目的:评估以工作为导向的干预措施对因常见精神障碍而休病假的人重返工作岗位的影响的证据(即,轻度至中度抑郁症,焦虑,调整障碍和对严重压力的反应)。
方法:系统评价是根据先验开发和注册的方案(ProsperoCRD42021235586)进行的。证据的确定性由两名独立审查员使用建议分级进行评估,评估,开发和评估。
结果:我们回顾了2015年至2021年之间发布的14,794条记录。其中,在11篇文章中发表的8篇RCT被纳入分析.
方法:工作年龄的成年人(18至64岁),由于轻度至中度抑郁而请病假,焦虑,调节障碍或对严重压力的反应。
方法:以工作为导向的干预措施。
方法:没有比较器,标准护理,或其他措施。
结果:返回工作,请病假的天数,收入。总的来说,与标准治疗或无干预相比,以工作为中心的CBT和以工作为中心的团队支持对RTW的影响导致了更多或更快的重返工作岗位(证据确定性低).与标准护理相比,单独放置和支持的效果在RTW中没有差异(证据的确定性非常低)。
结论:涉及工作场所的干预可以增加RTW的概率。纳入研究需要改进的地方,例如方法论问题,正在讨论。Further,提出了在进行大规模试验时提高方法学严谨性的建议.
OBJECTIVE: To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress).
METHODS: The systematic
review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations.
RESULTS: We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis.
METHODS: Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress.
METHODS: Work-directed interventions.
METHODS: No comparator, Standard care, or other measures.
RESULTS: return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence).
CONCLUSIONS: Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials.