| 1. |
- Jönsson, Peter, et al.
(författare)
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Cardiovascular and cortisol reactivity and habituation to a virtual reality version of the Trier Social Stress Test : a pilot study
- 2010
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 35:9, s. 1397-1403
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Tidskriftsartikel (refereegranskat)abstract
- The Trier Social Stress Test (TSST) is a widely used protocol to induce stress in laboratory settings. Briefly, in the TSST, the test participant is asked to hold a speech and to do an arithmetic task in front of an audience. In the present pilot study, we examined endocrine and autonomic reactivity and habituation to repeated stress provocations using a virtual reality (VR) version of TSST. The VR system was a CAVE™ system with three rear projected walls (4 m×3 m), and one floor projection. The system also included a head tracking system and passive stereoscopy. The virtual audience consisted of one woman, and two men. Ten healthy men, mean age 28.3 years (24-38 years), were confronted with the test twice (1 week between sessions), during which salivary cortisol, heart rate (HR), high frequency heart rate variability (HF-HRV, parasympathetic activity), and T-wave amplitude (TWA, suggested to be related to sympathetic influence on myocardial performance) were assessed. Cortisol secretion showed a marked increase (88% vs. baseline) during the first stress provocation, but habituated in the second session. The magnitude of HR and TWA reactivity during stress provocation was approximately the same at both sessions, implying a stable increase in sympathetic activity. Heart rate showed a maximum increase of 40% at the first session, and 32% at the second. TWA showed a maximum decrease of 42% at the first session, and 39% at the second. The results resemble those obtained in prior studies using the real-life TSST. If these results can be replicated with larger samples, VR technology may be used as a simple and standardized tool for social stress induction in experimental settings.
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| 2. |
- Karlson, Björn, et al.
(författare)
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Long-term stability of return to work after a workplace-oriented intervention for patients on sick leave for burnout
- 2014
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458 .- 1471-2458. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The period from the mid-1990s to the mid-2000s saw a rapid increase in long-term sick leave in Sweden, primarily due to mental illness and often related to job burnout. This led to an urge for effective treatment programs that could prevent the often long sick leaves. In 2010 we presented a newly developed work-place intervention method, showing that 89% of the intervention group had returned to work at a 1.5 year follow-up, compared to 73% of the control group. The main aim of this study was to assess the long-term stability of these promising results.METHODS:Sick leave registry data from the Regional Social Insurance Office were analyzed for an additional year (50 weeks) beyond the original 1.5 year period (80 weeks). Data from 68 matched pairs of intervention participants (IP) and controls were available. The proportions of participants being on full-time sick leave versus having returned to work to any extent were computed for every 10th week. Generalized estimating equations were used with GROUP (IP versus controls) as between-subjects factor, WEEKS and AGE as covariates, and return-to-work (RTW) as dependent variable. Significant differences (Wald χ2 with α ≤ .05) was followed up with polynomial contrasts. Individual relapses to higher degrees of sick leave (e.g. from 50% to 100%) and whether partial RTW led to later full-time RTW, were also analyzed.RESULTS:The omnibus test over all 130 weeks showed a GROUP*WEEKS interaction effect (p = .02), indicating differential group developments in RTW, though similarly high at week 130 in both groups with 82.4% of the IP and 77.9% of the controls having RTW (p = .22; χ2-test). A significant interaction with age led to separate analyses of the younger and older subgroups, indicating a stable pattern of superior RTW only among younger IP (week 130: 88.6% vs. 69.7%, p = .054; χ2-test). There was no group difference in relapses into increased degree of sick leave. Part-time sick leave did not predict a later stable full-time RTW.CONCLUSIONS:The previously reported improvement in RTW with the newly developed workplace-oriented intervention showed a long-term stability only among younger participants.
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| 3. |
- Karlson, Björn, et al.
(författare)
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Return to work after a workplace-oriented intervention for patients on sick-leave for burnout : a prospective controlled study
- 2010
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Ingår i: BMC Public Health. - 1471-2458 .- 1471-2458. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.METHODS: In a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.RESULTS: There was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.CONCLUSIONS: We conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.TRIAL REGISTRATION: Current Controlled Trials NCT01039168.
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