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Early identification in primary health care of people at risk for sick leave due to work-related stress - Study protocol of a randomized controlled trial (RCT)

Journal article
Authors Kristina Holmgren
Christine Sandheimer
Ann Charlotte Mårdby
Maria E H Larsson
Ute Bültmann
Dominique Hange
Gunnel Hensing
Published in BMC Public Health
Volume 16
Issue 1
Publication year 2016
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Medicine, School of Public Health and Community Medicine
Language en
Keywords Intervention, Organizational climate, Psychosocial work factors, Work commitment, Work Stress Questionnaire (WSQ)
Subject categories Occupational Therapy, Public Health, Global Health, Social Medicine and Epidemiology


© 2016 The Author(s).Background: Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. Method/design: The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Discussion: Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. Trial registration: Identifier: NCT02480855. Registered 20 May 2015

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