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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Study protocol

“Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study

Authors: Eva Rothermund, Reinhold Kilian, Michael Hoelzer, Dorothea Mayer, Daniel Mauss, Marc Krueger, Monika A Rieger, Harald Guendel

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Mental health issues are gaining in importance in society and the economic system. At the same time, the accessibility and stigmatisation of the mental health care system in Germany can obstruct help-seeking behavior and delay early psychotherapeutic interventions. Therefore, new models of care are being established at the interface of company-supported health promotion and conventional health insurance sponsored outpatient care for people developing mental illnesses. Two large industrial companies, in cooperation with two psychosomatic clinics, have recently established a model of “psychosomatic consultation in the workplace“. This new model of care offers the opportunity for a first psychotherapeutic door to door consultation with occupational medicine within the industrial workplace. The main empirical goals of this study are:
1) Describing the differences between patients who use this new diagnostic and therapeutic offer within the industrial workplace vs. patients who visit a conventional regional outpatient clinic, especially in regard to symptom duration and severity, work ability, and demographic characteristics, and
2) A first evaluation of how patients may benefit more from this new model of care compared to those first seen by standard outpatient care.
In the qualitative part of the study, occupational physicians, psychosomatic therapists, involved personnel and select employees of the involved companies will be asked to comment on their experiences with this new approach.

Methods/Design

The implementation study will take place in Ulm and in Stuttgart, with each site looking at one regional conventional psychosomatic outpatient clinic and one psychosomatic consultation offer within the workplace. 70 consecutive patients in each setting will be recruited (overall n = 280). For the cross-sectional study and pre-post comparison we will use established and validated survey instruments (PHQ, SF-12, WAI, MBI, IS) as well as standardized questions about health care use. For data analysis, we will use uni- and multivariate analytical methods. Qualitative data analysis (expert interviews) will be carried out using Mayring’s content analysis method.

Discussion

The results of this study have the potential to provide evidence-based knowledge about an innovative model of psychotherapeutic outpatient care and to further promote tailored solutions for early psychotherapeutic interventions within the worksite.

Trial Registration

DRKS00003184
Appendix
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Literature
1.
go back to reference Grobe T, Dörning H: Gesundheitsreport 2011. 2011, Techniker Krankenkasse, Hamburg Grobe T, Dörning H: Gesundheitsreport 2011. 2011, Techniker Krankenkasse, Hamburg
2.
go back to reference Deutsche Rentenversicherung Bund: Rentenversicherung in Zeitreihen 2010–3 Rentenzugang nach ausgewählten Diagnosegruppen. Berlin. 2010 Deutsche Rentenversicherung Bund: Rentenversicherung in Zeitreihen 2010–3 Rentenzugang nach ausgewählten Diagnosegruppen. Berlin. 2010
3.
go back to reference Limm H, Angerer P, Heinmueller M, Marten-Mittag B, Nater UM, Guendel H: Self-perceived stress reactivity is an indicator of psychosocial impairment at the workplace. BMC Public Health. 2010, 10: 252-261. 10.1186/1471-2458-10-252.CrossRefPubMedPubMedCentral Limm H, Angerer P, Heinmueller M, Marten-Mittag B, Nater UM, Guendel H: Self-perceived stress reactivity is an indicator of psychosocial impairment at the workplace. BMC Public Health. 2010, 10: 252-261. 10.1186/1471-2458-10-252.CrossRefPubMedPubMedCentral
4.
go back to reference Melchior M, Caspi A, Milne BJ, Danese A, Poulton R, Moffitt TE: Work stress precipitates depression and anxiety in young, working women and men. Psychol Med. 2007, 37: 1119-1129. 10.1017/S0033291707000414.CrossRefPubMedPubMedCentral Melchior M, Caspi A, Milne BJ, Danese A, Poulton R, Moffitt TE: Work stress precipitates depression and anxiety in young, working women and men. Psychol Med. 2007, 37: 1119-1129. 10.1017/S0033291707000414.CrossRefPubMedPubMedCentral
5.
go back to reference Rau R, Gebele N, Morling K, Roesler U: Untersuchung arbeitsbedingter Ursachen fuer das Auftreten von depressiven Stoerungen. 2010, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dortmund, Berlin, Dresden Rau R, Gebele N, Morling K, Roesler U: Untersuchung arbeitsbedingter Ursachen fuer das Auftreten von depressiven Stoerungen. 2010, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dortmund, Berlin, Dresden
6.
go back to reference Corrigan P, Rüsch N: Mental illness stereotypes and clinical care: do people avoid treatment because of stigma?. Psychiatr Rehabil Skills. 2002, 6: 312-334. 10.1080/10973430208408441.CrossRef Corrigan P, Rüsch N: Mental illness stereotypes and clinical care: do people avoid treatment because of stigma?. Psychiatr Rehabil Skills. 2002, 6: 312-334. 10.1080/10973430208408441.CrossRef
7.
go back to reference Schulz H, Barghaan D, Harfst T, Koch U: Psychotherapeutische versorgung. gesundheitsberichterstattung des bundes. Themenheft. 2008, 41: 1-47. Schulz H, Barghaan D, Harfst T, Koch U: Psychotherapeutische versorgung. gesundheitsberichterstattung des bundes. Themenheft. 2008, 41: 1-47.
8.
go back to reference Fuchs J, Zika G: Arbeitsmarktbilanz bis 2025: Demografie gibt die Richtung vor. IAB-Kurzbericht. Aktuelle Analysen und Kommentare aus dem Institut für Arbeitsmarkt- und Berufsforschung. 2010, 12: 1-8. Fuchs J, Zika G: Arbeitsmarktbilanz bis 2025: Demografie gibt die Richtung vor. IAB-Kurzbericht. Aktuelle Analysen und Kommentare aus dem Institut für Arbeitsmarkt- und Berufsforschung. 2010, 12: 1-8.
9.
go back to reference Limm H, Guendel H, Heinmueller M, Marten-Mittag B, Nater UM, Siegrist J, Angerer P: Stress management interventions in the workplace improve stress reactivity: a randomised controlled trial. Occup Environ Med. 2011, 68: 126-133. 10.1136/oem.2009.054148.CrossRefPubMed Limm H, Guendel H, Heinmueller M, Marten-Mittag B, Nater UM, Siegrist J, Angerer P: Stress management interventions in the workplace improve stress reactivity: a randomised controlled trial. Occup Environ Med. 2011, 68: 126-133. 10.1136/oem.2009.054148.CrossRefPubMed
10.
go back to reference Lipowski ZJ: Consultation-liaison psychiatry at century’s end. Psychosomatics. 1992, 33: 128-133. 10.1016/S0033-3182(92)71988-4.CrossRefPubMed Lipowski ZJ: Consultation-liaison psychiatry at century’s end. Psychosomatics. 1992, 33: 128-133. 10.1016/S0033-3182(92)71988-4.CrossRefPubMed
11.
go back to reference Mayer D, Schmidt H, Hoelzer M: Psychosomatische Sprechstunde “und „ Psychosomatische Grundversorgung in der Arbeitsmedizin “. Arbeitsmed Sozialmed Umweltmed. 2010, 45: 593-597. Mayer D, Schmidt H, Hoelzer M: Psychosomatische Sprechstunde “und „ Psychosomatische Grundversorgung in der Arbeitsmedizin “. Arbeitsmed Sozialmed Umweltmed. 2010, 45: 593-597.
12.
go back to reference Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. Br Med J. 2000, 321: 694-696. 10.1136/bmj.321.7262.694.CrossRef Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P: Framework for design and evaluation of complex interventions to improve health. Br Med J. 2000, 321: 694-696. 10.1136/bmj.321.7262.694.CrossRef
13.
go back to reference Wirtz M, Albert U, Bornemann R, Ernstmann N, Höhmann U, Ommen O, Pfaff H: Versorgungsnahe Organisationsforschung. Edited by: Lehrbuch V. 2011, Schattauer, Stuttgart, 284-290. Wirtz M, Albert U, Bornemann R, Ernstmann N, Höhmann U, Ommen O, Pfaff H: Versorgungsnahe Organisationsforschung. Edited by: Lehrbuch V. 2011, Schattauer, Stuttgart, 284-290.
14.
go back to reference Hasselhorn HM, Freude G: Der Work Ability Index – ein Leitfaden. 2007, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dortmund Hasselhorn HM, Freude G: Der Work Ability Index – ein Leitfaden. 2007, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dortmund
15.
go back to reference Kroenke K, Spitzer RL, Williams JBW, Loewe B: The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010, 32: 345-359. 10.1016/j.genhosppsych.2010.03.006.CrossRefPubMed Kroenke K, Spitzer RL, Williams JBW, Loewe B: The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry. 2010, 32: 345-359. 10.1016/j.genhosppsych.2010.03.006.CrossRefPubMed
16.
go back to reference Morfeld M, Bullinger M, Kirchberger I: SF-36 Fragebogen zum Gesundheitszustand. 2011, Goettingen, Hogrefe Verlag Morfeld M, Bullinger M, Kirchberger I: SF-36 Fragebogen zum Gesundheitszustand. 2011, Goettingen, Hogrefe Verlag
17.
go back to reference Maslach L, Jackson S, Leiter M: Maslach Burnout Inventory (MBI) Deutsche allgemeine Fassung. 1996, Palo Alto, California, Consulting Psychologists Press Maslach L, Jackson S, Leiter M: Maslach Burnout Inventory (MBI) Deutsche allgemeine Fassung. 1996, Palo Alto, California, Consulting Psychologists Press
18.
go back to reference Mohr G, Rigotti T, Müller A: Irritation - ein Instrument zur Erfassung psychischer Beanspruchung im Arbeitskontext. Skalen- und Itemparameter aus 15 Studien. Zeitschrift für Arbeits- und Organisationspsychologie. 2005, 49: 44-48. 10.1026/0932-4089.49.1.44.CrossRef Mohr G, Rigotti T, Müller A: Irritation - ein Instrument zur Erfassung psychischer Beanspruchung im Arbeitskontext. Skalen- und Itemparameter aus 15 Studien. Zeitschrift für Arbeits- und Organisationspsychologie. 2005, 49: 44-48. 10.1026/0932-4089.49.1.44.CrossRef
19.
go back to reference Pruemper J, Hartmannsgruber K, Frese M: KFZA. Kurz-Fragebogen zur Arbeisanalyse. Zeitschrift für Arbeits- und Organisationspsychologie . 1995, 39: 125-132. Pruemper J, Hartmannsgruber K, Frese M: KFZA. Kurz-Fragebogen zur Arbeisanalyse. Zeitschrift für Arbeits- und Organisationspsychologie . 1995, 39: 125-132.
20.
go back to reference Kriz D, Nuebling R, Steffanowski A, Wittmann WW, Schmidt J: Patientenzufriedenheit in der stationaeren Rehabilitation: Psychometrische Reanalyse des ZUF-8 auf der Basis multizentrischer Stichproben verschiedener Indikation. Zeitschrift fuer Medizinische Psychologie. 2008, 2008 (17): 67-79. Kriz D, Nuebling R, Steffanowski A, Wittmann WW, Schmidt J: Patientenzufriedenheit in der stationaeren Rehabilitation: Psychometrische Reanalyse des ZUF-8 auf der Basis multizentrischer Stichproben verschiedener Indikation. Zeitschrift fuer Medizinische Psychologie. 2008, 2008 (17): 67-79.
21.
go back to reference McLachlan G, Peel D: Finite Mixture Models. Technometrics. 2000, 44: 82-82. McLachlan G, Peel D: Finite Mixture Models. Technometrics. 2000, 44: 82-82.
22.
go back to reference Matschinger H, Kilian R, Angermeyer MC: Detecting Specific Patterns of Change for Two Outcome Scores in a Mental Health Study by Means of Linear Mixture Models. Methodol. 2006, 2: 113-123. Matschinger H, Kilian R, Angermeyer MC: Detecting Specific Patterns of Change for Two Outcome Scores in a Mental Health Study by Means of Linear Mixture Models. Methodol. 2006, 2: 113-123.
23.
go back to reference Meuser M, Nagel U: Experteninterviews - vielfach erprobt, wenig bedacht. Ein Beitrag zur qualitativen Methodendiskussion. Das Experteninterview. Edited by: Bogner A, Littig B, Menz W, Opladen L. 2002, Leske & Budrich, Opladens, 71-95.CrossRef Meuser M, Nagel U: Experteninterviews - vielfach erprobt, wenig bedacht. Ein Beitrag zur qualitativen Methodendiskussion. Das Experteninterview. Edited by: Bogner A, Littig B, Menz W, Opladen L. 2002, Leske & Budrich, Opladens, 71-95.CrossRef
24.
go back to reference Flick U: Qualitative Sozialforschung - Eine Einführung. 2010, Rohwolt Taschenbuchverlag, Hamburg, 3 Flick U: Qualitative Sozialforschung - Eine Einführung. 2010, Rohwolt Taschenbuchverlag, Hamburg, 3
25.
go back to reference Mayring P: Qualitative Inhaltsanalyse - Grundlagen und Techniken. 2010, Beltz, Weinheim, Basel, 11 Mayring P: Qualitative Inhaltsanalyse - Grundlagen und Techniken. 2010, Beltz, Weinheim, Basel, 11
26.
go back to reference Iversen AC, van Staden L, Hughes JH, Greenberg N, Hotopf M, Rona RJ, Thornicroft G, Wessely S, Fear NT: The stigma of mental health problems and other barriers to care in the UK Armed Forces. BMC Health Serv Res. 2011, 11: 31-10.1186/1472-6963-11-31.CrossRefPubMedPubMedCentral Iversen AC, van Staden L, Hughes JH, Greenberg N, Hotopf M, Rona RJ, Thornicroft G, Wessely S, Fear NT: The stigma of mental health problems and other barriers to care in the UK Armed Forces. BMC Health Serv Res. 2011, 11: 31-10.1186/1472-6963-11-31.CrossRefPubMedPubMedCentral
27.
go back to reference Kruse J, Herzog W: Zur ambulanten psychosomatischen/psychotherapeutischen Versorgung in der kassenärztlichen Versorgung in Deutschland - Formen der Versorgung und ihre Effizienz - Zwischenbericht 2012. 2012, Kassenaerztliche Bundesvereinigung, Berlin Kruse J, Herzog W: Zur ambulanten psychosomatischen/psychotherapeutischen Versorgung in der kassenärztlichen Versorgung in Deutschland - Formen der Versorgung und ihre Effizienz - Zwischenbericht 2012. 2012, Kassenaerztliche Bundesvereinigung, Berlin
28.
go back to reference Zepf S, Mengele U, Hartmann S: Zum Stand der ambulanten psychotherapeutischen Versorgung der Erwachsenen in der Bundesrepublik Deutschland. Psychother Psychosom Med Psychol. 2003, 53: 152-162. 10.1055/s-2003-38004.CrossRefPubMed Zepf S, Mengele U, Hartmann S: Zum Stand der ambulanten psychotherapeutischen Versorgung der Erwachsenen in der Bundesrepublik Deutschland. Psychother Psychosom Med Psychol. 2003, 53: 152-162. 10.1055/s-2003-38004.CrossRefPubMed
29.
go back to reference Kupfer DJ, Frank E, Perel JM: The Advantage of Early Treatment Intervention in Recurrent Depression. Arch Gen Psychiatry. 1989, 46: 771-775.CrossRefPubMed Kupfer DJ, Frank E, Perel JM: The Advantage of Early Treatment Intervention in Recurrent Depression. Arch Gen Psychiatry. 1989, 46: 771-775.CrossRefPubMed
30.
go back to reference Clark C, Pike C, McManus S, Harris J, Bebbington P, Brugha T, Jenkins R, Meltzer H, Weich S, Stansfeld S: The contribution of work and non-work stressors to common mental disorders in the 2007 Adult Psychiatric Morbidity Survey. Psychol Med. 2012, 42: 829-842. 10.1017/S0033291711001759.CrossRefPubMed Clark C, Pike C, McManus S, Harris J, Bebbington P, Brugha T, Jenkins R, Meltzer H, Weich S, Stansfeld S: The contribution of work and non-work stressors to common mental disorders in the 2007 Adult Psychiatric Morbidity Survey. Psychol Med. 2012, 42: 829-842. 10.1017/S0033291711001759.CrossRefPubMed
31.
go back to reference Schene AH, Koeter MWJ, Kikkert MJ, Swinkels JA, McCrone P: Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation. Psychol Med. 2007, 37: 351-362. 10.1017/S0033291706009366.CrossRefPubMed Schene AH, Koeter MWJ, Kikkert MJ, Swinkels JA, McCrone P: Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation. Psychol Med. 2007, 37: 351-362. 10.1017/S0033291706009366.CrossRefPubMed
32.
go back to reference Arends I, van der Klink J, Bultmann U: Prevention of recurrent sickness absence among employees with common mental disorders: design of a cluster-randomised controlled trial with cost-benefit and effectiveness evaluation. BMC Public Health. 2010, 10: 132-10.1186/1471-2458-10-132.CrossRefPubMedPubMedCentral Arends I, van der Klink J, Bultmann U: Prevention of recurrent sickness absence among employees with common mental disorders: design of a cluster-randomised controlled trial with cost-benefit and effectiveness evaluation. BMC Public Health. 2010, 10: 132-10.1186/1471-2458-10-132.CrossRefPubMedPubMedCentral
33.
go back to reference Ruotsalainen J, Serra C, Marine A, Verbeek J: Systematic review of interventions for reducing occupational stress in health care workers. Scand J Work Environ Health. 2008, 34: 169-178. 10.5271/sjweh.1240.CrossRefPubMed Ruotsalainen J, Serra C, Marine A, Verbeek J: Systematic review of interventions for reducing occupational stress in health care workers. Scand J Work Environ Health. 2008, 34: 169-178. 10.5271/sjweh.1240.CrossRefPubMed
34.
go back to reference Martin A, Sanderson K, Cocker F: Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety symptoms. Scand J Work Environ Health. 2009, 35: 7-18. 10.5271/sjweh.1295.CrossRefPubMed Martin A, Sanderson K, Cocker F: Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety symptoms. Scand J Work Environ Health. 2009, 35: 7-18. 10.5271/sjweh.1295.CrossRefPubMed
35.
go back to reference Guendel H, Limm H, Heinmueller M, Marten-Mittag B, Angerer P: Public Health Forum. 2011, 19: 20-20.e3. Guendel H, Limm H, Heinmueller M, Marten-Mittag B, Angerer P: Public Health Forum. 2011, 19: 20-20.e3.
36.
go back to reference Limm H, Gundel H, Heinmuller M, Marten-Mittag B, Nater UM, Siegrist J, Angerer P: Stress management interventions in the workplace improve stress reactivity: a randomised controlled trial. Occup Environ Med. 2011, 68: 126-133. 10.1136/oem.2009.054148.CrossRefPubMed Limm H, Gundel H, Heinmuller M, Marten-Mittag B, Nater UM, Siegrist J, Angerer P: Stress management interventions in the workplace improve stress reactivity: a randomised controlled trial. Occup Environ Med. 2011, 68: 126-133. 10.1136/oem.2009.054148.CrossRefPubMed
Metadata
Title
“Psychosomatic consultation in the workplace” – a new model of care at the interface of company-supported mental health care and consultation-liaison psychosomatics: design of a mixed methods implementation study
Authors
Eva Rothermund
Reinhold Kilian
Michael Hoelzer
Dorothea Mayer
Daniel Mauss
Marc Krueger
Monika A Rieger
Harald Guendel
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-780

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