Early identification of work-related stress

Research project

Short description

Early identification of people at risk for sick-leave due to work-related stress – A randomized controlled study of people with mental disorders and physical complaints consulting primary health care

Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. To date, no established method to do this exists. This project’s aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence.

The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC.

The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC.  The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register.


Does the number of reasons for seeking care and self-rated health predict sick leave during the following 12 months? A prospective, longitudinal study in Swedish primary health careILork K, Hultqvist J, Holmgren K
nt.J.Environ.Res. Public Health 2022 19(1):354

Does a brief work-stress intervention prevent sick-leave during the following 24 months? A randomized controlled trial in Swedish primary care
Hultqvist J, Bjerkeli P, Hensing G, Holmgren K
WORK 2021 70:1141–1150

Self-reported sick leave following a brief preventive intervention on work-related stress: a randomised controlled trial in primary health care
Hultén AM, Bjerkeli P, Holmgren K
BMJ Open 2021 Mars 22;11(3):e041157

Effects of a work stress intervention on healthcare use and treatment compared to treatment as usual: a randomised controlled trial in Swedish primary healthcare.
Sanhemimer C, Hederud T, Hensing G, Holmgren K
BMC Fam Pract. 2020 Jul 6;21(1) 133

Positioning work related stress - GPs’ reasoning about using the WSQ combined with feedback at consultatio
Hultén AM, Dahlin Ivanoff S, Holmgren K
BMC Family Practice 2020 Sep 11;21(1):187 

Does early indentification of high work related stress affect pharmacological treatment of primary care patients? - Analysis of Swedish pharmacy dispensing data in a randomised control study.
Bjerkeli P, Skoglund IM, Holmgren K
BMC Fam Pract, 2020 april 21:70

Does early identification of work-related stress, combined with feedback at GP-consultation, prevent sick leave in the following 12 months? a randomized controlled trial in primary health care. 
Holmgren K, Hensing G, Bültmann U, Hadzibajramovic E, Larsson MEH
BMC Public Health 2019 Aug 14;19(1):111

Early identification in primary health care of people at risk for sick leave due to work-related stress – study protocol of a randomized controlled trial (RCT)
Holmgren K, Sandheimer C, Mårdby AC, Larsson ME, Bültmann U, Hange D, Hensing G
BMC Public Health 2016 Nov 25;16(1):1193