A neuropsychologically based employment intervention for women with multiple sclerosis: A quasi-randomized controlled trial.
A neuropsychologically based employment intervention for women with multiple sclerosis: A quasi-randomized controlled trial.
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针对多发性硬化症女性的基于神经心理学的就业干预：一项准随机对照试验。
DOI：
10.1017/s1355617722000327
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Foley,FrederickW
中科院分区：
文献类型：
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作者：
Stimmel,MarninaB;Cohen,JennaN;Seng,ElizabethK;Shagalow,Shaina;Foley,FrederickW
失业在多发性硬化症（MS）中很常见，经常与抑郁，疲劳和认知功能障碍有关。确定这些可改变的风险因素，并为“高危”妇女提供基于神经心理学的干预措施，可能会改善就业结果。我们的研究旨在调查不同水平的治疗和随访的神经心理学为基础的干预的效用，并评估治疗和就业groups.MethodIn这个纵向，准随机对照试验，符合筛查标准的MS就业妇女被认为是工作不稳定的“风险”，并随机接受两种神经心理学测试干预措施之一（标准护理组接收测试和结果和建议的电话反馈;实验组接收测试和亲自反馈，随后护理协调员打电话给护士以帮助协调建议完成）。不符合标准的参与者被认为是“低风险”，只随时间推移。结果56名妇女在治疗组（标准护理= 23;实验= 33）和63名妇女在后续组进行了分析，在1年。标准治疗组（17.4%）和实验组（21.2%）的就业率下降率相似（OR = 0.782，95%CI 0.200 -3.057）。然而，实验组完成了更多的治疗建议，t（53）=-3.237，p = 0.002。就业率下降之间的“低风险”（17.5%）和“风险”组（19.6%），（OR = 0.721，95%CI 0.285 -1.826）。结论就业结果是相似的，在1年之间的治疗组接受不同水平的神经心理学为基础的干预，但治疗依从性显着改善实验组。治疗组也有类似的就业结果相比，“低风险”，没有干预组，这表明从事任何神经心理干预可能会影响工作稳定性。
ObjectiveJob loss is common in multiple sclerosis (MS) and frequently associated with depression, fatigue, and cognitive dysfunction. Identifying these modifiable risk factors and providing “at-risk” women with a neuropsychologically-based intervention may improve employment outcomes. Our study seeks to investigate the utility of a neuropsychologically-based intervention with varying levels of treatment and follow-up, and evaluate treatment and employment outcomes among groups.MethodIn this longitudinal, quasi-randomized controlled trial, employed women with MS meeting criteria on screening measures were considered “at-risk” for job instability and randomized to one of two neuropsychological testing interventions (standard-care group received testing and phone feedback of results and recommendations; experimental group received testing and in-person feedback with subsequent care-coordinator calls from a nurse to help coordinate recommendation completion). Participants who did not meet criteria were considered “low-risk” and only followed over time.Results56 women in the treatment groups (standard-care = 23; experimental = 33) and 63 women in the follow-only group were analyzed at 1 year. Rates of decreased employment were similar between standard-care (17.4%) and experimental (21.2%) groups (OR = .782, 95% CI .200–3.057). However, the experimental group completed significantly more treatment recommendations, t(53) = −3.237, p = .002. Rates of decreased employment were also similar between the “low-risk” (17.5%) and “at-risk” groups (19.6%), (OR = .721, 95% CI .285–1.826).ConclusionEmployment outcomes were similar at 1 year between treatment groups receiving differing levels of a neuropsychologically-based intervention, however treatment adherence significantly improved in the experimental group. Treatment groups also had similar employment outcomes as compared to a “low-risk,” no intervention group, suggesting that engaging in either neuropsychological intervention may have impacted job stability.