A randomized clinical trial of a telephone depression intervention to reduce employee presenteeism and absenteeism.
A randomized clinical trial of a telephone depression intervention to reduce employee presenteeism and absenteeism.
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DOI：
10.1176/appi.ps.201400350
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Azocar F
中科院分区：
文献类型：
--
作者：
Lerner D;Adler DA;Rogers WH;Chang H;Greenhill A;Cymerman E;Azocar F
这项研究测试了一项干预措施，旨在改善患有抑郁症和工作受限的中老年人的工作功能。一项随机临床试验将431名符合条件的就业成年人（年龄≥45岁）初始样本分配到以工作为中心的干预（WFI）或常规护理组。纳入标准为患者健康问卷-9 （PHQ-9）测量的抑郁症和工作限制问卷（WLQ）上生产力损失得分≥5%表明的工作限制。研究地点包括19家雇主和5家相关组织。电话咨询提供了三种综合模式：护理协调、认知行为治疗策略发展、工作指导和修改。有效性（从干预前到干预后4个月生产力损失得分的变化）用混杂因素调整的混合模型进行测试。次要结果包括WLQ工作表现量表的变化、自我报告的缺勤和抑郁。在1227名符合条件的员工（占筛选人数的7%）中，431人（35%）参加了研究，380人完成了研究（12%的流失率）。WFI组的工作效率损失改善了44%，而常规护理组改善了13%（变化差异，p< 0.001）。WFI组在四个WLQ量表上的得分提高了44%至47%，显著优于常规护理（每个量表的p< 0.001）。WFI组缺勤天数减少53%，常规护理组减少13%（变化差异，p< 0.001）。WFI组平均PHQ-9抑郁症状严重程度评分下降51%，常规护理组下降26%（变化差异，p< 0.001）。在4个月的随访中，WFI比常规护理更有效。鉴于越来越多的努力提供更多的以病人为中心，以价值为基础的护理，世界卫生基金可能是一个重要的资源。
The study tested an intervention aimed at improving work functioning among middle-aged and older adults with depression and work limitations. A randomized clinical trial allocated an initial sample of 431 eligible employed adults (age ≥45) to a work-focused intervention (WFI) or usual care. Inclusion criteria were depression as measured by the Patient Health Questionnaire–9 (PHQ-9) and at-work limitations indicated by a productivity loss score ≥5% on the Work Limitations Questionnaire (WLQ). Study sites included 19 employers and five related organizations. Telephone-based counseling provided three integrated modalities: care coordination, cognitive-behavioral therapy strategy development, and work coaching and modification. Effectiveness (change in productivity loss scores from preintervention to four months postintervention) was tested with mixed models adjusted for confounders. Secondary outcomes included change in WLQ work performance scales, self-reported absences, and depression. Of 1,227 eligible employees (7% of screened), 431 (35%) enrolled and 380 completed the study (12% attrition). At-work productivity loss improved 44% in the WFI group versus 13% in usual care (difference in change, p<.001). WFI group scores on the four WLQ scales improved 44% to 47%, significantly better than in usual care (p<.001 for each scale). Absence days declined by 53% in the WFI group versus 13% in usual care (difference in change, p<.001). Mean PHQ-9 depression symptom severity scores declined 51% for WFI versus 26% for usual care (difference in change, p<.001). The WFI was more effective than usual care at four-month follow-up. Given increasing efforts to provide more patient-centered, value-based care, the WFI could be an important resource.
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DOI：
10.1097/jom.0b013e31824409d8
发表时间：
2012-02
影响因子：
3.2
作者：
Lerner D;Adler D;Hermann RC;Chang H;Ludman EJ;Greenhill A;Perch K;McPeck WC;Rogers WH
通讯作者：
Rogers WH
影响因子：
120.7
作者：
Mohr, David C.;Ho, Joyce;Siddique, Juned
通讯作者：
Siddique, Juned
影响因子：
0.5
作者：
Kroenke, K;Spitzer, RL
通讯作者：
Spitzer, RL
影响因子：
1.5
作者：
Lane, Peter
通讯作者：
Lane, Peter
影响因子：
3
作者：
Lerner, D;Amick, BC;Cynn, D
通讯作者：
Cynn, D