Short summary

This realist evaluation concerns a Danish Cognitive Behavioral Therapy (CBT)-based stress management intervention for patients with work-related stress. The overall aim is to understand what works, for whom, in what circumstances. A mix of methods will be used to answer our research questions.

Rationale

The goal of this realist evaluation of a Danish Cognitive Behavioral Therapy (CBT)-based stress management intervention for patients with work-related stress is to understand what works, for whom, in what circumstances.The main objectives are:

To assess the effect of the stress management intervention on sustainable return to work.

To investigate what contexts and mechanisms are associated with patients' return to work rates and level of perceived stress after having received the stress management intervention.

To understand from a patient perspective how mechanisms work in specific contexts to generate effects of the stress management intervention.

The evaluation comprises two observational studies and one interview study. The intervention cohort are patients with work-related stress who received the stress management intervention between 2012-2018.

The comparison cohort are patients who would have been eligible to receive the intervention in 2011-2012, however they did not receive any intervention because it was not offered at that time.

In study one return to work rates are compared between the intervention cohort and the comparison cohort to find out if the intervention can help patients return to work at a faster rate.

Study two will investigate if there are any explanatory variables (such as work type, civil status or level of depressive symptoms) that may explain why some patients benefit more or less from the intervention.

Study three will explore what it is about the intervention (mechanisms) the patients find are helping them to cope with stress or the opposite in specific circumstances.

Description of the cohort

Patients with work-related stress (diagnoses F43.2/8/9 or Z56.3 (ICD-10)) seen at Department of Occupational and Environmental Medicine, Odense, in the period 2011-2018

Data and biological material

Questionnaire data (Perceived Stress Scale, Major Depression Inventory, Beck Anxiety Inventory, Symptom Checklist Revised, Basic Nordic Sleep Questionnaire, Cognitive Failures Questionnaire) Data from the national registries collected in the Pro-risk database - data on Danish patients seen at the Occupational Health Clinics (The Population Register, The Danish National Health Service Register, The Danish National Patient Registry, The Danish Psychiatric Central Research register, The Population Education Register, The Family Income Register, The Danish Register for Evaluation of Margialization (the DREAM database), The Occupation and Industry Register from DOC*X, IDAN database, The Causes of Death Register)

Collaborating researchers and departments

Department of Occupational and Environmental Medicine, Odense University Hospital

• Lars Peter Andreas Brandt
• Daniel Navy Ditlevsen

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark

• Lotte Nygaard Andersen
• Louise Fleng Sandal
• Karen Søgaard

Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital

• Morten Vejs Willert