Background Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. Methods This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. Discussion Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. Trial registration The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049.
Background Common mental disorders affect a significant proportion of the population worldwide at any given time. Psychotherapeutic consultation at work offers employees with mental distress short-term and low-threshold access to psychotherapeutic treatment. However, this offer is only accepted by one to two percent of the employees to whom it is offered. Taking into account employees ‘ preferences regarding organisational aspects might increase the use of psychotherapeutic consultation at work. This study therefore aimed to identify preferences on organisational aspects of psychotherapeutic consultation at work among employees of diverse occupational areas, company sizes, supervisor functions and job requirement levels. Methods A total of 755 employees were recruited via advertisements on social media (Instagram, Facebook and LinkedIn). Participants rated on a 5-point Likert scale their agreement to different implementation options of psychotherapeutic consultation at work: type (in-person/video/telephone), location (on/outside company premises), time (within/outside working hours), scope (diagnostic/diagnostic + treatment) and purpose (private/occupational). Additionally, the maximum accepted distance to the location of consultation was assessed. Various analyses of variances (ANOVA) were conducted to determine differences in agreement to implementation options within each organisational aspect and to analyse differences between occupational areas, company sizes, requirement levels and between employees with and without supervisor function. Results Participants indicated a preference for in-person psychotherapeutic consultation that takes places outside company premises and outside working hours. Furthermore, they preferred offers including diagnostic and treatment sessions compared to offers including diagnostic sessions only. Even though participants agreed that consultation should be offered for all purposes, agreement for occupational issues was stronger than for private issues. For some implementation options, the level of agreement varied according to occupational field, company size, supervisor function and level of requirement. However, these differences did not affect the key findings mentioned above. Conclusion Those findings give practical indications on the organisational design of psychotherapeutic consultation at work. The results suggest that in-person consultation outside company premises and working hours combining diagnostic and treatment sessions will be accepted by employees regardless of their occupational area, company size, supervisor function and requirement level.
Aim There is little evidence of the impact of diabetes risk scores on individual diabetes risk factors, motivation for behaviour changes and mental health. The aim of this study was to investigate the effect of applying a noninvasive diabetes risk score in primary care as component of routine health checks on physical activity and secondary outcomes. Methods Cluster randomised trial, in which primary care physicians (PCPs), randomised (1:1) by minimisation, enrolled participants with statutory health insurance without known diabetes, ≥ 35 years of age with a body mass index ≥ 27.0 kg/m2. The German Diabetes Risk Score was applied as add-on to the standard routine health check, conducted in the controls. Primary outcome was the difference in participants’ physical activity (International Physical Activity Questionnaire) after 12 months. Secondary outcomes included body mass index, perceived health, anxiety, depression, and motivation for lifestyle change. Analysis was by intention-to-treat principle using mixed models. Results 36 PCPs were randomised; remaining 30 PCPs (intervention: n = 16; control: n = 14) recruited 315 participants (intervention: n = 153; controls: n = 162). A slight increase in physical activity was observed in the intervention group with an adjusted mean change of 388 (95% confidence interval: − 235; 1011) metabolic equivalents minutes per week. There were no relevant changes in secondary outcomes. Conclusions The application of a noninvasive diabetes risk score alone is not effective in promoting physical activity in primary care. Clinical Trial Registration: ClinicalTrials.gov (NCT03234322, registration date: July 31, 2017).
Background Common mental disorders affect a significant proportion of the population worldwide at any given time. Psychotherapeutic consultation at work offers employees with mental distress short-term and low-threshold access to psychotherapeutic treatment. However, this offer is only accepted by one to two perfect of the employees to whom it is offered. Taking into account employees‘ preferences regarding organisational aspects might increase the use of psychotherapeutic consultation at work. This study therefore aimed to identify preferences on organisational aspects of psychotherapeutic consultation at work among employees of diverse occupational areas, company sizes, supervisor functions and job requirement levels. Methods A total of 755 employees were recruited via advertisements on social media (Instagram, Facebook and LinkedIn). Participants rated on a 5-point Likert scale their agreement to different implementation options of psychotherapeutic consultation at work: type (in-person/video/telephone), location (on/outside company premises), time (within/outside working hours), scope (diagnostic/diagnostic + treatment) and purpose (private/occupational). Additionally, the maximum accepted distance to the location of consultation was assessed. Various analyses of variances (ANOVA) were conducted to determine differences in agreement to implementation options within each organisational aspect and to analyse differences between occupational areas, company sizes, requirement levels and between employees with and without supervisor function. Results Participants indicated a preference for in-person psychotherapeutic consultation that takes places outside company premises and outside working hours. Furthermore, they preferred offers including diagnostic and treatment sessions compared to offers including diagnostic sessions only. Even though participants agreed that consultation should be offered for all purposes, agreement for occupational issues was stronger than for private issues. For some implementation options, the level of agreement varied according to occupational field, company size, supervisor function and level of requirement. However, these differences did not affect the key findings mentioned above. Conclusion Those findings give practical indications on the organisational design of psychotherapeutic consultation at work. The results suggest that in-person consultation outside company premises and working hours combining diagnostic and treatment sessions will be accepted by employees regardless of their occupational area, company size, supervisor function and requirement level.
Background An electronic handover system provides a potential way to bridge the interface between psychotherapy and occupational health. This qualitative study therefore aimed assessing (1) content-related and (2) functional requirements that psychotherapists and occupational health professionals expect from an electronic handover system to exchange relevant information about their patients with common mental disorders. Methods Five focus groups with psychotherapists and occupational health professionals (occupational physicians and members of company integration management) were conducted via video conference using an interview guide. The focus groups were transcribed and content-analysed using MAXQDA. Results With regard to content-related requirements, information that serve to assess employee’s ability to work was described as particularly relevant by occupational physicians and members of company integration management (e.g. restrictions in certain work areas or ability to work under time pressure). Psychotherapists indicated that information about the employee’s working conditions is particularly relevant. This includes description of work tasks or conflicts at the workplace. Concerning functional requirements, all professional groups attached importance to data security and functions to improve communication and collaboration (e.g. the use of standardised handover forms). Conclusion This study provides insight into the desired content-related and functional requirements by psychotherapists, occupational physicians and members of company integration management for an electronic handover system. However, the theoretical and practical development of such a system requires several additional steps, such as the involvement of further relevant stakeholders (e.g. patients, software developers).
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