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      Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation

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          Abstract

          Purpose Transfer from on-site rehabilitation to the participant’s daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06–3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.

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          The online version of this article (doi:10.1007/s10926-017-9711-4) contains supplementary material, which is available to authorized users.

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          Recommendations for a standard research assessment of insomnia.

          To present expert consensus recommendations for a standard set of research assessments in insomnia, reporting standards for these assessments, and recommendations for future research. N/A. N/A. An expert panel of 25 researchers reviewed the available literature on insomnia research assessments. Preliminary recommendations were reviewed and discussed at a meeting on March 10-11, 2005. These recommendations were further refined during writing of the current paper. The resulting key recommendations for standard research assessment of insomnia disorders include definitions/diagnosis of insomnia and comorbid conditions; measures of sleep and insomnia, including qualitative insomnia measures, diary, polysomnography, and actigraphy; and measures of the waking correlates and consequences of insomnia disorders, such as fatigue, sleepiness, mood, performance, and quality of life. Adoption of a standard research assessment of insomnia disorders will facilitate comparisons among different studies and advance the state of knowledge. These recommendations are not intended to be static but must be periodically revised to accommodate further developments and evidence in the field.
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            A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems.

            The current study presents the results of a meta-analysis of 39 randomized controlled trials on the efficacy of acceptance and commitment therapy (ACT), including 1,821 patients with mental disorders or somatic health problems. We searched PsycINFO, MEDLINE and the Cochrane Central Register of Controlled Trials. Information provided by the ACBS (Association of Contextual Behavioral Science) community was also included. Statistical calculations were conducted using Comprehensive Meta-Analysis software. Study quality was rated using a methodology rating form. ACT outperformed control conditions (Hedges' g = 0.57) at posttreatment and follow-up assessments in completer and intent-to-treat analyses for primary outcomes. ACT was superior to waitlist (Hedges' g = 0.82), to psychological placebo (Hedges' g = 0.51) and to treatment as usual (TAU) (we defined TAU as the standard treatment as usual; Hedges' g = 0.64). ACT was also superior on secondary outcomes (Hedges' g = 0.30), life satisfaction/quality measures (Hedges' g = 0.37) and process measures (Hedges' g = 0. 56) compared to control conditions. The comparison between ACT and established treatments (cognitive behavioral therapy) did not reveal any significant differences between these treatments (p = 0.140). Our findings indicate that ACT is more effective than treatment as usual or placebo and that ACT may be as effective in treating anxiety disorders, depression, addiction, and somatic health problems as established psychological interventions. More research that focuses on quality of life and processes of change is needed to understand the added value of ACT and its transdiagnostic nature. © 2014 S. Karger AG, Basel.
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              The association between anxiety, depression, and somatic symptoms in a large population: the HUNT-II study.

              Somatic symptoms are prevalent in the community, but at least one third of the symptoms lack organic explanation. Patients with such symptoms have a tendency to overuse the health care system with frequent consultations and have a high degree of disability and sickness compensation. Studies from clinical samples have shown that anxiety and depression are prevalent in such functional conditions. The aim of this study is to examine the connection between anxiety, depression, and functional somatic symptoms in a large community sample. The HUNT-II study invited all inhabitants aged 20 years and above in Nord-Trondelag County of Norway to have their health examined and sent a questionnaire asking about physical symptoms, demographic factors, lifestyle, and somatic diseases. Anxiety and depression were recorded by the Hospital Anxiety and Depression Scale. Of those invited, 62,651 participants (71.3%) filled in the questionnaire. A total of 10,492 people were excluded due to organic diseases, and 50,377 were taken into the analyses. Women reported more somatic symptoms than men (mean number of symptoms women/men: 3.8/2.9). There was a strong association between anxiety, depression, and functional somatic symptoms. The association was equally strong for anxiety and depression, and a somewhat stronger association was observed for comorbid anxiety and depression. The association of anxiety, depression, and functional somatic symptoms was equally strong in men and women (mean number of somatic symptoms men/women in anxiety: 4.5/5.9, in depression: 4.6/5.9, in comorbid anxiety and depression: 6.1/7.6, and in no anxiety or depression: 2.6/3.6) and in all age groups. The association between number of somatic symptoms and the total score on Hospital Anxiety and Depression Scale was linear. There was a statistically significant relationship between anxiety, depression, and functional somatic symptoms, independent of age and gender.
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                Author and article information

                Contributors
                + 47 93016098 , karen.w.hara@ntnu.no
                Journal
                J Occup Rehabil
                J Occup Rehabil
                Journal of Occupational Rehabilitation
                Springer US (New York )
                1053-0487
                1573-3688
                9 June 2017
                9 June 2017
                2018
                : 28
                : 2
                : 265-278
                Affiliations
                [1 ]ISNI 0000 0001 1516 2393, GRID grid.5947.f, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, , Norwegian University of Science and Technology (NTNU), ; Postbox 8905, 7491 Trondheim, Norway
                [2 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, , Trondheim University Hospital, ; Trondheim, Norway
                [3 ]ISNI 0000 0001 1516 2393, GRID grid.5947.f, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, , Norwegian University of Science and Technology (NTNU), ; Trondheim, Norway
                [4 ]The Norwegian Labour and Welfare Service of Sør-Trøndelag, Trondheim, Norway
                [5 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Forensic Department and Research Centre Brøset, St. Olavs Hospital, , Trondheim University Hospital, ; Trondheim, Norway
                [6 ]The Norwegian Directorate for Labour and Welfare, Oslo, Norway
                [7 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Hysnes Rehabilitation Center, St. Olavs Hospital, , Trondheim University Hospital, ; Trondheim, Norway
                [8 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Centre for Health Care Improvement, St. Olavs Hospital, , Trondheim University Hospital, ; Trondheim, Norway
                [9 ]ISNI 0000 0001 1516 2393, GRID grid.5947.f, Department of Psychology, Faculty of Social and Educational Sciences, , Norwegian University of Science and Technology (NTNU), ; Trondheim, Norway
                Author information
                http://orcid.org/0000-0002-5664-0395
                Article
                9711
                10.1007/s10926-017-9711-4
                5978834
                28597308
                4f302ee4-21a2-4fed-992f-3bda75c59372
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                Funding
                Funded by: The Norwegian Government, funding allocated through the Central Norway Regional Health Authority
                Categories
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                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2018

                Occupational & Environmental medicine
                acceptance and commitment therapy,mental disorders,musculoskeletal pain,vocational rehabilitation,telerehabilitation

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