Does stigmatization moderate the association between intention and implementation of learned prevention-strategies at work after a depressive episode? - a cross-sectional pilot study

J Occup Med Toxicol. 2019 Nov 5:14:26. doi: 10.1186/s12995-019-0246-9. eCollection 2019.

Abstract

Background: A depressive episode is a frequent reason for production loss due to long periods of absence at work. To maintain work ability after depression, affected employees need to implement learned coping strategies from interventions at work. Based on the theory of planned behavior, this paper examines how stigmatization relates to the implementation of the learned strategies at the workplace. Further, differences between employees with single or recurrent depressive episode were considered.

Methods: Data of an online survey from 112 participants who returned to work after sick leave because of a depressive episode were analyzed [men = 28 (25%); Age: mean = 42.3, SD = 10.9]. The strategies learned were asked openly, intention and implementation with a questionnaire based on the theory of planned behavior and stigmatization with an adapted version of the German inventory of subjective stigma experience.

Results: Intention is positively (β = .46, p < .001) and anticipated (β = -.18, p = .052) and experienced stigmatization not (β = -.11, p = .27) correlated with implementation. Only anticipated stigmatization moderates the association between intention and implementation (β = .26, p = .003). If individuals report a high intention to implement the learned strategies, stigmatization has no influence on implementation. Under low intention, stigmatization leads to less implementation. Participants with recurrent depressive episodes report higher anticipated stigmatization than participants with a single episode.

Conclusion: When employees return to work after a depressive episode, it is important to address anticipated stigmatization and to develop an organizational culture that helps them to reduce their fear of stigmatization and strengthens their work ability via implementing learned prevention-strategies. The reduction of patient's anticipated stigmatization should already be considered in the therapy and reduced in cooperation with occupational physicians.

Keywords: Depression; Humans; Implementation; Intention; Prevention; Return to work; Social stigma.