Effect on work ability and health-related quality of life following an interactive patient education aiming to increase sense of coherence and health literacy - the LEARN-to-COPE cluster randomized trial.
Märit Löfgren, Lena Nordeman, Nashmil Ariai, Cecilia Björkelund, Gun Rembeck, Irene Svenningsson, Karin Törnbom, Dominique Hange
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引用次数: 0
Abstract
Objective: To evaluate the effect of the LEARN-to-COPE intervention on sick leave, symptoms, and coping.
Design and setting: Cluster-randomized controlled trial including 40 primary care centers (PCCs) in Region Västra Götaland, Sweden. Randomization at the PCC level. Effect of the intervention was compared to Care-as-Usual (CAU). Follow-up was conducted using registry sick leave data, validated questionnaires, and patient-reported data.
Subjects: Primary healthcare patients with recurrent or long-term sick leave or health-related unemployment from included PCCs (n = 243).
Intervention: Patient education was conducted via interactive study groups, which convened for half a day every week over eight consecutive weeks. Implementation was centralized in close collaboration with educational associations. The purpose of the intervention was to strengthen participants' sense of coherence and health literacy, with the aim of enhancing their work ability and health.
Main outcome measures: The primary outcome measure was change in scheduled activity, derived from data on sick leave (obtained from the Swedish Social Insurance Agency) and participation in work-oriented rehabilitation (self-reported occupational status). Secondary outcomes (symptoms and coping) were measured with validated questionnaires at baseline and follow-ups after 3, 6, and 12 months.
Results: Included participants suffered from anxiety, depression, exhaustion, and pain and had poor health-related quality of life. After 12 months, there was no significant change in scheduled activity, sense of coherence, symptoms, or health-related quality of life, but a statistically significant positive change in health literacy and self-efficacy was found in the intervention group.
Conclusion: Considering participants' pronounced burden of symptoms, the focus should be on improving the sick leave process as a whole, rather than seeking quick remedies for patients' complex health issues. Centralized implementation of the intervention was a promising concept that deserves further evaluation.
期刊介绍：
Scandinavian Journal of Primary Health Care is an international online open access journal publishing articles with relevance to general practice and primary health care. Focusing on the continuous professional development in family medicine the journal addresses clinical, epidemiological and humanistic topics in relation to the daily clinical practice.
Scandinavian Journal of Primary Health Care is owned by the members of the National Colleges of General Practice in the five Nordic countries through the Nordic Federation of General Practice (NFGP). The journal includes original research on topics related to general practice and family medicine, and publishes both quantitative and qualitative original research, editorials, discussion and analysis papers and reviews to facilitate continuing professional development in family medicine. The journal''s topics range broadly and include:
• Clinical family medicine
• Epidemiological research
• Qualitative research
• Health services research.
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