Effects of a stress management intervention on absenteeism and return to work--results from a randomized wait-list controlled trial.
OBJECTIVE
High levels of work-related stress are associated with increased absenteeism from work and reduced work ability. In this study, we investigated the effects of a stress management intervention on absenteeism and return to work.


METHODS
We randomized 102 participants into either the intervention or wait-list control (WLC) group. The intervention group received the intervention in weeks 1-16 from baseline, and the WLC group received the intervention in weeks 17-32. Self-reported data on absenteeism (number of days full- or part-time absent from work within the previous three months) were obtained at 16, 32, and 48 weeks follow-up. Register-based data on long-term absence from work were drawn from the Danish public transfer payments (DREAM) database from baseline and 48 weeks onwards. The DREAM database contains weekly information on long-term sickness absence compensation. The threshold to enter DREAM is sick leave for two consecutive weeks.


RESULTS
At follow-up in week 16, self-reported absenteeism in the intervention group [median 11 days (range 3-25)] was lower (P=0.02) than in the WLC group [median 45 days (range 19-60)], corresponding to a 29% [95% confidence interval (95% CI) 5-52] reduction. On register-based data (cumulated weeks in DREAM, weeks 1-16), the intervention group median [6 weeks (range 0-11)] was lower than that of the WLC group [median 12 weeks (range 8-16)], though not significantly (P=0.06), corresponding to a 21% (95% CI 0-42) reduction. For return to work, a hazard ratio of 1.58 (95% CI 0.89-2.81) favoring the intervention group was found (P=0.12).


CONCLUSIONS
The intervention reduces self-reported absenteeism from work. A similar trend was found from register-based records. No conclusive evidence was found for return to work.
Department of Occupational Medicine, Aarhus University Hospital, Noerrebrogade 44, Building 2C, DK-8000 Aarhus C, Denmark. morten.willert@aarhus.rm.dk
Morten Vejs
MV
Willert
Ane Marie
AM
Thulstrup
Jens Peter
JP
Bonde
D000041:Absenteeism; D000328:Adult; D015928:Cognitive Behavioral Therapy; D016208:Databases, Factual; D003718:Denmark; D004651:Employment; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000628:therapy*; D014850:Waiting Lists; D014937:Work / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult