Berglund Erik, Anderzén Ingrid, Helgesson Magnus, Lytsy Per, Andersén Åsa
Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22, Sweden.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden.
BMC Public Health. 2024 Dec 21;24(1):3558. doi: 10.1186/s12889-024-21116-1.
The return-to-work (RTW) process for individuals on long-term sick leave can be complex. Vocational rehabilitation may facilitate RTW; however, many intervention studies often have relatively short follow-up periods. The purpose of this study was to assess long-term work participation 2-7 years after the initiation of a three-armed randomized controlled trial aimed at RTW for individuals on long-term sick leave because of mental disorders and/or chronic pain.
This study followed 220 participants out of 402 (response rate 55%, 205 female) who had previously participated in a randomized controlled trial. They were allocated to one of three groups: multidisciplinary team assessment and individualized treatment (MDT), acceptance and commitment therapy (ACT) or a control group. The participants were followed up at two, three, four, five, six, and seven years after inclusion. The outcome, work participation, was assessed using registry data and defined as having the main source of annual income from paid work during the follow-up years.
Participants in the MDT intervention group were, to a larger extent, in paid work during follow-up in years four (9.0% points), five (2.5% points), six (7.6% points), and seven (4.1% points) after inclusion, compared to the control group. Participants in the ACT intervention group were, to a larger extent, in paid work during follow-up in years four (14.8% points), six (17.6% points), and seven (13.9% points) after inclusion, compared to the control group.
This study, primarily involving female individuals on long-term sick leave, suggests that both MDT and ACT interventions can improve long-term work participation. The results also indicate some time-lag effect of the interventions.
The original randomized study was registered at the Clinicaltrials.gov Register Platform (ID NCT03343457); registered on November 15, 2017 (retrospectively registered).
长期病假人员的重返工作岗位（RTW）过程可能很复杂。职业康复可能有助于RTW；然而，许多干预研究的随访期往往相对较短。本研究的目的是评估一项针对因精神障碍和/或慢性疼痛而长期病假的人员进行RTW的三臂随机对照试验启动2至7年后的长期工作参与情况。
本研究跟踪了402名曾参与随机对照试验的参与者中的220名（回复率55%，女性205名）。他们被分配到三个组之一：多学科团队评估和个体化治疗（MDT）、接受与承诺疗法（ACT）或对照组。在纳入后的两年、三年、四年、五年、六年和七年对参与者进行随访。使用登记数据评估工作参与这一结果，并将其定义为在随访年份中主要年收入来源为有偿工作。
与对照组相比，MDT干预组的参与者在纳入后的第四年（9.0个百分点）、第五年（2.5个百分点）、第六年（7.6个百分点）和第七年（4.1个百分点）的随访期间，更多地从事有偿工作。与对照组相比，ACT干预组的参与者在纳入后的第四年（14.8个百分点）、第六年（17.6个百分点）和第七年（13.9个百分点）的随访期间，更多地从事有偿工作。
本研究主要涉及长期病假的女性个体，表明MDT和ACT干预均可改善长期工作参与情况。结果还表明了干预的一些时间滞后效应。
原始随机研究在Clinicaltrials.gov注册平台注册（ID NCT03343457）；于2017年11月15日注册（追溯注册）。
