Gunnarsson A Birgitta, Wagman Petra, Hörberg Ulrica, Holmgren Kristina, Holmberg Sara
Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Research and Development, Region Kronoberg, Växjö, Sweden.
Scand J Prim Health Care. 2025 Mar;43(1):194-204. doi: 10.1080/02813432.2024.2421588. Epub 2024 Nov 6.
Health-promotion approaches to address stress-related exhaustion disorders, reduce personal suffering, improve coping and participation in everyday life are needed in primary care. The aim of this study was to investigate self-reported health and well-being before and after an intervention focusing on well-being with photo-supported conversations (BeWell).
Eighty-one patients (69 women), 20-67 years old, with exhaustion disorders were recruited at Swedish primary health care centres (PHCC) to a controlled clinical study. The intervention group ( = 40) were offered BeWell by therapists in addition to care as usual. Controls ( = 41) received only care as usual. The primary outcome, self-rated symptoms of exhaustion (Karolinska exhaustion disorder scale, KEDS), and secondary outcomes, anxiety and depression, sense of coherence, quality of life, occupational balance, and work ability, were assessed by validated questionnaires. Non-parametric statistical analyses were used to compare data collected directly after the treatment period with baseline measures.
Demographics and self-rated baseline measures of health and well-being were comparable between the groups, apart from sick leave being more common in the intervention group. Participants in the intervention group reduced their level of exhaustion more than the control group (median difference on KEDS -9.0 vs -4.0, = .035). However, the size of the KEDS reduction was related to baseline KEDS and, not independently associated with group assignment. Both groups improved regarding secondary outcome measures.
Stress-related symptoms decreased considerably over the treatment period for both groups. The potential benefit of the BeWell, which was intended to facilitate recovery, needs to be further evaluated.
初级保健需要采取促进健康的方法来应对与压力相关的疲惫障碍,减轻个人痛苦,改善应对能力并提高日常生活参与度。本研究的目的是调查在一项以照片辅助对话促进幸福感(BeWell)为重点的干预前后自我报告的健康状况和幸福感。
在瑞典初级卫生保健中心(PHCC)招募了81名年龄在20至67岁之间患有疲惫障碍的患者,进行一项对照临床研究。干预组(n = 40)除接受常规护理外,还由治疗师提供BeWell干预。对照组(n = 41)仅接受常规护理。通过经过验证的问卷评估主要结局指标——自我评定的疲惫症状(卡罗林斯卡疲惫障碍量表,KEDS),以及次要结局指标——焦虑、抑郁、连贯感、生活质量、职业平衡和工作能力。采用非参数统计分析方法,将治疗期结束后直接收集的数据与基线测量数据进行比较。
除病假在干预组中更为常见外,两组之间的人口统计学特征以及自我评定的健康和幸福感基线测量结果具有可比性。干预组参与者的疲惫程度降低幅度大于对照组(KEDS中位数差异为-9.0对-4.0,P = 0.035)。然而,KEDS降低的幅度与基线KEDS有关,并非独立于分组情况。两组在次要结局指标方面均有所改善。
两组在治疗期间与压力相关的症状均有显著下降。旨在促进康复的BeWell干预的潜在益处需要进一步评估。