David John Glasscock

Reduktion af stress og sygefravær blandt patienter med arbejdsrelaterede belastnings- og tilpasningsreaktioner henvist til Arbejdsmedicinsk klinik.

Publikation: Bog/antologi/afhandling/rapportRapportForskning

The literature contains many empirical studies of interventions aimed at reducing work-related stress. These include randomized controlled trials (RCT). In general it has been found that cognitive behavioural interventions are more effective than other forms of intervention. However, the research is plagued by a number of methodological limitations. The definition of study populations is often unclear and there is a lack of studies with patients that have a clinically documented need for treatment. There is also a lack of research that evaluates interventions aimed at both the individual patient and his or her place of work.
In the present study, patients referred by general practitioners to a department of occupational medicine for an evaluation of the role of work stress in the development of their symptoms were examined according to protocol. When it was assessed that symptoms reflected reactions to stress or adjustment disorders that were work related, patients were offered participation in the project, if inclusion and exclusion criteria were satisfied. Patients answered baseline questionnaires prior to initial examination. The questionnaire, which was used to measure treatment effects, was repeated again 4 and 10 months after inclusion. Treatment effects were assessed with validated scales: Perceived stress (PSS-10), mental health (GHQ-30), sleep quality (selected items from the BNSQ), and cognitive functioning (two subscales from the CFQ). There were also items concerning sick-leave. After inclusion, patients were randomly assigned to either an intervention group or a control group. Participants in the control group were subsequently only followed via questionnaires. The intervention contains both individual cognitive behavioural therapy, conducted by a psychologist, and the offer of participation by the same psychologist in a meeting with the workplace concerning changes in stressful work conditions.
Results showed that there was a significant effect of time in both groups. Ten months after baseline, both groups reported less perceived stress, fewer symptoms, improved sleep and cognitive functioning. Four months after baseline we found a significant treatment effect on two measures,
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perceived stress and mental health. The intervention group experienced less stress and fewer symptoms compared to the control group. There was also a non-significant trend in the same direction concerning sleep and distraction (a sub-scale of the CFQ). In short, the intervention group experienced a faster rate of recovery than the control group (PSS and GHQ), but in the period from 4 to 10 months after baseline, further improvement in the control group meant that the two groups were again comparable on all measures at 10-months follow-up. No between group differences were found concerning sick-leave duration. This was the case both when analyzing self-reported sick-leave data and follow-up data from the DREAM-register.
In conclusion, the evaluated intervention results in a faster reduction of perceived stress (PSS) and stress symptoms (GHQ), compared with a control group, amongst patients with work-related stress reactions and adjustment disorders referred to a department of occupational medicine. Six months after the end of the intervention, there are no longer differences between the groups
OriginalsprogDansk
UdgivelsesstedHerning
ForlagArbejdsmedicinsk Klinik, Regionshospitalet Herning
Antal sider25
StatusUdgivet - jun. 2014

    Forskningsområder

  • stress, arbejde, behandling

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