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1.
J Clin Epidemiol ; 62(4): 408-414.e2, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18986798

RESUMO

OBJECTIVE: To develop and validate a screening instrument to identify employees at high risk for future long-term sickness absence. STUDY DESIGN AND SETTING: The instrument was developed (n=5,601) and internally validated (n=3,383) through data analyses of the Maastricht Cohort Study, among a group of office workers not absent from work. External validation was performed in a cohort of 3,895 bank employees. RESULTS: The screening instrument, Balansmeter, captures 34 questions on demographics, work environment, private situation, (mental) health, and sickness absence history. The Balansmeter showed good predictive values for future sickness absence (>28 days) in men (internal validation relative risk [RR] 4.69 [95% confidence interval (CI): 2.74, 8.02]; external validation RR 3.90 [95% CI: 2.35, 6.45]) and women (internal validation RR 4.16 [95% CI: 2.05, 8.43]; external validation RR 2.62 [95% CI: 1.44, 4.77]). CONCLUSION: It is possible to predict future sickness absence. The Balansmeter can be considered a valuable screening instrument.


Assuntos
Fadiga/epidemiologia , Doenças Profissionais/epidemiologia , Licença Médica/tendências , Inquéritos e Questionários/normas , Adulto , Estudos de Coortes , Feminino , Previsões , Humanos , Masculino , Países Baixos/epidemiologia , Valor Preditivo dos Testes , Fatores de Risco
2.
J Occup Rehabil ; 18(1): 79-86, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18196446

RESUMO

OBJECTIVE: To examine the efficacy of structured early consultation among employees at high risk for future long-term sickness absence, in the prevention and/or reduction of sickness absence. The focus of the experiment was the timing of the intervention, that is, treatment before sickness absence actually occurs. METHODS: In the current prospective randomized controlled trial (RCT), employees at high risk for long-term sickness absence were selected based on responses to a 34-item screening questionnaire including demographic, workplace, health and psychosocial factors associated with long-term sickness absence (>28 days). A total of 299 subjects at risk for future long-term sickness absence were randomized in an experimental group (n = 147) or in a control group (n = 152). Subjects in the experimental group received a structured early consult with their occupational physician (OP), in some cases followed by targeted intervention. The control group received care as usual. Sickness absence was assessed objectively through record linkage with the company registers on sickness absence over a 1 year follow-up period. RESULTS: Modified intention-to-treat analysis revealed substantial and statistically significant differences (p = 0.007) in total sickness absence duration over 1 year follow-up between the experimental (mean 18.98; SD 29.50) and control group (mean 31.13; SD 55.47). Per-protocol analysis additionally showed that the proportion of long-term sickness absence spells (>28 days) over 1 year follow-up was significantly (p = 0.048) lower in the experimental (9.1%) versus control group (18.3%). CONCLUSIONS: Structured early consultation with the OP among employees at high risk for future long-term sickness absence is successful in reducing total sickness absence.


Assuntos
Absenteísmo , Serviços de Saúde do Trabalhador/métodos , Saúde Ocupacional/estatística & dados numéricos , Encaminhamento e Consulta , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , Papel do Médico , Medição de Risco , Fatores de Risco , Local de Trabalho
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