| Study characteristics |
| Methods |
Cluster‐RCT, Denmark |
| Participants |
210 eldercare workers |
| Interventions |
1) Experimental 1: Stress Management Intervention: The SMI was developed to address the work stress in health care with particular attention to prevention of burnout and development of strategies for stress management. Training occurred over 20 weeks, with group sessions every 2 weeks, and each session lasting 2 hours. Between sessions, the participants were given assignments concerning implementation of the programme in daily practice.
2) Experimental 2: Transfer Technique Intervention: The TTI was based on the Stockholm training concept, which aims to reduce the biomechanical load on the back, minimise work in asymmetric postures, and prevent sudden unexpected loads. Training in the TTI arm was a combination of practical classroom education (24 hours for each worker) and instruction at the work site. There were 11 instructors who belonged to the 7 groups in the TTI arm, with 1 to 2 persons in each group who received 30 hours of education during the initial phase of the study.
3) Control: Reference Programme consisting of lessons of the participants' own choice in matters unrelated to the intervention programmes but of the same duration as the active intervention lessons (e.g. on skin care, proper treatment of a person with diabetes, etc.) |
| Outcomes |
MBI (results not reported in article but obtained directly from author)
|
| Identification |
MBI‐EE included in analysis 1.2 |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
"Randomization was performed at group level because the intervention programs were meant to involve the employee as a group during education and implementation. The assignment to the different intervention programs was balanced to secure representation of all 3 programs in each of the wards." (p.1762) |
| Allocation concealment (selection bias) |
Unclear risk |
Not reported. |
| Blinding of participants and personnel (performance bias)
All outcomes |
High risk |
Participants not blinded. |
| Blinding of outcome assessment (detection bias)
All outcomes |
High risk |
Participants were not blinded whereas outcomes are self‐reported. |
| Incomplete outcome data (attrition bias)
All outcomes |
High risk |
Quote: "Altogether, 163 members of the source population (79%) participated in both baseline and follow‐up investigation, and completed at least 2 sets of diaries during the study period. The proportion of dropouts from baseline to follow‐up did not differ significantly across intervention groups. We observed no differences in age and number of years occupied in health care and mean intensity of LBP during the past year between participants who remained in the study and participants who dropped out." (p.1762). |
| Selective reporting (reporting bias) |
High risk |
Results data for the MBI, Setterlind's Stress Scores and rating of social support were not reported because they were not statistically significantly different between groups. "...[N]o significant changes were found in either of the intervention arms in ... the Maslach Burnout Inventory, the Setterlind stress scores, or the rating of social support (data not shown)" (p. 1765) |
| Other bias |
Low risk |
We did not find any indications of other sources of bias. |
