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Problem-based self-care groups versus cognitive behavioural therapy for persons on sick leave due to common mental disorders: A randomised controlled study
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.ORCID iD: 0002-3309-2816
Kronoberg City Council, Unit for Research and Development, Växjö, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.ORCID iD: 0000-0003-3594-4805
Kalmar City Hospital, Kalmar, Sweden.
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2015 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 1, p. 127-140Article in journal (Refereed) Published
Abstract [en]

Purpose To evaluate the interventional capacity of problem based method groups (PBM) regarding mental health and work ability compared to cognitive behavioural therapy (CBT) for persons on sick leave due to common mental disorders. Methods In a randomised controlled design the experimental group received PBM and the control group received CBT. Outcomes were measured by the Hospital Anxiety and Depression Scale (HADS), the Stress and Crisis Inventory 93 (SCI-93) and the Dialogue about Working Ability instrument (DOA). Results Twenty-two participants in the PBM group and 28 in the CBT group completed intervention. Both groups showed significant lower scores on the two HADS subscales. Regarding stress the PBM group showed significant decrease in one (out of three) subscales of SCI-93. The CBT group showed significant decrease on all subscales of SCI-93. Regarding work ability the PBM group showed significant higher scores on one of five subscales of DOA. The CBT group showed significant higher scores on four of five subscales of DOA. Between groups there were significant differences to the favour of CBT on one of two subscales of HADS, all three subscales of SCI-93 and on two of the five subscales of DOA. Conclusion PBM seem to be able to reduce anxiety- and depression symptoms. CBT showed to be superior to PBM in reducing symptoms in all aspects of mental health, except for anxiety, in which they seem equally effective. Regarding work ability CBT showed to be superior, with significant effect on more aspects compared to PBM.

Place, publisher, year, edition, pages
2015. Vol. 25, no 1, p. 127-140
Keywords [en]
Anxiety, Depression, Intervention, Primary health care, Return to work, Sickness absence, Stress
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-28210DOI: 10.1007/s10926-014-9530-9ISI: 000349971100013PubMedID: 24972663Scopus ID: 2-s2.0-84939873309OAI: oai:DiVA.org:hj-28210DiVA, id: diva2:862597
Funder
Vårdal FoundationMedical Research Council of Southeast Sweden (FORSS)Available from: 2015-10-23 Created: 2015-10-23 Last updated: 2018-02-28Bibliographically approved
In thesis
1. On the nature of work ability
Open this publication in new window or tab >>On the nature of work ability
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

‘Work ability’ is a multidimensional concept with importance for both society and the individual. The overall aim of this thesis was to illuminate work ability from the perspective of individuals (Studies I, III), rehabilitation (Study II) and employers (Study IV). In Study I five focus-group interviews were conducted with a total of 16 former unemployed sickness absentee participants. The interviews focused on their experiences of the environmental impact on return to work. The participants expressed a changed self-image and life rhythm. A need for reorientation and support from professionals was stressed. Experiences of being stuck in a ‘time quarantine’, i.e. a long and destructive wait for support, were also revealed. Study II was a randomised controlled study evaluating the interventional capacity of problem-based method (PBM) groups regarding anxiety, depression and stress and work ability compared to cognitive behavioural therapy (CBT) as a method within the Rehabilitation Guarantee. Effects were measured with psychometric instruments. The participants, 22 in the PBM group and 28 in the CBT group, were persons on sick leave because of common mental disorders. Within-group analysis showed significant lower degree of symptoms regarding anxiety and depression for both interventions. Between-group analysis showed significant lower degree of symptoms for CBT regarding anxiety, depression and stress. Within-group analysis of work ability showed significant improvement in one (out of five) subscales for the PBM group and in four for the CBT group. No significant between-group differences were found regarding work ability. In Study III, 16 participants were interviewed after completed interventions in Study II, eight from each intervention group. The interviews focused on their experiences from the interventions and the impact on their ability to work and perform other everyday activities. The interventions were experienced as having a positive impact on their ability to work and perform other everyday activities in a more sustainable way. Reflecting on behaviour and achieving limiting strategies were perceived as helpful in both interventions, although varying abilities to incorporate strategies were described. The findings support the use of active coping-developing interventions rather than passive treatments. Study IV included interviews with 12 employers and investigated their conceptions of ‘work ability’. In the results three domains were identified: ‘employees’ contributions to work ability’, ‘employers’ contributions to work ability’ and ‘circumstances with limited work ability’. Work ability was regarded as a tool in production and its output, production, was the main issue. The employees’ commitment could bridge other shortcomings. In summary, in the work rehabilitation process, different perspectives on work ability need to be considered in order to improve not only individual performance but also rehabilitation interventions, work-places and everyday circumstances. Clearly pronounced perspectives can contribute to better illustrating the dynamic within the relational and multifaceted concept of ‘work ability’. The ability to work can thus be enhanced through improving individual abilities, discovered through reorientation and created through support and adaptation.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2014. p. 120
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 48
Keywords
context, disability, occupational therapy, participation, work demand
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-23610 (URN)978-91-85835-47-8 (ISBN)
Public defence
2014-04-11, Forum Humanum, 13:00 (English)
Opponent
Supervisors
Available from: 2014-03-14 Created: 2014-03-14 Last updated: 2018-02-28Bibliographically approved

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Jansson, IngerBjörklund, AnitaPerseius, Kent-Inge

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