Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial

被引:48
作者
Geraedts, Anna S. [1 ,2 ,3 ,4 ]
Kleiboer, Annet M. [1 ,2 ,3 ,4 ]
Twisk, Jos [5 ,6 ]
Wiezer, Noortje M. [4 ,7 ]
van Mechelen, Willem [2 ,3 ,4 ,8 ]
Cuijpers, Pim [1 ,2 ,3 ,4 ]
机构
[1] Vrije Univ Amsterdam, Dept Clin Psychol, NL-1081 BT Amsterdam, Netherlands
[2] Vrije Univ Amsterdam, EMGO Inst Hlth & Care Res, Amsterdam, Netherlands
[3] VU Univ Med Ctr Amsterdam, Amsterdam, Netherlands
[4] TNO VU VUmc, Res Ctr Phys Act Work & Hlth, Amsterdam, Netherlands
[5] Vrije Univ Amsterdam Med Ctr, Dept Epidemiol & Biostat, Amsterdam, Netherlands
[6] Vrije Univ Amsterdam, Dept Hlth Sci, Sect Methodol & Appl Biostat, NL-1081 BT Amsterdam, Netherlands
[7] TNO, Hoofddorp, Netherlands
[8] Vrije Univ Amsterdam Med Ctr, Dept Publ & Occupat Hlth, Amsterdam, Netherlands
关键词
depression; employees; occupational intervention; self-help; prevention; burnout; Internet; COGNITIVE-BEHAVIORAL THERAPY; HEALTH-ORGANIZATION HEALTH; INTERNET-BASED TREATMENT; SICKNESS ABSENCE; MENTAL-DISORDERS; PSYCHOLOGICAL TREATMENTS; STRESS REDUCTION; HOSPITAL ANXIETY; PRIMARY-CARE; CES-D;
D O I
10.2196/jmir.3539
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Depressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving. Objective: In this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy@Work, for employees with depressive symptoms who were not on sick leave. Methods: A two-arm randomized controlled trial comparing a worker-directed, Web-based, guided self-help intervention to care as usual (CAU) was carried out. We recruited employees from 6 companies via the company's Intranet and by putting up posters. The inclusion criteria were elevated depressive symptoms as measured by a score >= 16 on the Center for Epidemiologic Studies Depression scale (CES-D) and not being on sick leave. The intervention contained 6 lessons and consisted of problem-solving treatment and cognitive therapy. Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), burnout (Maslach Burnout Inventory, MBI), work performance (Health and Work Performance Questionnaire, HPQ), duration of absenteeism, and anxiety (Hospital Anxiety and Depression Scale, HADS; secondary outcomes), were completed at baseline, posttreatment, and at 6-, and 12-month follow-up. Several subgroup and per-protocol analyses were performed. Results: A total of 231 employees were randomized to either the intervention group (n=116) or to CAU (n=115). Completion of assessments varied between 54%-74%. Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time. However, there were no differences between the 2 groups (adjusted regression coefficient=0.46, 95% CI -2.11 to 3.03, P=.72; Cohen's d=0.05). Differences between groups were also not significant for the secondary outcomes. No subgroups were identified to show differences between the groups, nor did we find a between-group effect in the per-protocol analyses. Conclusions: This study showed that a worker-directed, Web-based, guided self-help intervention was not more effective than CAU in reducing depressive symptoms among employees with depressive symptoms who were not on sick leave over the period of 1 year. An intervention for this specific target group might not be necessary because the recovery in the CAU group was comparable to the intervention group and sustained over a 12-month period.
引用
收藏
页码:11 / 25
页数:15
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