Process Evaluation of a Problem-Solving Intervention with Workplace Involvement for Employees on Sickness Absence Due to Common Mental Disorders in Swedish Primary Health Care.

IF 2.7 3区医学 Q1 REHABILITATION

Journal of Occupational Rehabilitation Pub Date : 2026-08-01 DOI:10.1007/s10926-026-10441-4

Ida Karlsson, Lydia Kwak, Ute Bültmann, Gunnar Bergström, Iben Axén, Elisabeth Björk Brämberg

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Abstract

Purpose: This process evaluation examined the implementation of a problem-solving intervention with workplace involvement (PSI-WPI) for employees with common mental disorders, developed to reduce sickness absence. The aim was to understand factors influencing the "problem-solving in primary care" (PROSA) effect evaluation, which showed no significant difference in sickness absence days between PSI-WPI and care-as-usual (CAU).

Methods: PSI-WPI included a five-step process typically delivered over three sessions by primary care rehabilitation coordinators. Process outcomes assessed were reach, dose delivered, dose received, fidelity and dose response. Data came from questionnaires, medical records, and registry data. Kruskal-Wallis tests assessed associations between number of PSI-WPI sessions and sickness absence days. A post hoc analysis explored characteristics of employees receiving no, one or ≥ three PSI-WPI sessions.

Results: PSI-WPI coordinators reported slightly more face-to-face sessions and three-part meetings, whereas CAU coordinators reported more telephone sessions. Coordinator support was received by 85% of PSI-WPI participants compared to 43% of CAU; 41% PSI-WPI participants received ≥ three sessions. Employees receiving ≥ three sessions had significantly more sickness absence days during 18-months follow-up than those receiving none.

Conclusion: The intervention was largely delivered as intended and supported by sufficient training and resources. Dose-response findings suggest the intervention was primarily delivered to employees with more complex needs, highlighting the importance of accounting for preintervention sickness absence and targeting support. Future studies should strengthen implementation planning, refine theoretical assumptions, and ensure alignment between intervention design and participant needs, particularly when adapting return-to-work interventions from occupational health services to primary health care.

Trials registration number: The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.

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瑞典初级卫生保健中因常见精神障碍而缺勤的员工工作场所参与问题解决干预的过程评价。

目的：本过程评估检查了工作场所参与解决问题干预（PSI-WPI）对患有常见精神障碍的员工的实施情况，旨在减少病假。目的是了解影响“初级保健问题解决”（PROSA）效果评估的因素，结果显示PSI-WPI和照护照度（CAU）在缺勤天数上无显著差异。方法：PSI-WPI包括一个五步过程，通常由初级保健康复协调员在三个会议上交付。评估的过程结果包括到达量、交付剂量、接受剂量、保真度和剂量反应。数据来自问卷调查、医疗记录和注册数据。Kruskal-Wallis测试评估了PSI-WPI会话次数与病假天数之间的关系。事后分析探讨了不接受一次或≥三次PSI-WPI培训的员工的特征。结果：PSI-WPI协调员报告了更多的面对面会议和三部分会议，而CAU协调员报告了更多的电话会议。85%的PSI-WPI参与者得到了协调员的支持，而CAU的这一比例为43%；41%的PSI-WPI参与者接受了≥3次治疗。在18个月的随访中，接受≥3次治疗的员工的病假天数明显多于未接受治疗的员工。结论：干预在很大程度上是按计划进行的，并有足够的培训和资源支持。剂量-反应研究结果表明，干预措施主要针对有更复杂需求的员工，强调了考虑干预前病假和目标支持的重要性。未来的研究应加强实施规划，完善理论假设，并确保干预设计与参与者需求之间的一致性，特别是在将重返工作的干预措施从职业卫生服务调整到初级卫生保健时。试验注册号：该试验于2018年1月12日在ClinicalTrials.gov注册，标识符：NCT03346395。

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来源期刊

Journal of Occupational Rehabilitation Multiple-

CiteScore

5.80

自引率

12.10%

发文量

期刊介绍： The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law. A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.