或从事同等工作。次要结局是（压力相关症状的）严重程度、总病假天数、RTW 自我效能和自我报告的健康状况。还将进行包括现实主义评估的过程评估。
早期干预侧重于 RTW，尽管有症状但关注 RTW 的认知，并涉及工作场所环境，这在管理有心理困扰的员工的病假方面起着至关重要的作用。如果有效，阶梯式护理方法对员工、雇主和整个社会都具有重要意义。
ISRCTN：90663076。于 2023 年 10 月 5 日注册。
