The combination of work organizational climate and individual work commitment predicts return to work in women but not in men

Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour

Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2-24 months. Data were collected in October 2019-January 2020 and October 2020-January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

BACKGROUND

Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes.

METHODS

This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education).

RESULTS

Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R² = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ²(7) = 41.38 p < .001.

CONCLUSION

An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment.

TRIAL REGISTRATION

NCT04083404 Registered 05 September 2019 (retrospectively registered).

Cardiopulmonary capacity and psychological factors are related to return to work in orthopedic rehabilitation patients

Health psychology sheds light on the process of returning to work after sick leave and subsequent medical rehabilitation. A 15-month longitudinal study with N = 201 orthopedic rehabilitation patients is reported. It examined whether and how both physiological health (e.g. body mass index and oxygen reabsorption) and psychological/social-cognitive factors (e.g. self-efficacy and social support) are related to returning to work. It was found that social-cognitive and physiological variables, such as oxygen consumption at anaerobic threshold, are important for returning to work. While physical activity was significantly correlated with social-cognitive variables, it was not significantly correlated directly with returning to work. Results suggest that self-efficacy and oxygen consumption at anaerobic threshold should be improved during medical rehabilitation.

Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample

PURPOSE

Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample.

METHODS

Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW.

RESULTS

Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was - 3.09 (- 5.47, - 0.72), while for GHQ it was - 3.91 (- 7.15, - 0.68). There were no group differences in RTW.

CONCLUSIONS

The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups.

Registry-based analysis of participator representativeness: a source of concern for sickness absence research?

OBJECTIVES

Selective participation can bias results in epidemiological surveys. The importance of health status is often suggested as a possible explanation for non-participation but few empirical studies exist. In a population-based study, explicitly focused on sickness absence, health and work, we examined whether a history of high levels of sickness absence was associated with non-participation.

DESIGN

The study is based on data from official sickness absence registers from participants, non-participants and the total target population of the baseline survey of the Health Assets Project (HAP).

SETTING

HAP is a population-based cohort study in the Västra Götaland region in South Western Sweden.

PARTICIPANTS

HAP included a random population cohort (n=7984) and 2 cohorts with recent sickness absence (employees (n=6140) and non-employees (n=990)), extracted from the same overall general working-age population.

PRIMARY OUTCOME MEASURES

We examined differences in participation rates between cohorts (2008), and differences in previous sickness absence (2001-2008) between participants (individual-level data) and non-participants or the target population (group-level data) within cohorts.

RESULTS

Participants had statistically significant less registered sickness absence in the past than non-participants and the target population for some, but not all, of the years analysed. Yet these differences were not of substantial size. Other factors than sickness absence were more important in explaining differences in participation, whereby participants were more likely to be women, older, born in Nordic countries, married and have higher incomes than non-participants.

CONCLUSIONS

Although specifically addressing sickness absence, having such experience did not add any substantial layer to selective participation in the present survey. Detailed measures are needed to gain a better understanding for health selection in health-related surveys such as those addressing sickness absence, for instance in order to discriminate between selection due to ability or motivation for participation.

Previous sickness absence and current low perceived social support at work among employees in the general population: a historical cohort study

OBJECTIVE

Although sickness absence often is a process over time, most studies have treated the phenomenon as a discrete event and focused more on its causes than its consequences. We aimed to examine whether various patterns of previous long-term sickness absence were associated with current low perceived social support at work.

METHOD

This is a historical cohort study based on data from a population-based survey among Swedish employees (n=2581). The survey data were linked to official registries yielding data on sickness absence 1-7 years prior to the survey.

RESULTS

The main finding was that previous sickness absence was associated with current low perceived social support at work. The highest odds for low social support were found among those who had a stable high level of sickness absence. The two indicators of perceived social support employed were somewhat differently associated with previous sickness absence: Recency of absence showed to be of importance for general support at the workplace and the relationship with colleagues and superiors. Experiencing that one's immediate superior rarely or never regards one's view was, on the other hand, mainly related to having had a high level of sickness absence, irrespective of recency.

CONCLUSIONS

Our results indicate that recency and extent of previous sickness absence are related to perceived social support at work. Future research on the relationship between social support and sickness absence should use repeated measurements and acknowledge the possible bidirectional relationship.

Remain in work--what work-related factors are associated with sustainable work attendance: a general population-based study of women and men

OBJECTIVE

To analyze if organizational climate and work commitment, demand and control, job strain, social support, and physical demands at work are associated with remain in work (RIW), that is, work attendance without sick leave over 15 days per year.

METHODS

This Swedish cross-sectional study was based on 4013 workers (aged 19 to 64 years), randomly selected from a general population. Data were collected (2008) through postal questionnaire and registers.

RESULTS

Fair organizational climate, the combination of fair organizational climate and fair work commitment, high control, and low physical demands were associated with RIW for women and men.

CONCLUSIONS

This study adds to the rather scarce research findings on factors that promote RIW by identifying work organizational factors and physical prerequisites as being important. Preventive work to create a healthy work environment could be directed at improving organizational climate and reducing physical demands.