3 research outputs found
Occupational rehabilitation programs for musculoskeletal pain and common mental health disorders: Study protocol of a randomized controlled trial
Background: Long-term sick leave has considerably negative impact on the individual and society. Hence, the
need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational
rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous
evaluation has been performed. The described randomized controlled trial aims primarily to compare two
structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative
cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual
care reference group.
Methods/design: The study is designed as a randomized controlled trial with parallel groups. The Social Security
Office performs monthly extractions of sick listed individuals aged 18â60 years, on sick leave 2â12 months, with sick
leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized
twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter
âuntouchedâ control group will be monitored for future sick leave in the National Social Security Register, and
2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which
invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program
consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two
weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental
training, physical training and work-related problem solving. The primary outcome is number of sick leave days.
Secondary outcomes include time until full sustainable return to work, health related quality of life, health related
behavior, functional status, somatic and mental health, and perceptions of work. In addition, health economic
evaluation will be performed, and the implementation of the interventions, expectations and experiences of users
and service providers will be investigated with different qualitative methods
Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - A study protocol
Background
Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed personsâ, rehabilitation therapistsâ and employersâ perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation.
Methods
Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapistsâ experiences with working towards return to work within an ACT-approach and stakeholdersâ experiences with the workplace intervention. A mixed methods study will combine quantitative and qualitative findings on the participantsâ expectations and motivation for return to work.
Discussion
The outline of this comprehensive study could represent an important addition to the standard designs of return to work evaluation. The mixed methods design, with qualitative approaches as well as a rigorous randomized controlled trial, might prove useful to shed light on contextual factors.publishedVersionŠ The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated