Abstract：
OBJECTIVE: This study assessed the effectiveness of Individual Placement and Support (IPS), Participatory Workplace Intervention (PWI), and IPS + PWI on work participation and health of people with work disabilities.
METHODS: A randomised controlled 2 × 2 factorial trial with 120 clients and an 18-month follow-up was performed. Differences between IPS and no-IPS and between PWI and no-PWI were assessed using log-rank tests and Cox proportional hazards models.
RESULTS: In the IPS group, restricted mean survival time (RMST) for sustainable paid employment was 352 days, compared to 394 in the no-IPS group (HR = 1.47, 95% CI = 0.81-2.63). In the PWI group the RMST was 378 days, compared to 367 in the no-PWI group (HR = 0.89, 95% CI = 0.48-1.64). For the secondary outcome \'starting any paid employment, a trial placement, or education\' RMST was significantly lower for the IPS group (222 days) than for the no-IPS group (335 days; HR = 1.85, 95% CI = 1.01-3.42). Mental health was significantly lower (worse) in the PWI group (difference -4.07, 95% CI = -7.93 to -0.22) than in the no-PWI group. For all other secondary outcomes, no statistically significant differences were found.
CONCLUSIONS: No statistically significant differences were observed in the duration until starting sustainable employment between IPS and no-IPS, and between PWI and no-PWI. The duration until starting any paid employment, a trial placement, or education was shorter in the IPS group than in the no-IPS group, but further research should explore whether this also increases sustainable employment in the longer term.
METHODS: A randomised controlled 2 × 2 factorial trial with 120 clients and an 18-month follow-up was performed. Differences between IPS and no-IPS and between PWI and no-PWI were assessed using log-rank tests and Cox proportional hazards models.
RESULTS: In the IPS group, restricted mean survival time (RMST) for sustainable paid employment was 352 days, compared to 394 in the no-IPS group (HR = 1.47, 95% CI = 0.81-2.63). In the PWI group the RMST was 378 days, compared to 367 in the no-PWI group (HR = 0.89, 95% CI = 0.48-1.64). For the secondary outcome \'starting any paid employment, a trial placement, or education\' RMST was significantly lower for the IPS group (222 days) than for the no-IPS group (335 days; HR = 1.85, 95% CI = 1.01-3.42). Mental health was significantly lower (worse) in the PWI group (difference -4.07, 95% CI = -7.93 to -0.22) than in the no-PWI group. For all other secondary outcomes, no statistically significant differences were found.
CONCLUSIONS: No statistically significant differences were observed in the duration until starting sustainable employment between IPS and no-IPS, and between PWI and no-PWI. The duration until starting any paid employment, a trial placement, or education was shorter in the IPS group than in the no-IPS group, but further research should explore whether this also increases sustainable employment in the longer term.
摘要：
目的：本研究评估了个人安置和支持（IPS）的有效性，参与式工作场所干预(PWI)和IPS+PWI关于工作残疾人的工作参与和健康。
方法：进行了一项随机对照2×2因子试验，对120名患者进行了18个月的随访。使用对数秩检验和Cox比例风险模型评估了IPS与no-IPS之间以及PWI与no-PWI之间的差异。
结果：在IPS组中，可持续有偿就业的限制平均生存时间(RMST)为352天，与无IPS组的394相比（HR=1.47，95％CI=0.81-2.63）。在PWI组中，RMST为378天，与无PWI组的367相比（HR=0.89，95％CI=0.48-1.64）。对于次要结果\'开始任何有偿工作，试用位置，IPS组(222天)的RMST显著低于非IPS组(335天;HR=1.85,95%CI=1.01-3.42)。PWI组的心理健康水平明显低于（差）（差异-4.07，95％CI=-7.93至-0.22）。对于所有其他次要结果，差异无统计学意义。
结论：在IPS和no-IPS开始可持续就业之前，未观察到有统计学意义的差异，在PWI和非PWI之间。开始任何有偿工作之前的持续时间，试用位置，IPS组比无IPS组短，但是进一步的研究应该探索这是否也增加了长期的可持续就业。
方法：进行了一项随机对照2×2因子试验，对120名患者进行了18个月的随访。使用对数秩检验和Cox比例风险模型评估了IPS与no-IPS之间以及PWI与no-PWI之间的差异。
结果：在IPS组中，可持续有偿就业的限制平均生存时间(RMST)为352天，与无IPS组的394相比（HR=1.47，95％CI=0.81-2.63）。在PWI组中，RMST为378天，与无PWI组的367相比（HR=0.89，95％CI=0.48-1.64）。对于次要结果\'开始任何有偿工作，试用位置，IPS组(222天)的RMST显著低于非IPS组(335天;HR=1.85,95%CI=1.01-3.42)。PWI组的心理健康水平明显低于（差）（差异-4.07，95％CI=-7.93至-0.22）。对于所有其他次要结果，差异无统计学意义。
结论：在IPS和no-IPS开始可持续就业之前，未观察到有统计学意义的差异，在PWI和非PWI之间。开始任何有偿工作之前的持续时间，试用位置，IPS组比无IPS组短，但是进一步的研究应该探索这是否也增加了长期的可持续就业。
