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Lecours A, Coutu MF, Durand MJ. Fostering Stay at Work After a Period of Disability: A Scoping Review of Occupational Rehabilitation Strategies to Support Workers in the Adoption of Preventive Behaviours. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:56-70. [PMID: 37358726 DOI: 10.1007/s10926-023-10122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, Québec, J2C 0R5, Canada.
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec, Canada.
| | - Marie-France Coutu
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
| | - Marie-José Durand
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
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Starke F, Sikora A, Stegmann R, Knebel L, Buntrock C, de Rijk A, Houkes I, Szycik GR, Unger HP, Schumacher JO, Stark H, Hauth I, Holzapfel C, Borgolte A, Schneller C, Unterschemmann SL, Paetow W, Jung AL, Berking M, Zimmermann J, Wegewitz U. Evaluating a multimodal, clinical and work-directed intervention (RTW-PIA) to support sustainable return to work among employees with mental disorders: study protocol of a multicentre, randomised controlled trial. BMC Psychiatry 2023; 23:380. [PMID: 37254157 DOI: 10.1186/s12888-023-04753-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/05/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Mental disorders (MDs) are one of the leading causes for workforce sickness absence and disability worldwide. The burden, costs and challenges are enormous for the individuals concerned, employers and society at large. Although most MDs are characterised by a high risk of relapse after treatment or by chronic courses, interventions that link medical-psychotherapeutic approaches with work-directed components to facilitate a sustainable return to work (RTW) are rare. This protocol describes the design of a study to evaluate the (cost-)effectiveness and implementation process of a multimodal, clinical and work-directed intervention, called RTW-PIA, aimed at employees with MDs to achieve sustainable RTW in Germany. METHODS The study consists of an effectiveness, a health-economic and a process evaluation, designed as a two-armed, multicentre, randomised controlled trial, conducted in German psychiatric outpatient clinics. Sick-listed employees with MDs will receive either the 18-month RTW-PIA treatment in conjunction with care as usual, or care as usual only. RTW-PIA consists of a face-to-face individual RTW support, RTW aftercare group meetings, and web-based aftercare. Assessments will be conducted at baseline and 6, 12, 18 and 24 months after completion of baseline survey. The primary outcome is the employees´ achievement of sustainable RTW, defined as reporting less than six weeks of working days missed out due to sickness absence within 12 months after first RTW. Secondary outcomes include health-related quality of life, mental functioning, RTW self-efficacy, overall job satisfaction, severity of mental illness and work ability. The health-economic evaluation will be conducted from a societal and public health care perspective, as well as from the employer's perspective in a cost-benefit analysis. The design will be supplemented by a qualitative effect evaluation using pre- and post-interviews, and a multimethod process evaluation examining various predefined key process indicators from different stakeholder perspectives. DISCUSSION By applying a comprehensive, multimethodological evaluation design, this study captures various facets of RTW-PIA. In case of promising results for sustainable RTW, RTW-PIA may be integrated into standard care within German psychiatric outpatient clinics. TRIAL REGISTRATION The study was prospectively registered with the German Clinical Trials Register ( DRKS00026232 , 1 September 2021).
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Affiliation(s)
- Fiona Starke
- Division 3 Work and Health, Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, Berlin, 10317, Germany.
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands.
| | - Alexandra Sikora
- Division 3 Work and Health, Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, Berlin, 10317, Germany
| | - Ralf Stegmann
- Division 3 Work and Health, Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, Berlin, 10317, Germany
| | - Leonie Knebel
- Division 3 Work and Health, Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, Berlin, 10317, Germany
| | - Claudia Buntrock
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto-Von-Guericke University Magdeburg (OVGU), Leipziger Str. 44, 39120, Magdeburg, Germany
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nägelsbachstr. 25a, 91052, Erlangen, Germany
| | - Angelique de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Inge Houkes
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands
| | - Gregor R Szycik
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Podbielskistr. 162, Hanover, OE7110, Germany
| | - Hans-Peter Unger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Centre for Mental Health, Asklepios Clinic Harburg, Eißendorfer Pferdeweg 52, Hamburg, 21075, Germany
| | - Jan Ole Schumacher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Centre for Mental Health, Asklepios Clinic Harburg, Eißendorfer Pferdeweg 52, Hamburg, 21075, Germany
| | - Heiko Stark
- Department of Psychiatry, Burghof-Clinic, Ritterstr. 19, 31737, Rinteln, Germany
| | - Iris Hauth
- Department of Psychiatry, Psychotherapy and Psychosomatics, Alexian St. Joseph-Hospital Berlin-Weissensee, Gartenstr. 1, 13088, Berlin, Germany
| | | | - Anna Borgolte
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hanover Medical School, Podbielskistr. 162, Hanover, OE7110, Germany
| | - Carlotta Schneller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Alexian St. Joseph-Hospital Berlin-Weissensee, Gartenstr. 1, 13088, Berlin, Germany
| | | | - Wiebke Paetow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Centre for Mental Health, Asklepios Clinic Harburg, Eißendorfer Pferdeweg 52, Hamburg, 21075, Germany
| | - Anna Lena Jung
- Clinic Wittgenstein, Sählingsstr. 60, 57319, Bad Berleburg, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nägelsbachstr. 25a, 91052, Erlangen, Germany
| | - Johannes Zimmermann
- Department of Psychology, University of Kassel, Holländische Str. 36-38, 34127, Kassel, Germany
| | - Uta Wegewitz
- Division 3 Work and Health, Unit 3.5 Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, Berlin, 10317, Germany
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Bjørkedal ST, Fisker J, Hellström LC, Hoff A, Poulsen RM, Hjorthøj C, Bojesen AB, Rosenberg NG, Eplov LF. Predictors of return to work for people on sick leave with depression, anxiety and stress: secondary analysis from a randomized controlled trial. Int Arch Occup Environ Health 2023; 96:715-734. [PMID: 36934162 DOI: 10.1007/s00420-023-01968-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE Knowledge about predictors of return to work (RTW) in people on sick leave with common mental disorders (CMDs) may inform the development of effective vocational rehabilitation interventions for this target group. In this study, we investigated predictors of RTW at 6 and 12 months in people on sick leave with depression, anxiety disorders or stress-related disorders. METHODS We have performed a secondary analysis, utilizing data from two RCTs that evaluated the efficacy of an integrated health care and vocational rehabilitation intervention. Data were obtained from mental health assessments, questionnaires and registers. Using Cox regression analysis, the relationship between baseline variables and RTW was analysed at 6 and 12 months after randomization within the group of CMD as a whole and within the subgroups of depression, anxiety and stress-related disorders. RESULTS Symptom burden and employment status at baseline predicted RTW in the CMD group (n = 1245) and in the three diagnostic subgroups at both time points. RTW self-efficacy predicted RTW in the depression group but not in the anxiety or stress subgroups. CONCLUSION Many predictors of RTW were similar over time and, to some extent, across the CMD subgroups. Findings highlight the need not only to take health-related and psychological factors into account when developing vocational rehabilitation interventions but also to consider workplace strategies and options for support.
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Affiliation(s)
- Siv-Therese Bjørkedal
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark.
| | - Jonas Fisker
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
| | - Lone Christina Hellström
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
| | - Andreas Hoff
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
| | - Rie Mandrup Poulsen
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark.,National Board of Social Services in Denmark, Edisonsvej 1, 5000, Odense, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
| | - Nicole Gremaud Rosenberg
- Mental Health Centre Copenhagen, Mental Health Services Capital Region of Denmark, 2200, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Institute for Mental Health [CORE], Mental Health Services Capital Region of Denmark, University of Copenhagen, Gentofte Hospitalsvej 15.4, 2900, Hellerup, Denmark
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Hellström L, Christensen TN, Bojesen AB, Eplov LF. Predictors of Return to Work for People with Anxiety or Depression Participating in a Randomized Trial Investigating the Effect of a Supported Employment Intervention. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:61-70. [PMID: 35612640 DOI: 10.1007/s10926-022-10046-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
Purpose Common mental disorders have a severe impact on society and individuals; rates of unemployment and disability pensions are high. Knowing which factors facilitate or hinder people's return to work is important when designing effective vocational rehabilitation interventions. Methods We conducted secondary analyses on data from 289 participants with depression or anxiety included in the Individual Placement and Support modified for people with mood and anxiety disorders (IPS-MA) trial. Associations of baseline characteristics and employment or education after 24 months were tested in univariate logistic regression analyses, variables with a p-value below 0.1 were included in multivariate analyses. Results In the univariate analyses, self-reported level of functioning (p = 0.032), higher age (p = 0.070), and higher level of readiness to change (p = 0.001) were associated with the outcome and included in the multivariate analysis. Only age (p = 0.030) and readiness to change (p = 0.003) remained significantly associated with return to work or education after 24 months in the multivariate analysis. Conclusion Higher age and lower readiness to change were associated with a lower chance of having returned to work or education. Factors modifying the effect of higher age should be identified, just as vocational rehabilitation should focus on improving factors related to people's readiness to change.
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Affiliation(s)
- Lone Hellström
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark.
| | - Thomas Nordahl Christensen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
- Biostatistics (Insulin & Devices), Novo Nordisk A/S, Alfred Nobels Vej 27, 9220, Aalborg Øst, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
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Tanaka S, Kuge RI, Nakano M, Inukai S, Hamamoto M, Terasawa M, Nakamura T, Sugiyama N, Kobayashi M, Washizuka S. Outcomes of an interdisciplinary return to work intervention including occupational therapy for mood and adjustment disorders: A single-arm clinical trial. Work 2023; 74:515-530. [PMID: 36278381 PMCID: PMC9986701 DOI: 10.3233/wor-211144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW) intervention was attempted, targeting patients with mood and adjustment disorders. OBJECTIVE This study aimed to investigate the outcome of an interdisciplinary RTW intervention including occupational therapy implemented within the Japanese healthcare framework. METHODS An interdisciplinary RTW intervention including occupational therapy was conducted five times a week for approximately three months, targeting individuals with mood and adjustment disorders who took a leave of absence. Their mental symptoms, cognitive functioning, job performance, temperament, social adaptation, psychosocial state, and readiness to RTW before and after the intervention were evaluated. Full-time RTW ratios at 3, 6, 12, 18, and 24 months from baseline were followed up and compared with those of prior studies. RESULTS A total of 30 individuals completed the intervention. After the intervention, participants' psychological symptoms, cognitive function, vocational aptitude, temperament, social adaptation, psychosocial state, and readiness to RTW improved (p≤0.001-0.0279). The ratios of RTW at 3, 6, 12, 18, and 24 months from the baseline were 6.7%, 46.7%, 73.3%, 77.8%, and 82.6%, respectively, reflecting a higher pattern than prior reports. CONCLUSIONS The interdisciplinary RTW intervention including occupational therapy has the potential to improve not only depressive symptoms but also cognitive functioning, job performance, social adaptation, and readiness to RTW. They can also raise RTW ratios.
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Affiliation(s)
- Sachie Tanaka
- Department of Fundamental Occupational Therapy, Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan
| | - Ryunosuke Iwai Kuge
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Nagano, Japan.,Department of Health Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Miku Nakano
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Nagano, Japan.,Department of Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Sayaka Inukai
- Patient Support Center, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Midori Hamamoto
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Miho Terasawa
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Toshinori Nakamura
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Nobuhiro Sugiyama
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.,Department of Applied Occupational Therapy, Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Fundamental Occupational Therapy, Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan.,Department of Health Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Shinsuke Washizuka
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Corbière M, Lachance JP, Jean-Baptiste F, Hache-Labelle C, Riopel G, Lecomte T. Healthy Minds: Group Cognitive-Behavioral Intervention for Sustainable Return to Work After a Sick Leave Due to Depression. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:505-514. [PMID: 34279759 PMCID: PMC8287279 DOI: 10.1007/s10926-021-09991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Background Depression is one of the major causes for sick leave and loss of productivity at work. Many studies have investigated return to work (RTW) interventions for people with common mental disorders. However, a paucity of studies has targeted depressive symptoms in the workplace, as well as work productivity. Objectives This study presents preliminary results on a novel group intervention based on cognitive behavioral principles in order to optimize sustainable RTW, by reducing clinical symptoms (anxiety and depression) and improving work productivity. Method This pilot study followed a quasi-experimental design, with participants randomly receiving the group intervention (N = 19) or only receiving usual services (N = 11, control group). The group intervention called Healthy Minds for Sustainable RTW consists of eight sessions based on cognitive behavioral therapy principles and techniques. Outcome measures on depressive and anxiety symptoms and work productivity were administered at baseline (i.e. the start of return-to-work or gradual RTW), as well 2 months later (post-intervention), and at 6-month follow-up. Results The results did not show a time × group interaction for symptoms of depression or anxiety (p = 0.07). Those who received the group intervention however did see a within-group reduction in anxiety and depressive symptoms over time, clinically significant for the group intervention only. A significant time × group interaction for work productivity was found, with those in the intervention group improving over time compared to the control condition. Conclusion Although replication is needed, these results suggest that a brief group cognitive-behavioral intervention specifically tailored to work-related issues is promising. Future studies are warranted, particularly with larger samples and remote webconferencing delivery.
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Affiliation(s)
- Marc Corbière
- Faculty of Educational Sciences, Université of Québec à Montréal, 1205, Rue Saint-Denis, Montréal, QC, H2X 3R9, Canada.
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Canada.
| | - Jean-Philippe Lachance
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Health and Society Institute, Université du Québec à Montréal, Montreal, Canada
| | | | - Catherine Hache-Labelle
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Gabrielle Riopel
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Tania Lecomte
- Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
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Lecours A, Durand MJ, Coutu MF, Groleau C, Bédard-Mercier R. Stay at Work After a Period of Disability Due to an Occupational Injury: A Complex Process Marked by Social Exchanges. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:319-328. [PMID: 34668121 DOI: 10.1007/s10926-021-10008-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
Purpose Rooted in a social exchange lens, this study aimed to explore the interactions between the factors influencing stay at work after a period of disability due to an occupational injury. Methods Based on a descriptive interpretative research design, interviews with 15 participants (i.e., representatives of workers, workplaces, insurers, and the health care system) were conducted to gather their perspectives about stay at work. Qualitative data was analyzed through thematic analysis. Results Ten different factors interacting together and influencing stay at work were identified. These factors prevail either during stay at work or previously. They are either related to the person (personal resources, occupation outside of work), environment (accommodations, support, access to rehabilitation services) or interaction between the person and her/his environment (perceptions, leeway, communication and information), whether it concerns the workplace, health services or insurance. Conclusions This study contributes to the advancement of knowledge concerning two main themes: (1) the importance of considering social exchanges as factors of success, and (2) the importance of considering the stay at work within a larger process.
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Affiliation(s)
- Alexandra Lecours
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, QC, J2C 0R5, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada.
| | - Marie-José Durand
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, Quebec, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, Quebec, Canada
| | - Charles Groleau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada
| | - Roxanne Bédard-Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada
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Hannerz H, Flyvholm MA. Do baseline industry and job group skill level predict welfare dependency at 1, 3 and 5 years after mental health related sickness absence? A Danish cohort study. BMC Public Health 2022; 22:697. [PMID: 35397597 PMCID: PMC8994387 DOI: 10.1186/s12889-022-13105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background The cost of mental ill health in the EU-28 nations has been estimated at approximately 4.1% of the total gross domestic products (GDP). Improved rates of return to sustainable employment among people who are sick-listed due to mental ill health would decrease spending on welfare benefits. The present cohort study provides statistical information that may be helpful in the design and prioritizing of efforts aimed at reducing the burden of sickness absence due to mental ill health among employees in the general working population of Denmark. Our primary aim was to estimate odds of being i) deceased or recipient of health related welfare benefits and ii) recipient non-health related welfare benefits, compared to being alive and self-reliant at 1, 3 and 5 years after first visit to a jobs and benefits office due to mental health related sickness absence, as a function of industrial sector and job group skill level at baseline. A secondary aim was to analyze these odds as a function of baseline age, gender, type of mental ill health, family type and employment status. Methods The study population consisted of 20–54 year-old persons on long-term sickness absence due to mental health problems in 21 Danish municipalities in 2010–2012 (N = 19,660). Odds ratios were estimated by use of multinomial logistic regression. The outcomes were ascertained through national registers. Results We did not find any statistically significant association between baseline industrial sector or job group skill level and welfare dependency at follow-up. In the secondary analyses, the estimated odds of health and non-health related welfare dependencies at follow-up tended to increase with unemployment, age, being single and being on sick leave due to self-reported anxiety or depression versus stress/burnout at baseline. Conclusions The present study does not support that industry and job group skill level predict welfare dependency after health related sickness absence, after adjustment for relevant covariates, in the general population of Denmark. It suggests, however, that the vulnerability lies in population groups characterized by unemployment, older age, being single and being on sick leave due to self-reported anxiety or depression versus stress/burnout.
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Fisker J, Hjorthøj C, Hellström L, Mundy SS, Rosenberg NG, Eplov LF. Predictors of return to work for people on sick leave with common mental disorders: a systematic review and meta-analysis. Int Arch Occup Environ Health 2022; 95:1-13. [PMID: 35106629 DOI: 10.1007/s00420-021-01827-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/15/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To support the return to work following common mental disorders knowing which factors influence the return to work is important. We aimed to identify factors predicting return to work for people on sick leave with disorders like stress, anxiety, and depression. METHODS A systematic review and meta-analyses were conducted regarding return to work at any time point, < 3 months, 3-12 months, and > 12 months of sick leave, respectively, and diagnostic subgroups. RESULTS The meta-analyses included 29 studies. Predictors decreasing return to work probability at any time point were higher age, being male, neuroticism and openness, previous sickness absence, and higher symptom scores. Predictors increasing return to work probability were positive return to work expectations, high return to work- and general self-efficacy, conscientiousness, and high workability index. Return to work within < 3 months of sick leave was associated with positive return to work expectations. Return to work after > 12 months was increased by higher education. Higher age was associated with decreased return to work probability after > 12 months. No significant predictors were found in diagnostic subgroups. CONCLUSION Results are overall consistent with earlier reviews. Future studies should focus on specific time points, diagnostic subgroups, and work-related factors. PROSPERO REGISTRATION ID CRD42018073396.
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Affiliation(s)
- Jonas Fisker
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
| | - Lone Hellström
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark.
| | - Sara Skriver Mundy
- Mental Health Center Copenhagen, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Nicole Gremaud Rosenberg
- Mental Health Center Copenhagen, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health - CORE, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
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Ter Meulen WG, Draisma S, van Hemert AM, Schoevers RA, Kupka RW, Beekman ATF, Penninx BWJH. Depressive and anxiety disorders in concert-A synthesis of findings on comorbidity in the NESDA study. J Affect Disord 2021; 284:85-97. [PMID: 33588240 DOI: 10.1016/j.jad.2021.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Comorbidity of depressive and anxiety disorders is common and remains incompletely comprehended. This paper summarizes findings from the Netherlands Study of Depression and Anxiety (NESDA) regarding prevalence, temporal sequence, course and longitudinal patterns; sociodemographic, vulnerability and neurobiological indicators; and functional, somatic and mental health indicators of comorbidity. METHODS Narrative synthesis of earlier NESDA based papers on comorbidity (n=76). RESULTS Comorbidity was the rule in over three-quarter of subjects with depressive and/or anxiety disorders, most often preceded by an anxiety disorder. Higher severity and chronicity characterized a poorer comorbidity course. Over time, transitions between depressive and anxiety disorders were common. Consistent comorbidity risk indicators in subjects with depressive and anxiety disorders were childhood trauma, neuroticism and early age of onset. Psychological vulnerabilities, such as trait avoidance tendencies, were more pronounced in comorbid than in single disorders. In general, there were few differences in biological markers and neuroimaging findings between persons with comorbid versus single disorders. Most functional, somatic, and other mental health indicators, ranging from disability to cardiovascular and psychiatric multimorbidity, were highest in comorbid disorders. LIMITATIONS The observational design of NESDA limits causal inference. Attrition was higher in comorbid relative to single disorders. CONCLUSIONS As compared to single disorders, persons with comorbid depressive and anxiety disorders were characterized by more psychosocial risk determinants, more somatic and other psychiatric morbidities, more functional impairments, and poorer outcome. These results justify specific attention for comorbidity of depressive and anxiety disorders, particularly in treatment settings.
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Affiliation(s)
- Wendela G Ter Meulen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Albert M van Hemert
- Leiden University, Leiden University Medical Centre, Department of Psychiatry, Leiden, the Netherlands.
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands.
| | - Ralph W Kupka
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
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11
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Durand MJ, Coutu MF, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Kirouac L, Paquette MA, Nastasia I, Coté D. Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:92-106. [PMID: 32347441 DOI: 10.1007/s10926-020-09894-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-France Coutu
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Dominique Tremblay
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Laurie Kirouac
- Department of Industrial Relations, Université Laval, 1025 avenue des Sciences-Humaines, Québec, QC, G1V 0A6, Canada
| | - Marie-Andrée Paquette
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
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Villotti P, Gragnano A, Larivière C, Negrini A, Dionne CE, Corbière M. Tools Appraisal of Organizational Factors Associated with Return-to-Work in Workers on Sick Leave Due to Musculoskeletal and Common Mental Disorders: A Systematic Search and Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:7-25. [PMID: 32440855 DOI: 10.1007/s10926-020-09902-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose The objective of this study was to identify organizational factors that are predictive of return-to-work (RTW) among workers with musculoskeletal (MSD) and common mental disorders (CMD), and to subsequently catalogue and characterize the questionnaires (tools) used to measure them. Methods A systematic search on PubMed, Web of Science and PsycINFO library databases and grey literature was conducted. First, a list of organizational factors predictive of RTW for the two populations considered was built. Second, the questionnaires used to measure these factors were retrieved. Third, we looked in the scientific literature for studies on the psychometric properties and practical relevance of these questionnaires. Results Among the factors retained, perceived social support from supervisor and co-workers, work accommodations, and job strain were identified as common RTW factors. Other risk/protective factors, and associated tools, specifically targeting either people with MSD or CMD were also analysed. Conclusions Researchers and practitioners are often uncertain of which tools to use to measure organizational factors which can facilitate or hinder RTW. This study provides an evaluation of the tools measuring predictive organizational RTW factors in people with MSD and CMD. The identified tools can be used in everyday practice and/or research.
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Affiliation(s)
- Patrizia Villotti
- Career counselling - Department of Education, Université du Québec à Montréal, 1205 rue St-Denis, Montréal, QC, H2X 3R9, Canada.
| | - Andrea Gragnano
- Department of Psychology, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
| | - Clermont E Dionne
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Marc Corbière
- Career counselling - Department of Education, Université du Québec à Montréal, 1205 rue St-Denis, Montréal, QC, H2X 3R9, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Canada
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Louwerse I, van Rijssen HJ, Huysmans MA, van der Beek AJ, Anema JR. Predicting Long-Term Sickness Absence and Identifying Subgroups Among Individuals Without an Employment Contract. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:371-380. [PMID: 32030546 PMCID: PMC7406482 DOI: 10.1007/s10926-020-09874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Today, decreasing numbers of workers in Europe are employed in standard employment relationships. Temporary contracts and job insecurity have become more common. This study among workers without an employment contract aimed to (i) predict risk of long-term sickness absence and (ii) identify distinct subgroups of sick-listed workers. Methods 437 individuals without an employment contract who were granted a sickness absence benefit for at least two weeks were followed for 1 year. We used registration data and self-reported questionnaires on sociodemographics, work-related, health-related and psychosocial factors. Both were retrieved from the databases of the Dutch Social Security Institute and measured at the time of entry into the benefit. We used logistic regression analysis to identify individuals at risk of long-term sickness absence. Latent class analysis was used to identify homogenous subgroups of individuals. Results Almost one-third of the study population (n = 133; 30%) was still at sickness absence at 1-year follow-up. The final prediction model showed fair discrimination between individuals with and without long-term sickness absence (optimism adjusted AUC to correct for overfitting = 0.761). Four subgroups of individuals were identified based on predicted risk of long-term sickness absence, self-reported expectations about recovery and return to work, reason of sickness absence and coping skills. Conclusion The logistic regression model could be used to identify individuals at risk of long-term sickness absence. Identification of risk groups can aid professionals to offer tailored return to work interventions.
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Affiliation(s)
- Ilse Louwerse
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands.
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands.
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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Corbière M, Mazaniello-Chézol M, Bastien MF, Wathieu E, Bouchard R, Panaccio A, Guay S, Lecomte T. Stakeholders' Role and Actions in the Return-to-Work Process of Workers on Sick-Leave Due to Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:381-419. [PMID: 31673934 DOI: 10.1007/s10926-019-09861-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The lack of knowledge regarding the roles and actions of return to work (RTW) stakeholders create confusion and uncertainty about how and when to RTW after experiencing a common mental disorder (CMD). Purpose The purpose of this scoping review is to disentangle the various stakeholders' role and actions in the RTW process of workers on sick-leave due to CMDs. The research question is: What is documented in the existing literature regarding the roles and actions of the identified stakeholders involved in the RTW process of workers on sick-leave due to CMDs? Methods In conducting this scoping review, we followed Arksey and O'Malley's (Int J Soc Res Methodol 8:19-32, 2005) methodology, consisting of different stages (e.g., charting the data by categorizing key results). Results 3709 articles were screened for inclusion, 243 of which were included for qualitative synthesis. Several RTW stakeholders (n=11) were identified (e.g., workers on sick leave due to CMDs, managers, union representatives, rehabilitation professionals, insurers, return to work coordinators). RTW stakeholders' roles and actions inter- and intra-system were recommended, either general (e.g., know and understand the perspectives of all RTW stakeholders) or specific to an actor (e.g., the return to work coordinator needs to create and maintain a working alliance between all RTW stakeholders). Furthermore, close to 200 stakeholders' actions, spread out on different RTW phases, were recommended for facilitating the RTW process. Conclusions Eleven RTW stakeholders from the work, heath and insurance systems have been identified, as well as their respective roles and actions. Thanks to these results, RTW stakeholders and policy makers will be able to build practical relationships and collaboration regarding the RTW of workers on sick leave due to CMDs.
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Affiliation(s)
- Marc Corbière
- Department of Education, Career counselling, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada.
| | - Maud Mazaniello-Chézol
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Marie-France Bastien
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Estelle Wathieu
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Art History, Concordia University, Montreal, QC, Canada
| | | | - Alexandra Panaccio
- John Molson School of Business, Concordia University, Montréal, QC, Canada
| | - Stéphane Guay
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychiatry and Addictology, Université de Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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15
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Etuknwa A, Daniels K, Eib C. Sustainable Return to Work: A Systematic Review Focusing on Personal and Social Factors. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:679-700. [PMID: 30767151 PMCID: PMC6838034 DOI: 10.1007/s10926-019-09832-7] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Purpose A systematic review was conducted to evaluate the impact of important personal and social factors on sustainable return to work (RTW) after ill-health due musculoskeletal disorders (MSDs) and common mental disorders (CMDs) and to compare the effects of these personal and social factors across both conditions. Sustainable RTW is defined as a stable full-time or part-time RTW to either original or modified job for a period of at least 3 months without relapse or sickness absence re-occurrence. Methods A literature search was conducted in 13 databases and 79 studies were selected for the review, of which the methodological design was graded as very high, high and low quality. Results The most consistent evidence for achieving sustainable RTW for both MSDs and CMDs was from support from line managers or supervisors and co-workers, positive attitude, self-efficacy, young age and higher education levels. Job crafting, economic status, length of absence and job contract/security showed promising results, but too few studies exist to draw definite conclusions. Results regarding gender were inconsistent. Conclusions This review demonstrates that a variety of personal and social factors have positive and negative influences on sustainable RTW. We suggest that the social environment and how it interrelates with personal factors like attitudes and self-efficacy should be studied in more detail in the future as the inter-relationship between these factors appears to impact positively on sustainable RTW outcomes. Areas for future research include more high-quality studies on job crafting, economic status/income, length of absence, job contract/security and gender.
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Affiliation(s)
- Abasiama Etuknwa
- Norwich Business School, University of East Anglia, Norwich Research Park, Norwich, NR47TJ UK
| | - Kevin Daniels
- Norwich Business School, University of East Anglia, Norwich Research Park, Norwich, NR47TJ UK
| | - Constanze Eib
- Department of Psychology, Uppsala Universitet, Von Kraemers allé 1A och 1C 752 37, Box 1225, 751 42 Uppsala, Sweden
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Vendrig L, Wijnvoord L, Schaafsma F. Reliability and Validity of the Work and Well-Being Inventory (WBI) for Self-Employed Workers: Test Norms of Employees Are Not Suitable for Entrepreneurs. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:595-608. [PMID: 30570693 DOI: 10.1007/s10926-018-9821-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Sickness absence and work disability can be a major burden for society and for both employees and self-employed workers. Validated tools for assessing the psychosocial risk factors of long-term disability, for matching effective interventions and for deciding when to resume work can be of great value. However, no validated tools exist for self-employed workers. The purpose of this study is to adjust and to validate the Work and Wellbeing Inventory (WBI) for entrepreneurs. Methods The sample consisted of 676 self-employed workers with a private disability insurance policy. Three groups were distinguished: business owners, liberal professions and doctors and paramedics. Reliability, construct validity and concurrent validity of the WBI were examined. Scale scores were calculated for each group of self-employed workers and compared with the scores of a representative group of 912 Dutch employees to test the adequacy of the existing (employee) test norms. Results The WBI for the self-employed showed good to excellent reliability figures. The construct validity and the concurrent validity of the WBI could be confirmed. Overall, the self-employed scored higher on job satisfaction, social support at work and perfectionism (diligence) and had fewer mental health problems compared to employees. Self-employed workers should not be treated as one group, as there were important differences between entrepreneurs, liberal professions and doctors and paramedics. Conclusions The reliability and validity of the WBI were confirmed. Important differences in the scores of employees and the self-employed were revealed. In addition, the group of self-employed workers appeared to be rather heterogeneous.
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Affiliation(s)
- Lex Vendrig
- Vledder Medical Centra, Pastorieweg 16, 8381 AX, Vledder, The Netherlands.
| | | | - Frederieke Schaafsma
- Department of Public and Occupational Health, Research Center for Insurance Medicine, AMC UMCG UWV VUmc. Amsterdam Public Health Research Institute, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
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Kox RJ, Hoving JL, Verbeek JH, Schouten MJE, Hulshof CTJ, Wind H, Frings-Dresen MHW. Assessment of prognosis by physicians involved in work disability evaluation: A qualitative study. PLoS One 2019; 14:e0212276. [PMID: 30735562 PMCID: PMC6368383 DOI: 10.1371/journal.pone.0212276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/30/2019] [Indexed: 11/18/2022] Open
Abstract
Background Assessment of prognosis of work functioning is a challenging aspect of work disability evaluations. To gain insight into this process, we conducted a qualitative study to determine the aspects considered and the difficulties, needs and potential solutions affecting the prognosis assessment by physicians performing disability evaluations. Methods In-depth, semi-structured individual interviews were conducted with 20 physicians performing disability evaluations for the Dutch social security institute: the national institute for employee benefit schemes. Verbatim transcripts were independently analyzed by two researchers using MAXQDA software until significant themes emerged and data saturation was achieved. Results The responses that emerged from the interviews were clustered in three primary themes. The first theme was “Aspects considered by physicians in assessing prognosis.” When making a prognosis, physicians considered the following medical issues: nature and severity of disease, the role of treatment, course of the disease, external information, and medical evidence. Patient-related issues and physician-related aspects were also distinguished. Patient-related aspects concerned the patients’ work perspectives and coping or recovery behavior. Physician-related aspects concerned awareness of the physician’s own role and reflection on aspects such as empathy for clients and ethical considerations. The second theme was “Difficulties physicians face in assessing prognosis,” which included challenges during the assessment of diseases of a complex or less concrete nature, applying prognostic evidence to the individual, and lack of time when seeking prognostic evidence. The third theme concerned “Needs and solutions” formulated by physicians that facilitated the prognostic assessment. It consisted of continuous education, better collaboration with medical specialists and/or labor experts, and the use of prognostic tools such as checklists, apps or internet applications incorporating evidence on prognosis. Conclusions Physicians identified several medical and patient-related aspects that elucidated the prognosis assessment. Given the variety of challenges and the need for further support found in the current study, future research should focus on the development and evaluation of training, tools, and guidelines to improve prognosis assessment by physicians.
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Affiliation(s)
- René J. Kox
- Amsterdam UMC, Location AMC, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| | - Jan L. Hoving
- Amsterdam UMC, Location AMC, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
- * E-mail:
| | - Jos H. Verbeek
- Finnish Institute of Occupational Health, Kuopio, Finland
| | | | - Carel T. J. Hulshof
- Amsterdam UMC, Location AMC, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Haije Wind
- Amsterdam UMC, Location AMC, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| | - Monique H. W. Frings-Dresen
- Amsterdam UMC, Location AMC, Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
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Hellström L, Madsen T, Nordentoft M, Bech P, Eplov LF. Trajectories of Return to Work Among People on Sick Leave with Mood or Anxiety Disorders: Secondary Analysis from a Randomized Controlled Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:666-677. [PMID: 29282650 DOI: 10.1007/s10926-017-9750-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose The return to work (RTW) of people with mood and anxiety disorders is a heterogeneous process. We aimed to identify prototypical trajectories of RTW over a two-year period in people on sick leave with mood and anxiety disorders, and investigate if socio-demographic or clinical factors predicted trajectory membership. Methods We used data from the randomized IPS-MA trial (n = 283), evaluating a supported employment intervention for participants with recently diagnosed mood or anxiety disorders. Information on "weeks in employment in the past 6 months" was measured after 1/2, 1, 1 ½ and 2 years, using data from a nationwide Danish register (DREAM). Latent growth mixture modelling analysis was carried out to identify trajectories of RTW and logistic regression analyses were used to estimate predictors for trajectory membership. Results Four trajectory classes of RTW were identified; non-RTW [70% (196/283)] (practically no return to work); delayed-RTW [19% (56/283)] (6 months delay before full RTW); rapid-unstable-RTW [7% (19/283)] (members rapidly returned to work, but only worked half the time); and the smallest class, rapid-RTW [4% (12/283)] (members rapidly reached full employment, but later experienced a decrease in weeks of employment). Self-reported disability score according to the SDS, not living with a partner, and readiness to change on the CQ scale were found to be significantly associated with RTW. Conclusion The trajectories identified support that many do not benefit from vocational rehabilitation, or experience difficulties sustaining employment; enhanced support of this patient group is still warranted.Trial registration: http://www.clinicaltrials.gov (Identifier: NCT01721824).
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Affiliation(s)
- Lone Hellström
- Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
- Research Unit, Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
| | - Trine Madsen
- Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Merete Nordentoft
- Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark
| | - Per Bech
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Dyrehavevej 48, 3400, Hillerød, Denmark
| | - Lene Falgaard Eplov
- Copenhagen University Hospital, Mental Health Centre Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark
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Hara KW, Bjørngaard JH, Brage S, Borchgrevink PC, Halsteinli V, Stiles TC, Johnsen R, Woodhouse A. Randomized Controlled Trial of Adding Telephone Follow-Up to an Occupational Rehabilitation Program to Increase Work Participation. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:265-278. [PMID: 28597308 PMCID: PMC5978834 DOI: 10.1007/s10926-017-9711-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose Transfer from on-site rehabilitation to the participant's daily environment is considered a weak link in the rehabilitation chain. The main objective of this study is to see if adding boosted telephone follow-up directly after completing an occupational rehabilitation program effects work participation. Methods A randomized controlled study included participants with chronic pain, chronic fatigue or common mental disorders on long-term sick leave. After completing 3½ weeks of acceptance and commitment therapy based occupational rehabilitation, participants were randomized to boosted follow-up or a control group before returning to their daily environment. The intervention was delivered over 6 months by on-site RTW coordinators mainly via telephone. Primary outcome was RTW categorized as participation in competitive work ≥1 day per week on average over 8 weeks. Results There were 213 participants of mean age 42 years old. Main diagnoses of sick leave certification were mental disorders (38%) and musculoskeletal disorders (30%). One year after discharge the intervention group had 87% increased odds (OR 1.87, 95% confidence interval 1.06-3.31, p = 0.031), of (re)entry to competitive work ≥1 day per week compared with the controls, with similar positive results for sensitivity analysis of participation half time (≥2.5 days per week). The cost of boosted follow-up was 390.5 EUR per participant. Conclusion Participants receiving boosted RTW follow-up had higher (re)entry to competitive work ≥1 day per week at 1 year when compared to the control group. Adding low-cost boosted follow-up by telephone after completing an occupational rehabilitation program augmented the effect on return-to-work.
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Affiliation(s)
- Karen Walseth Hara
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- The Norwegian Labour and Welfare Service of Sør-Trøndelag, Trondheim, Norway.
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Forensic Department and Research Centre Brøset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Søren Brage
- The Norwegian Directorate for Labour and Welfare, Oslo, Norway
| | - Petter Christian Borchgrevink
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Vidar Halsteinli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Centre for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tore Charles Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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20
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Gragnano A, Negrini A, Miglioretti M, Corbière M. Common Psychosocial Factors Predicting Return to Work After Common Mental Disorders, Cardiovascular Diseases, and Cancers: A Review of Reviews Supporting a Cross-Disease Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:215-231. [PMID: 28589524 DOI: 10.1007/s10926-017-9714-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose This systematic review aimed at identifying the common psychosocial factors that facilitate or hinder the return to work (RTW) after a sick leave due to common mental disorders (CMDs), cardiovascular diseases (CVDs), or cancers (CAs). Methods We conducted a review of reviews searching 13 databases from 1994 to 2016 for peer-reviewed, quantitative, cohort studies investigating factors influencing RTW after a CMD, CVD, or CA. Then, for each disease we identified additional cohort studies published after the date of the latest review included. Data were extracted following a three steps best-evidence synthesis method: the extraction of results about each predictor from studies within each single review and in the additional papers; the synthesis of results across the reviews and additional papers investigating the same disease; and the synthesis of results across the diseases. Results The search strategy identified 1029 unique records from which 27 reviews and 75 additional studies underwent comprehensive review. 14 reviews and 32 additional cohort studies met eligibility criteria. Specific predictors of RTW with different levels of evidence are provided for each disease. We found four common facilitators of RTW (job control, work ability, perceived good health and high socioeconomic status), and six barriers of RTW (job strain, anxiety, depression, comorbidity, older age and low education). Conclusion This is the first review to systematically analyze commonalities in RTW after CMDs, CVDs, or CAs. The common factors identified indicate that the RTW process presents many similarities across various diseases, thus supporting the validity of a cross-disease approach.
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Affiliation(s)
- Andrea Gragnano
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada.
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
| | | | - Marc Corbière
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
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21
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Demou E, Smith S, Bhaskar A, Mackay DF, Brown J, Hunt K, Vargas-Prada S, Macdonald EB. Evaluating sickness absence duration by musculoskeletal and mental health issues: a retrospective cohort study of Scottish healthcare workers. BMJ Open 2018; 8:e018085. [PMID: 29374662 PMCID: PMC5829784 DOI: 10.1136/bmjopen-2017-018085] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Sickness absence (SA) among healthcare workers is associated with occupational and non-occupational risk factors and impacts employee health, healthcare delivery and patient health. At the same time, healthcare is one of the employment sectors with the highest rates of work-related ill health in the UK. Musculoskeletal (MSK) and mental health (MH) issues are leading causes of SA, but there is a lack of research on how certain MSK/MH conditions impact on SA duration. The study aim is to determine differences in SA duration by MH and MSK disorders in healthcare employees. METHODS Survival analyses were used to estimate SA duration due to MSK and MH problems over 6 years, and Cox's proportional hazards models to determine the HRs of returning to work, using a bespoke Scottish health board database with over 53 000 SA events. SA duration and time to return-to-work (RTW) were estimated for employees by age, gender, job and health conditions. RESULTS MSK and MH conditions accounted for 27% and 6% of all SA events and 23.7% and 19.5% of all days lost, respectively. Average SA duration was 43.5 days for MSK and 53.9 days for MH conditions. For MSK conditions, employees with low back or neck pain had the fastest RTW (median P50: 7 days), whereas employees absent due to depression took the longest (P50: 54 days). The most influential sociodemographic variables affecting RTW were age, gender and job category. CONCLUSIONS Using a unique and rich database, we found significant differences in SA duration by presenting condition in healthcare workers. MH conditions, and depression specifically, accounted for the most working days' absence. Significant variations in duration were also observed for MSK conditions. Our findings can inform public health practitioners and healthcare managers of the most significant factors impacting MSK-related and MH-related SA to develop and implement tailored and targeted workplace interventions.
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Affiliation(s)
- Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Shanley Smith
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Abita Bhaskar
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Daniel F Mackay
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Judith Brown
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Sergio Vargas-Prada
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- Unidad Central de Contingencias Comunes (U3C), ASEPEYO, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Ewan B Macdonald
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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22
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Ervasti J, Joensuu M, Pentti J, Oksanen T, Ahola K, Vahtera J, Kivimäki M, Virtanen M. Prognostic factors for return to work after depression-related work disability: A systematic review and meta-analysis. J Psychiatr Res 2017; 95:28-36. [PMID: 28772111 DOI: 10.1016/j.jpsychires.2017.07.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 11/21/2022]
Abstract
Knowledge about factors influencing return to work (RTW) after depression-related absence is highly relevant, but the evidence is scattered. We performed a systematic search of PubMed and Embase databases up to February 1, 2016 to retrieve cohort studies on the association between various predictive factors and return to work among employees with depression for review and meta-analysis. We also analyzed unpublished data from the Finnish Public Sector study. Most-adjusted estimates were pooled using fixed effects meta-analysis. Eleven published studies fulfilled the eligibility criteria, representing 22 358 person-observations from five different countries. With the additional unpublished data from the 14 101 person-observations from the Finnish Public Sector study, the total number of person-observations was 36 459. The pooled estimates were derived from 2 to 5 studies, with the number of observations ranging from 260 to 26 348. Older age (pooled relative risk [RR] 0.95; 95% confidence interval [CI] 0.84-0.87), somatic comorbidity (RR = 0.80, 95% CI 0.77-0.83), psychiatric comorbidity (RR = 0.86, 95% CI 0.83-0.88) and more severe depression (RR = 0.96, 95% CI 0.94-0.98) were associated with a lower rate of return to work, and personality trait conscientiousness with higher (RR = 1.06, 95% CI 1.02-1.10) return to work. While older age and clinical factors predicted slower return, significant heterogeneity was observed between the studies. There is a dearth of observational studies on the predictors of RTW after depression. Future research should pay attention to quality aspects and particularly focus on the role of workplace and labor market factors as well as individual and clinical characteristics on RTW.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Matti Joensuu
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kirsi Ahola
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; Clinicum, Faculty of Medicine, University of Helsinki, Finland; Department of Epidemiology and Public Health, University College London, UK
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Prognostic factors for return to work of employees with common mental disorders: a meta-analysis of cohort studies. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1205-1215. [PMID: 28577211 DOI: 10.1007/s00127-017-1402-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/23/2017] [Indexed: 01/11/2023]
Abstract
PURPOSE To examine prognostic factors for return to work (RTW) of employees with common mental disorders (CMDs). METHODS A systematic review and meta-analysis were performed using data from 18 published cohort studies with 24,579 participants. The studies were identified from MEDLINE/PubMed, PsycINFO, EMBASE, SocINDEX, and Human resource management databases from 1995 to 2016. Two authors independently screened selected studies and assessed the quality of the studies as well as the extracted data. RESULTS We screened 7755 abstracts, from which 211 full text articles were reviewed. Eighteen cohort studies met the inclusion criteria and were included in the analysis. Significant prognostic factors for RTW included age, contact with medical specialists, RTW-self-efficacy, and work ability. The pooled hazard ratios and 95% confidence interval (CI) for age, RTW-SE, contact with medical specialists, and high work ability/low work demands in relation to RTW were 0.77 (95% CI 0.65-0.88), 1.79 (95% CI 1.24-2.33), 0.64 (95% CI 0.49-0.80) and 1.08 (95% CI 1.06-1.11), respectively. CONCLUSIONS Self-efficacy (SE) is a key factor in the enhancement of work ability and RTW. Improving employee's SE and collaborating with employers to enhance work ability may help to facilitate RTW. As the RTW process is complex, exploring theoretical frameworks for RTW in individuals with a CMD is also needed.
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Victor M, Lau B, Ruud T. Predictors of return to work among patients in treatment for common mental disorders: a pre-post study. BMC Public Health 2017; 18:27. [PMID: 28720129 PMCID: PMC5516307 DOI: 10.1186/s12889-017-4581-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/10/2017] [Indexed: 11/20/2022] Open
Abstract
Background Effects of return to work (RTW) interventions vary, and more knowledge is needed about the factors that contribute to RTW. This study investigated changes in work participation and mental health, and predictors of RTW among patients being treated for common mental disorders (CMDs). Methods The study was a prospective pre–post study of 164 patients treated at an RTW outpatient clinic for CMDs. Differences between before and after treatment were analysed using paired t tests for continuous variables and marginal homogeneity test for categorical variables. Univariable and multivariable logistic regression analyses were used to identify factors associated with RTW. Baseline data (patient characteristics, clinical status, generalized self-efficacy, expectations of future work ability) and treatment variables were used as independent variables in logistic regressions. Further analysis investigated whether improvements in symptoms, work ability, expectations of future work ability and generalized self-efficacy were associated with RTW. Results Number of individuals with full work participation increased, and there were improvements in symptoms, work ability and generalized self-efficacy. In the final model for predicting RTW, baseline work ability and expectancy of future work ability, a history of psychiatric treatment and focus on RTW in the treatment predicted RTW. Improvement in expectations of future work ability at post-treatment did also predict RTW. Conclusions Assessing work ability and expectations of RTW at the beginning of treatment is recommended to identify patients at risk of long-term sick leave. Individuals with a history of psychiatric treatment are also risking long-term work disability. It is essential that treatment focus not only on symptom-relief, but also on improving work ability and expectations of RTW. An RTW-focused approach in therapy is associated with RTW. Trail registration ClinicalTrails.gov ID NCT01181635. Registered 08/12/2010. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4581-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mattias Victor
- Lovisenberg Hospital, Postboks 4970, Nydalen, 0440, Oslo, Norway. .,University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
| | - Bjørn Lau
- Lovisenberg Hospital, Postboks 4970, Nydalen, 0440, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Torleif Ruud
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway.,Division Mental Health Services, Akershus University Hospital, 1478, Lørenskog, Norway
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Lammerts L, van Dongen JM, Schaafsma FG, van Mechelen W, Anema JR. A participatory supportive return to work program for workers without an employment contract, sick-listed due to a common mental disorder: an economic evaluation alongside a randomized controlled trial. BMC Public Health 2017; 17:162. [PMID: 28152999 PMCID: PMC5290622 DOI: 10.1186/s12889-017-4079-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 01/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders are associated with high costs for productivity loss, sickness absence and unemployment. A participatory supportive return to work (RTW) program was developed in order to improve RTW among workers without an employment contract, sick-listed due to a common mental disorder. The program contained a participatory approach, integrated care and direct placement in a competitive job. The aim of this study was to evaluate the cost-effectiveness and cost-utility of this new program, compared to usual care. In addition, its return on investment was evaluated. METHODS An economic evaluation was conducted alongside a 12-month randomized controlled trial. A total of 186 participants was randomly allocated to the new program (n = 94) or to usual care (n = 92). Effect measures were the duration until sustainable RTW in competitive employment and quality-adjusted life years (QALYs) gained. Costs included intervention costs, medical costs and absenteeism costs. Registered data of the Dutch Social Security Agency were used to assess the duration until sustainable RTW, intervention costs and absenteeism costs. QALYs and medical costs were assessed using three- or six-monthly questionnaires. Missing data were imputed using multiple imputations. Cost-effectiveness analysis and cost-utility analysis were conducted from the societal perspective. A return on investment analysis was conducted from the social insurer's perspective. Various sensitivity analyses were performed to assess the robustness of the results. RESULTS The new program had no significant effect on the duration until sustainable RTW and QALYs gained. Intervention costs and medical costs were significantly higher in the intervention group. From the societal perspective, the maximum probability of cost-effectiveness for duration until sustainable RTW was 0.64 at a willingness to pay of about €10 000/day, and 0.27 for QALYs gained, regardless of the willingness to pay. From the social insurer's perspective, the probability of financial return was 0.18. CONCLUSIONS From the societal perspective, the new program was neither cost-effective in improving sustainable RTW nor in gaining QALYs. From the social insurer's perspective, the program did not result in a positive financial return. Therefore, the present study provided no evidence to support its implementation. TRIAL REGISTRATION The trial was listed at the Dutch Trial Register (NTR) under NTR3563 on August 7, 2012.
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Affiliation(s)
- Lieke Lammerts
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, NL-1081 BT The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Johanna M. van Dongen
- Department of Health Sciences, EMGO+ Institute for Health and Care Research, Faculty of Earth & Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, NL-1081 BT The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, NL-1081 BT The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, NL-1081 BT The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
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Young AE, Viikari-Juntura E, Boot CRL, Chan C, Gimeno Ruiz de Porras D, Linton SJ. Workplace Outcomes in Work-Disability Prevention Research: A Review with Recommendations for Future Research. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:434-447. [PMID: 27787691 PMCID: PMC5104762 DOI: 10.1007/s10926-016-9675-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Introduction Outcome assessment is a central issue in work disability prevention research. The goal of this paper was to (1) ascertain the most salient workplace outcomes; (2) evaluate the congruence between business and science perspectives; (3) illustrate new perspectives on assessing longitudinal outcomes; and (4) provide recommendations for advancing outcome evaluation in this area of research. Methods The authors participated in a year-long collaboration that culminated in a sponsored 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results Numerous workplace work-disability prevention outcome measures were identified. Analysis indicated that their applicability varied depending on the type of work disability the worker was experiencing. For those who were working, but with health-related work limitations (Type 1), predominant outcomes were measures of productivity, presenteeism, and work-related limitations. For those who were off work due to a health condition (Type 2), predominant outcomes were measures of time off work, supervisor/employee interactions, and return-to-work (RTW) preparation. For those who had returned to work (Type 3), predominant outcomes were measures of presenteeism, time until RTW, percentage of work resumption, employment characteristics, stigma, work engagement, co-worker interactions, and sustained or durable RTW. For those who had withdrawn from the labor force (Type 4), predominant outcomes were cost and vocational status. Discussion Currently available measures provide a good basis to use more consistent outcomes in disability prevention in the future. The research area would also benefit from more involvement of employers as stakeholders, and multilevel conceptualizations of disability outcomes.
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Affiliation(s)
- Amanda E Young
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
| | | | - Cécile R L Boot
- EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Chetwyn Chan
- The Hong Kong Polytechnic Institute, Hong Kong, China
| | | | - Steven J Linton
- Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
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