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- Axén, I., et al.
(author)
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Frequently repeated measurements-our experience of collecting data with SMS
- 2020
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In: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 20
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Journal article (peer-reviewed)abstract
- Background: As technology is advancing, so are the possibilities for new data collection methods in research, potentially improving data quality and validity of the results. In Sweden, a system using frequent repeated data collection using text messages, SMS Track, has been used in clinical research for more than a decade. In this paper, compliance with repeated text message questions was examined across five different studies, i.e. if compliance was 1: associated with study-specific factors (age or gender of the subjects, the condition, its' severity or course, i.e. improvement, relapse or steady state) and/or. 2: associated with the methodology itself (the question being asked, the frequency and number of questions, duration of data collection, initial compliance or the management of the system). Methods: Descriptive comparisons were done across five studies. Three studies were collecting weekly responses over at least 52 weeks ("Weekly studies") and were used to investigate the effect of age, sex and pain severity on compliance, the effect of early compliance for late compliance, and finally the early occurrence of two successive weeks with non-compliance. Result: Compliance was excellent across all five studies, and only influenced somewhat by age, sex and pain-level. The factor "study" remained significant in the final model thus the observed differences may be a result of the conditions studied but does not seem to be attributable to severity or development of these conditions. Number and frequency of questions did not influence compliance, nor did study duration. Conclusions: Compliance was excellent in the included studies and was not affected by population factors. However, differences in compliance were observed that cannot be easily explained and warrant further investigation. In particular, the nature of the variables or the management of the study are potential areas for further investigations.
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- Axen, I., et al.
(author)
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Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis
- 2020
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 93:7, s. 823-838
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Journal article (peer-reviewed)abstract
- Introduction Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health. Objective To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis. Data sources The literature search was performed in four electronic databases in two searches, in 2014 and in 2017. Eligibility criteria (using PICO) Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included. Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof. Results Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect. Limitations Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common.
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- Karlsson, Ida, et al.
(author)
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Exploring ethical issues arising from a problem-solving intervention in the Swedish Primary Care
- 2022
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In: European Journal of Public Health Vol.32 Issue Supplement 3. - : Oxford University Press (OUP). - 1101-1262.
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Conference paper (peer-reviewed)abstract
- Background Common mental disorders count for a large percentage of sick leave cases in Europe and in Sweden. Problem-solving with workplace involvement have shown promising results in reducing the number of sick leave days for employees on sick leave for these conditions. Engaging the workplace by for example including the first-line manager in the return-to-work process changes the usual role of the primary care. Hence, this study aims to explore ethical issues that potentially arise when introducing workplace involvement as part of a problem-solving intervention. Methods A qualitative study in the Swedish Primary Care using data from semi-structured interviews with rehabilitation coordinators (n = 6), employees on sick leave for common mental disorders (n = 13), and their first-line managers (n = 8). A theoretical framework for systematic identification of ethical aspects of healthcare technologies was used to guide the interviews and reporting of results. Content analysis was used to code the data, searching for latent content. Ethical issues related to the ethical values privacy, identity, autonomy, professional values, third party, equality and justice were identified and described. The analysis was concluded by a normative discussion. Results Ethical issues were identified such as difficulties for the employees to control personal information. A need to create an integrated role of a patient and an employee and for coordinators to act neutral instead of as a patient advocate. Managers needed to balance the needs of the organization with the needs of the employee. A pre-requisite for participation was agreeing to manager involvement which may affect the equality of the intervention. Conclusions A conversation about sharing of information, roles, responsibilities and expectations during the rehabilitation should be initiated early and be continuous. Managers need support in learning the “how to” when having an employee on sick leave due to a common mental disorder. Key messages The problem-solving intervention imposed ethical issues in regard to control over personal information and role shifting, which can be handled through discussions and awareness. By analysing ethical aspects and norms and values connected to the intervention, adaptations and solutions can be discussed and handled before full scale implementation.
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