BackgroundMental well-being is an important, yet understudied, area of research, partly due to lack of appropriate population-based measures. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) was developed to meet the needs for such a measure. This article assesses the psychometric properties of the Norwegian version of the WEMWBS, and its short-version (SWEMWBS) among a sample of primary health care patients who participated in the evaluation of Prompt Mental Health Care (PMHC), a novel Norwegian mental health care program aimed to increase access to treatment for anxiety and depression.MethodsForward and back-translations were conducted, and 1168 patients filled out an electronic survey including the WEMWBS, and other mental health scales. The original dataset was randomly divided into a training sample (≈70%) and a validation sample (≈30%). Parallel analysis and confirmatory factor analysis were carried out to assess construct validity and precision. The final models were cross-validated in the validation sample by specifying a model with fixed parameters based on the estimates from the trainings set. Criterion validity and measurement invariance of the (S)WEMWBS were examined as well.ResultsSupport was found for the single factor hypothesis in both scales, but similar to previous studies, only after a number of residuals were allowed to correlate (WEMWBS: CFI = 0.99; RMSEA = 0.06, SWEMWBS: CFI = .99; RMSEA = 0.06). Further analyses showed that the correlated residuals did not alter the meaning of the underlying construct and did not substantially affect the associations with other variables. Precision was high for both versions of the WEMWBS (>.80), and scalar measurement invariance was obtained for gender and age group. The final measurement models displayed adequate fit statistics in the validation sample as well. Correlations with other mental health scales were largely in line with expectations. No statistically significant differences were found in mean latent (S)WEMWBS scores for age and gender.ConclusionBoth WEMWBS scales appear to be valid and precise instruments to measure mental well-being in primary health care patients. The results encourage the use of mental well-being as an outcome in future epidemiological, clinical, and evaluation studies, and may as such be valuable for both research and public health practice.
ObjectivesThe objective of this study was to conduct a systematic review assessing workplace factors related to work retention (or return to work) in employees with acquired brain injury (ABI). Additionally, we aimed to synthesise the evidence and state of knowledge on this subject.MethodsA database search was performed in nine relevant electronic databases. Inclusion criteria were quantitative peer-reviewed publications empirically investigating the relationship between work/workplace factors and work retention in employees following ABI. The methodological quality was determined by Effective Public Health Practice Project scoring, and evidence was synthesised narratively.ResultsThirteen studies were included. We found moderate evidence for a negative relationship between manual work and work retention. We also found limited evidence for a U-shaped relationship between workload and complete work retention at 6 months and no relationship at 12 months; a positive relationship between managers, compared with non-managers, and faster work retention; a positive relationship between large enterprise size defined as ≥250 employees, and no relationship between large enterprise size, defined as ≥1000 employees, and work retention.ConclusionRelative to individual factors, there is little evidence on specific workplace factors’ relationship to work retention among employees with ABI. For most workplace factors, there were too few high-quality studies to designate evidence as more than limited or insufficient. Future studies should replicate rigorous studies of well-defined modifiable workplace factors related to work retention.PROSPERO registration numberCRD42018082201.
BackgroundA considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces.Methods/designThis study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed.DiscussionThe proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided.Trial registrationClinicalTrials.gov, NCT03092713. Registered on 10 March 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2218-7) contains supplementary material, which is available to authorized users.
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