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Aasdahl L, Gismervik SØ, Johnsen R, Vasseljen O, Bjørnelv GMW, Bjørngaard JH, Fimland MS. Effects of Inpatient Occupational Rehabilitation vs. Outpatient Acceptance and Commitment Therapy on Sick Leave and Cost of Lost Production: 7-Year Follow-Up of a Randomized Controlled Trial. J Occup Rehabil 2024:10.1007/s10926-024-10195-x. [PMID: 38678497 DOI: 10.1007/s10926-024-10195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production. METHODS We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5 weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5 h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production. RESULTS Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI - 264 to 104), with an adjusted difference of 114 fewer days (95% CI - 298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI - 35,009 to 89,104). CONCLUSIONS I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway.
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
| | - Sigmund Østgård Gismervik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
| | - Ottar Vasseljen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
| | - Gudrun M W Bjørnelv
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
- Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491, Trondheim, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Marius Steiro Fimland
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Kjeldgård L, Stigson H, Farrants K, Friberg E. Sickness absence and disability pension after road traffic accidents, a nationwide register-based study comparing different road user groups with matched references. Heliyon 2024; 10:e28596. [PMID: 38571629 PMCID: PMC10988042 DOI: 10.1016/j.heliyon.2024.e28596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
Background Being injured in a road traffic accident may affect individuals' functional ability and in turn lead to sickness absence (SA) and disability pension (DP). Knowledge regarding long-term consequences in terms of SA and DP following a road traffic accident is lacking, especially comparing different groups of road users and compared to the general population. The aim was to estimate excess diagnosis-specific SA and DP among individuals of different road user groups injured in a road traffic accident compared to matched references without such injury. Methods A nationwide register-based study, including all working individuals aged 20-59 years and living in Sweden who in 2015 had in- or specialized outpatient healthcare after a new traffic-related injury (n = 20 177) and population-based matched references (matched on: sex, age, level of education, country of birth, living in cities) without any traffic-related injury during 2014-2015 (n = 100 885). Diagnosis-specific (injury and other diagnoses) SA and DP were assessed during 5 years: 1 year before and 4 years following the accident. Mean SA and DP net days/year for each road user group and mean differences of (excess) SA and DP net days/year compared with their matched references were calculated with independent t-tests with bootstrapped 95% confidence intervals (CIs). Results A third of all injured road users were bicyclists, 31% were car occupants, 16% were pedestrians (including fall accidents), and 19% were other and unspecified accidents. Pedestrians and other road users were the groups with the highest mean number of SA days during the first year following the accident (51 and 49 days/year respectively). The matched references had between 8 and 13 SA days/year throughout the study period. The excess SA days/year were elevated for all road user groups all five studied years. Excess SA due to injury diagnoses was 15-35 days/year during the first year following the accident. Excess SA due to diagnoses other than injuries were about eight days/year during the whole study period for pedestrians and car occupants and about zero for the bicyclists. The excess DP was low, although it increased every year after the accident for pedestrians and car occupants; for bicyclists no excess DP was seen. Conclusion Higher levels of SA due to injury diagnoses were seen among all road user groups during the first year after the accident compared to their references. Pedestrians and car occupants had more excess SA due to other diagnoses and more excess DP four years after the accident than bicyclists and other road users.
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Affiliation(s)
- Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Helena Stigson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Division of Vehicle Safety, Mechanics and Maritime Sciences, Chalmers University of Technology, Gothenburg, Sweden
- Folksam Research, Folksam Insurance Group, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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Marcuzzi A, Mork PJ, Aasdahl L, Skarpsno E, Moe K, Nilsen TIL. Incidence of sick leave and disability pension in adults with musculoskeletal pain and co-occurring long-term conditions: data from the Norwegian HUNT study and national registries. BMC Musculoskelet Disord 2024; 25:273. [PMID: 38589843 PMCID: PMC11003184 DOI: 10.1186/s12891-024-07405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Musculoskeletal pain is one of the leading causes of work productivity loss. Long-term conditions (LTCs) commonly occur alongside musculoskeletal pain. However, the incidence of sick leave and disability pension according to LTC status in people with musculoskeletal pain has not been previously described. METHODS Working-age participants (20-65 years) with persistent musculoskeletal pain who participated in the HUNT3 Study (1995-97) were included. Twenty-five LTCs were classified into 8 LTC groups according to the International Classification of Diseases version 11. Data on sickness and disability benefits were obtained from the National Insurance Database and linked to the HUNT3 data using participants' personal identification number. Age-adjusted incidence rates (IRs) (per 10,000 person-years) and hazard ratios (HRs) of sick leave during 5-year follow-up and disability pension during ~ 25-year follow-up were estimated with 95% confidence intervals (CIs) and presented according to LTC status. RESULTS Overall, 11,080 participants with musculoskeletal pain were included. Of those, 32% reported one LTC and 45% reported ≥ 2 LTCs. During the follow up period, 1,312 participants (12%) received disability pension due to musculoskeletal conditions. The IR of sick leave and disability pension due to musculoskeletal conditions increased with number of LTCs. Specifically, the IR of sick leave was 720 (95% CI 672 to 768) in participants without any LTCs and 968 (95% CI 927 to 1,009) if they had ≥ 2 LTCs. The IRs of disability pension were 87 (95% CI 75 to 98) and 167 (95% CI 154 to 179) among those with no LTCs and ≥ 2 LTCs, respectively. The incidence of sick leave and disability pension due to musculoskeletal conditions was largely similar across LTCs, although the incidence of disability pension was somewhat higher among people with sleep disorders (IR: 223, 95% CI 194 to 252). CONCLUSIONS Among people with persistent musculoskeletal pain, the incidence of prematurely leaving the work force due to musculoskeletal conditions was twice as high for those with multiple LTCs compared to those without any LTCs. This was largely irrespective of the type of LTC, indicating that the number of LTCs are an important feature when evaluating work participation among people with musculoskeletal pain.
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Affiliation(s)
- Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim, Norway.
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Unicare Helsefort Rehabilitation Center, Rissa, Norway
| | - Eivind Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karoline Moe
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Heining C, Ishii H, Cheung L, Clark M. Sick-leave duration after elective day case surgery in ENT: Is it affected by the type of employment? Surgeon 2024; 22:88-91. [PMID: 37923667 DOI: 10.1016/j.surge.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Many ENT day-case procedures are performed on otherwise healthy individuals in employment. We hypothesised patients' type of employment may affect the amount of time taken off work following such procedures. We aimed to disprove the hypothesis that there is no difference in time taken off between employees and self-employed individuals. MATERIALS AND METHODS We prospectively collected data on working adult patients undertaking elective day-case procedures at our department. Collected information included basic patient demographics and type of employment. A telephone call was made to collect data on actual period of time taken off work, 5-6 weeks later. RESULTS 23% of patients were self-employed, the rest were employees. 92% of self-employed patients received no pay during their time off. This compared with 10% of employed patients receiving no pay. 77% of employed patients received full pay. Although mean time taken off work was less if the patient was self-employed (9.5 days vs 10.63), this was not found to be statistically significant. DISCUSSION AND CONCLUSION Our study demonstrates time off work following day-case ENT procedures places a higher financial burden on self-employed patients. This should inform patient counselling prior to operations. We demonstrated no statistically significant difference in time off work post-surgery between the 2 groups. There was a possible trend towards less time off in self-employed individuals and we speculate that further research with more patients may demonstrate a statistically significant difference in time off work. Perhaps most importantly is for doctors to consider how long an individual needs off after a given procedure, after taking account of their individual patient needs, rather than defaulting to a standard 2-weeks.
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Affiliation(s)
- Christopher Heining
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Hiro Ishii
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Linnea Cheung
- ENT Department, University Hospitals Bristol and Weston NHS Foundation Trust, England.
| | - Matthew Clark
- ENT Department, Gloucestershire Hospitals NHS Foundation Trust, England.
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Kostev K, Oswald S, Frajerman A, Haro JM, Jacob L. Trends in burnout and related sick leave duration in working-age adults followed in general practices in Germany between 2012 and 2022. J Psychiatr Res 2024; 172:52-58. [PMID: 38359618 DOI: 10.1016/j.jpsychires.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
AIMS This study investigated burnout trends and related sick leave duration in working-age adults followed in general practices in Germany. METHODS Participants were aged 20-65 years and were diagnosed with burnout in one of 442 general practices in this country in 2012-2014, 2016-2018, and 2020-2022. The prevalence of burnout and the duration of sick leave in all practices were compared between 2012-2014 and 2016-2018 and between 2016-2018 and 2020-2022. The association between diagnosis years (i.e., 2012-2014, 2016-2018, and 2020-2022) and long-term sick leave (i.e., more than 42 days of sick leave) was investigated using adjusted logistic regression. RESULTS The study included 39,793, 46,708, and 50,721 patients diagnosed with burnout in the periods from 2012 to 2014, 2016-2018, and 2020-2022, respectively, and the prevalence of burnout in all patients was 3.6%, 3.8%, and 3.6% during these three periods. This prevalence increased significantly in people aged 61-65 years and those with a Charlson Comorbidity Index of ≥1. The mean (SD) sick leave duration in the population of people with burnout rose from 24.1 (41.9) days in the period of 2012-2014 to 36.2 (65.6) days in the period from 2020 to 2022. Finally, compared with 2012-2014, burnout diagnosed in 2016-2018 and 2020-2022 was associated with higher odds of long-term sick leave. CONCLUSIONS In view of these findings, it is clear that public health measures are urgently needed to improve burnout prevention in Germany.
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Affiliation(s)
| | | | - Ariel Frajerman
- Université Paris-Saclay, AP-HP, Service Hospitalo-Universitaire de Psychiatrie, Hôpital de Bicêtre, France; Équipe MOODS, Inserm, U1178, CESP (Centre de Recherche en Épidémiologie et Santé des Populations), Le Kremlin-Bicêtre, France
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France; Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France
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Ohm E, Madsen C, Gravseth HM, Brage S, Grøholt EK, Alver K, Holvik K. Post-injury long-term sickness absence and risk of disability pension: The role of socioeconomic status. Injury 2024; 55:111480. [PMID: 38452702 DOI: 10.1016/j.injury.2024.111480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/02/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Previous research has identified low socioeconomic status (SES) as a risk factor for long-term sickness absence (LTSA) and disability pension (DP) following trauma. However, most studies lack information on medical diagnoses, limiting our understanding of the underlying factors. To address this gap, we retrieved information about diagnostic causes for receipt of welfare benefits to explore the role of SES in the transition from post-injury LTSA to permanent DP among the working population in Norway. MATERIALS AND METHODS We conducted a population-based cohort study of all Norwegian residents aged 25-59 years registered with a spell of LTSA due to injury commencing in the period 2000-2003. This cohort was followed through 2014 by linking information on receipt of welfare benefits with sociodemographic data from administrative registers. SES was defined as a composite measure of educational attainment and income level. We used flexible parametric survival models to estimate hazard ratios (HR) with 95 % confidence intervals (CI) for all-cause and diagnosis-specific DP according to SES, adjusting for sex, age, marital status, immigrant status and healthcare region of residence. RESULTS Of 53,937 adults with post-injury LTSA, 9,665 (18 %) transferred to DP during follow-up. The crude risk of DP was highest for LTSA spells due to poisoning and head injuries. Overall, individuals in the lowest SES category had twice the risk of DP compared to those in the highest SES category (HR = 2.25, 95 % CI 2.13-2.38). The difference by SES was greatest for LTSA due to poisoning and smallest for LTSA due to head injuries. A majority (75 %) of DP recipients had a non-injury diagnosis as the primary cause of DP. The socioeconomic gradient was more pronounced for non-injury causes of DP (HR = 2.47, 95 % CI 2.31-2.63) than for injury causes (HR = 1.73, 95 % CI 1.56-1.92) and was especially steep for DP due to musculoskeletal diseases and mental and behavioural disorders. CONCLUSIONS The relationship between SES and DP varied by both the type of injury that caused LTSA and the diagnosis used to grant DP, highlighting the importance of taking diagnostic information into account when investigating long-term consequences of injuries.
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Affiliation(s)
- Eyvind Ohm
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway.
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Zander Kaaesgt. 7 5015 Bergen, Norway
| | - Hans Magne Gravseth
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 5330 Majorstuen 0304 Oslo, Norway
| | - Søren Brage
- Retired medical doctor with a PhD in epidemiology/social medicine. Before retirement SB held a position in the Norwegian Labour and Welfare Administration, leading the unit responsible for medical coding of welfare benefits from 1998 to 2015
| | - Else Karin Grøholt
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kari Alver
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
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Núñez-Cortés R, Espin A, Pérez-Alenda S, López-Bueno R, Cruz-Montecinos C, Vincents-Seeberg KG, Püschel TA, Calatayud J, Andersen LL. Association Between Pain Coping and Symptoms of Anxiety and Depression, and Work Absenteeism in People With Upper Limb Musculoskeletal Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024; 105:781-791. [PMID: 37490961 DOI: 10.1016/j.apmr.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/02/2023] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To determine the prospective association of pain coping strategies and symptoms of anxiety and depression with work absenteeism in people with upper limb musculoskeletal disorders. DATA SOURCES A systematic search of PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases was conducted from inception to September 23, 2022. STUDY SELECTION Prospective observational studies of adults with upper limb musculoskeletal disorders were included. Included studies had to provide data on the association of pain coping strategies (catastrophizing, kinesiophobia, self-efficacy or fear avoidance) or symptoms of anxiety and depression with work absenteeism. DATA EXTRACTION Study selection, data extraction, and assessment of methodological quality (Newcastle Ottawa Scale) were performed by 2 independent authors. Random-effects models were used for quantitative synthesis. DATA SYNTHESIS Eighteen studies (n=12,393 participants) were included. Most studies (77.8%) reported at least 1 significant association between 1 or more exposure factors (pain coping strategies or symptoms of anxiety and depression) and work absenteeism. Meta-analyses showed a statistically significant correlation between the exposure factors of catastrophizing (r=0.28, 95% confidence interval [CI]: 0.15 to 0.40; P<.0001) and symptoms of anxiety and depression (r=0.23, 95% CI: 0.10 to 0.34; P=.0003) with work absenteeism. The correlation between self-efficacy and work absenteeism was non-significant (r=0.24, 95% CI: -0.02 to 0.47; P=.0747). CONCLUSIONS Rehabilitation teams should consider assessing catastrophizing and symptoms of anxiety and depression to identify patients at risk for work absenteeism. Addressing these variables may also be considered in return-to-work programs for individuals with upper limb disorders.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Ander Espin
- National Research Centre for the Working Environment, Copenhagen, Denmark; Ageing On Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), Leioa, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Division of Research, Development and Innovation in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile
| | | | - Thomas A Püschel
- Ecology and Evolutionary Biology Division, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
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Knutsen RH, Nielsen MB, Lunde LK, Skare Ø, Johannessen HA. Impact of psychosocial work factors on risk of medically certified sick leave due to common mental disorders: a nationwide prospective cohort study of Norwegian home care workers. BMC Public Health 2024; 24:773. [PMID: 38475747 DOI: 10.1186/s12889-024-18299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The Norwegian home care services experience a high level of sick leave, a large proportion of which is due to common mental disorders. A substantial number of such cases can be attributed to psychosocial factors at work, but more knowledge about occupation-specific risk factors is needed to develop targeted preventive measures to reduce sick leave levels. The aim of this study is to identify the most prominent psychosocial work factors influencing the risk of sick leave spells due to common mental disorders. METHODS Employees from a random sample of 130 Norwegian home care services (N = 1.819) completed a baseline survey on 15 psychosocial work factors. Participants were subsequently followed up for 26 months using registry data on sick leave. The outcome measure was the number of medically certified sick leave spells due to common mental disorders during follow-up in the Norwegian social insurance database. Incidence risk ratios (IRR) and 95% confidence intervals (CIs) were calculated using negative binomial regression with robust standard errors. RESULTS Emotional dissonance (IRR 1.30, 95% CI 1.05-1.60) and emotional demands (IRR 1.35, 95% CI 1.14-1.58) were associated with an excess risk of sick leave, while control over work pacing (IRR 0.78, 95% CI 0.62-0.98) was associated with a reduced risk. An estimated 30% (95% CI 8.73-48.82) of sick leave cases were attributable to emotional dissonance and 27% (95% CI 4.80-46.33) were attributable to emotional demands. Control over work pacing was estimated to have prevented 20% (95% CI 1.32-37.78) of the sick leave cases. CONCLUSIONS This study found that emotional dissonance and emotional demands were robust risk factors for sick leave due to common mental disorders, and that control of work pacing constituted a robust protective factor against sick leave.
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Affiliation(s)
- Rigmor Harang Knutsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Morten Birkeland Nielsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Lars-Kristian Lunde
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Øivind Skare
- Research Group for Occupational Medicine and Epidemiology, National Institute for Occupational Health, Oslo, Norway
| | - Håkon A Johannessen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
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Marson L, Dadoun S, Roure F, Rozenberg S, Marty M, Gossec L, Fautrel B, Foltz V. Entering functional restoration programs for chronic low back pain is delayed when patients do not receive support at work: A study of 185 patients in France. Joint Bone Spine 2024; 91:105721. [PMID: 38479579 DOI: 10.1016/j.jbspin.2024.105721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Laetitia Marson
- Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Sabrina Dadoun
- Inserm, Sorbonne université, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Paris, France; Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Fanny Roure
- Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Sylvie Rozenberg
- Inserm, Sorbonne université, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Paris, France; Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Marc Marty
- Rheumatology department, Henri-Mondor Hospital, AP-HP, UPEC université, Créteil, France
| | - Laure Gossec
- Inserm, Sorbonne université, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Paris, France; Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Bruno Fautrel
- Inserm, Sorbonne université, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Paris, France; Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France
| | - Violaine Foltz
- Inserm, Sorbonne université, Institut Pierre-Louis d'épidémiologie et de Santé Publique, Paris, France; Rheumatology department, Pitié-Salpêtrière hospital, AP-HP, Sorbonne université, Paris, France.
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10
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Holmgren R, Grotta A, Farrants K, Magnusson Hanson LL. Bidirectional associations between workplace bullying and sickness absence due to common mental disorders - a propensity-score matched cohort study. BMC Public Health 2024; 24:744. [PMID: 38459468 PMCID: PMC10921817 DOI: 10.1186/s12889-024-18214-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/26/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The link between workplace bullying and poor mental health is well-known. However, little is known about the prospective and potentially reciprocal association between workplace bullying and mental health-related sickness absence. This 2-year prospective study examined bidirectional associations between exposure to workplace bullying and sickness absence due to common mental disorders (SA-CMD) while controlling for confounding factors from both work and private life. METHODS The study was based on propensity score-matched samples (N = 3216 and N = 552) from the Swedish Longitudinal Occupational Survey of Health, using surveys from years 2012, 2014 and 2016. Self-reported exposure to workplace bullying was linked to registry-based information regarding medically certified SA-CMD (≥ 14 consecutive days). The associations were examined by means of Cox proportional hazards regression and via conditional logistic regression analysis. Hazard ratios and odds ratios with 95% confidence intervals were estimated. RESULTS Exposure to workplace bullying was associated with an increased risk of incident SA-CMD (HR: 1.3, 95% CI: 1.0-1.8), after accounting for the influence of job demands, decision authority, previous SA-CMD, as well as other sociodemographic covariates. However, we found no statistically significant association between SA-CMD and subsequent workplace bullying (OR 1.2, 95% CI 0.7-1.9). CONCLUSIONS The results support an association between self-reported workplace bullying and SA-CMD, independent of other sociodemographic factors and workplace stressors. Preventing workplace bullying could alleviate a share of the individual and societal burden caused by SA globally.
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Affiliation(s)
- Rebecka Holmgren
- Stress Research Institute, Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Sweden & Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linda L Magnusson Hanson
- Stress Research Institute, Division of Psychobiology and Epidemiology, Department of Psychology, Stockholm University, Stockholm, Sweden
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11
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Gautun H, Bratt C. Caring for older parents in Norway - How does it affect labor market participation and absence from work? Soc Sci Med 2024; 346:116722. [PMID: 38498960 DOI: 10.1016/j.socscimed.2024.116722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/25/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
As the population ages, younger generations will increasingly be called upon to provide informal care to their aging parents. To prepare for this development, it is essential to understand how employees combine the dual responsibilities of work and caring for aging parents. By analyzing data collected in Norway in 2022 from a nationally representative sample of 6049 respondents, aged 35 to 67, we investigated how caring for older parents affects labor market participation and work absence. We provide descriptive statistics and conduct analyses with structural equation modeling. These analyses indicated that caregiving had no substantial impact on overall participation in the workforce. However, employees did use work absences to assist their parents. We differentiate between using holidays, compensatory time, and three types of formal leave: paid, unpaid, and sick leave. More than a third of the formal leave was taken as sick leave. Women were moderately more likely to use work absence to care for their parents. We conclude that caregiving for older parents currently has little effect on work participation in Norway and attribute the favorable situation in Norway to its comprehensive public elderly care system. However, a contributing factor is Norway's generous sick leave policy. Although intended for use when employees are sick themselves, sick leave is used by employees to provide care to aging parents. Sick leave seems to act as a safety valve. To mitigate the effects of informal care on work participation, welfare states may create conditions that allow employees to combine work and informal care without resorting to unauthorized sick leave. A solution could be to extend the existing support scheme for employees with young children to those providing care for their aging parents.
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Affiliation(s)
- Heidi Gautun
- Norwegian Social Research - NOVA, Department of Ageing Research and Housing Studies, Oslo Metropolitan University, Stensberggata 26, 0170 Oslo, Norway.
| | - Christopher Bratt
- Department of Psychology, Inland Norway University of Applied Sciences, Vormstuguvegen 2, 2624, Lillehammer, Norway; School of Psychology, University of Kent, Canterbury, UK.
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12
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Xu H, Cai J, Sawhney R, Jiang S, Buys N, Sun J. The Effectiveness of Cognitive-Behavioral Therapy in Helping People on Sick Leave to Return to Work: A Systematic Review and Meta-analysis. J Occup Rehabil 2024; 34:4-36. [PMID: 37067701 PMCID: PMC10899273 DOI: 10.1007/s10926-023-10116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. METHODS Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). RESULTS Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. CONCLUSIONS The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.
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Affiliation(s)
- Huaying Xu
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Jinxuan Cai
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Rakshat Sawhney
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Stephen Jiang
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia
| | - Nicholas Buys
- Centre for Work, Organisation and Wellbing, Griffith University, Nathan, Q4215, Australia
| | - Jing Sun
- School of Medicine and Dentistry, Griffith University, Nathan, Q4215, Australia.
- Institute for Integrated Intelligence and Systems, Griffith University, Nathan, Q4215, Australia.
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13
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Lauridsen J, Momsen AH, Pedersen P, Hansen ML, Andersen DR, Maimburg RD. Workplace intervention among pregnant hospital employees - A protocol of a cluster randomized trial. Sex Reprod Healthc 2024; 39:100940. [PMID: 38065048 DOI: 10.1016/j.srhc.2023.100940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/03/2023] [Accepted: 12/01/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Sick leave during pregnancy is frequent and 36 % of Danish pregnant employees are on sick leave > 14 days. Health care professionals are considered a risk population. This intervention applies preventive sessions including the pregnant employee, her manager and a midwife in addition to usual practiceat Aarhus University Hospital, Denmark (AUH). It is hypothesised that pregnant employees who participate in preventive sessions will have less sick leave and report better wellbeing compared to the reference group. METHODS All departments at AUHare cluster randomized. A total of 25 and 24 departments are allocated to the intervention and reference group, respectively. The intervention is protocolled with preventive sessions in addition to usual practice. The reference group receives usual practice. The primary outcome is mean number of days on sick leave during pregnancy. Secondary outcomes are wellbeing measured as physical and mental health, general work ability, work-life balance, manager support, and completed work adjustments during pregnancy. Data on sick leave will be collected from the hospital payment system and survey data will be collected at inclusion and follow-up. DISCUSSION This study will contribute to limited experimental research aimed to reduce sickness leave during pregnancy. The overall strength is the study design with easy access to study participants within a large hospital. The main limitation of the study is the high complexity of the study. TRIAL REGISTRATION The trial is registered in ClinicalTrials.gov with ID number 29-2019-03.
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Affiliation(s)
- Jane Lauridsen
- Department of Occupational Medicine, Aarhus University Hospital, Denmark.
| | - Anne Hedeager Momsen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Denmark.
| | - Pernille Pedersen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Denmark; Department of Public Health, Aarhus University, Denmark.
| | | | - Dorte Raaby Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Denmark.
| | - Rikke Damkjær Maimburg
- Department of Occupational Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; University College of Northern Denmark, Denmark; School of Nursing and Midwifery, Western Sydney University, Australia.
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14
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László KD, Svedberg P, Lindfors P, Lidwall U, Alexanderson K. Sickness absence and disability pension three years before and seven years after first childbirth: A Swedish population-based cohort study. Scand J Public Health 2024; 52:80-88. [PMID: 36286644 PMCID: PMC10845816 DOI: 10.1177/14034948221125153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/19/2022] [Accepted: 08/19/2022] [Indexed: 02/06/2024]
Abstract
AIMS There is a widely held belief, in Sweden and internationally, that women with children are more likely to be on sickness absence (SA) than their nulliparous counterparts. However, empirical findings in the field are limited and inconsistent. We aimed to explore initially nulliparous women's patterns of SA and disability pension (DP) three years before and seven years after 2009, by later parity. METHODS We conducted a longitudinal cohort study of nulliparous women in Sweden on 31 December 2009 (N=426,918). We compared crude and standardized numbers of SA/DP net days in the three years before (Y-3 to Y-1) and the seven years (Y+1 to Y+7) after the date of the first birth in 2010 or 2 July 2010 in the following three groups: (1) women with no childbirth during the seven-year follow-up and an additional nine months (i.e. 7.8 years), (2) women with a first childbirth in 2010 and no additional childbirth during the next 7.8 years, and (3) women with their first childbirth in 2010 and minimum one more during the next 7.8 years. RESULTS Women remaining nulliparous had consistently more standardized mean SA/DP days than women giving birth. Compared with women with one birth, women with several births had similar mean numbers of standardized SA/DP days during Y-3 and Y-2, more during Y+1 to Y+3 and fewer during Y+4 to Y+7. CONCLUSIONS In contrast to the widely held societal belief, we found that in all years women who gave birth had fewer SA/DP days than those remaining nulliparous.
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Affiliation(s)
- Krisztina D. László
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department for Analysis, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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15
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Occhi Gómez B, Galvan Ortiz de Urbina M, López Ruiz de Salazar A, Alonso Benavente AJ, Rodrigo Alonso Á. Temporary work disability following trapezial resection and suspension arthroplasty for thumb carpometacarpal osteoarthritis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00039-0. [PMID: 38246346 DOI: 10.1016/j.recot.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our center and to investigate factors that might delay return to work following this surgery. MATERIAL AND METHODS A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability. RESULTS A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not. CONCLUSIONS Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.
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Affiliation(s)
- B Occhi Gómez
- Unidad de Mano, Servicio de Traumatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España; Unidad de Mano, Servicio de Traumatología, Mutua Universal, Hospital Nuestra Señora del Rosario, Madrid, España.
| | - M Galvan Ortiz de Urbina
- Unidad de Mano, Servicio de Traumatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España; Policlínica Dalí, Móstoles, Madrid, España
| | - A López Ruiz de Salazar
- Unidad de Mano, Servicio de Traumatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
| | - A J Alonso Benavente
- Unidad de Mano, Servicio de Traumatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
| | - Á Rodrigo Alonso
- Unidad de Mano, Servicio de Traumatología, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
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16
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Karlsson EA, Hellgren M, Sandqvist JL, Seing I, Ståhl C. Social Insurance Literacy Among the Sick-listed-A Study of Clients' Comprehension and Self-Rated System Comprehensibility of the Sickness Insurance System. J Occup Rehabil 2024:10.1007/s10926-023-10166-8. [PMID: 38214781 DOI: 10.1007/s10926-023-10166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Sickness insurance systems and their processes have been studied in terms of transparency, comprehensibility and fairness, highlighting the importance of just procedures that make sense to clients. Related research demonstrates differences between groups of clients, pointing towards a social gradient. The concept of social insurance literacy and the Social Insurance Literacy Questionnaire (SILQ) was recently developed and serves as a measure for client's ability to obtain, understand and act on information in a sickness insurance system, relating to the comprehensibility of the information that the system provides. OBJECTIVE The purpose of this study was to investigate social insurance literacy among clients on sick leave and its associations with perceived justice, being granted sickness benefits and background factors. METHODS This was a questionnaire study with clients on sick leave in Sweden. In the selection process 3993 clients were invited, of which 1173 recently had their sickness benefits withdrawn. Those who answered the SILQ (n = 1152) also answered a perceived justice measure and accepted sharing register data from the Swedish Social Insurance Agency. Data were analyzed through regression analysis. RESULTS The findings demonstrate that clients' perceptions of system comprehensibility and the status of their sick leave case was significantly associated with perceived justice, and being granted sickness benefits, while their individual abilities to obtain, understand, and act on information had lesser influence. CONCLUSIONS The system's ability to provide understandable information seems more important than clients' abilities to comprehend it. From a client perspective, a just system seems to be related to their experiences of the sick leave process (i,e., whether they had an ongoing or closed case) rather than their skills to obtain the correct information.
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Affiliation(s)
- Elin A Karlsson
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Unit of Public Health, Linköping University, 58183, Linköping, Sweden.
| | - Mattias Hellgren
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Jan L Sandqvist
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Norrköping, Sweden
| | - Ida Seing
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Christian Ståhl
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
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17
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Knudsen SDP, Roland CB, Alomairah SA, Jessen AD, Maindal HT, Bendix JM, Clausen TD, Løkkegaard E, Stallknecht B, Molsted S. The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity. BMC Public Health 2024; 24:92. [PMID: 38178045 PMCID: PMC10768443 DOI: 10.1186/s12889-023-17525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND A physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial. METHODS Two hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks. RESULTS Participants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery. CONCLUSION Structured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation. TRIAL REGISTRATION The study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019-512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.
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Affiliation(s)
- Signe de Place Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.
| | - Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Public Health Department, Saudi Electronic University, College of Health Sciences, Riyadh, Saudi Arabia
| | - Anne Dsane Jessen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Jane M Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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18
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Lipponen AH, Mikkonen S, Kollanus V, Tiittanen P, Lanki T. Increase in summertime ambient temperature is associated with decreased sick leave risk in Helsinki, Finland. Environ Res 2024; 240:117396. [PMID: 37863162 DOI: 10.1016/j.envres.2023.117396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/06/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES Climate change has increased attention to the health effects of high ambient temperatures and heatwaves worldwide. Both cause-specific mortality and hospital admissions are studied widely, mainly concentrating on warmer climates, but studies focusing on more subtle health effects and cold climates lack. This study investigated the effect of summertime daily ambient temperatures and heatwaves on sick leaves in the employed population in Helsinki, Finland, a Nordic country with a relatively cold climate. METHODS We obtained from the City of Helsinki personnel register data on sick leaves for the summer months (June-August) of 2002-2017. We estimated the overall cumulative association of all and short (maximum 3-day) sick leaves with daily mean temperature over a 21-day lag period using a negative binomial regression model coupled with a penalized distributed lag non-linear model (penalized DLNM). The association of sick leaves with heatwaves (cut-off temperature 20.8 °C), and prolonged heatwaves, was estimated using a negative binomial regression model coupled with DLNM. We adjusted the time series model for potential confounders, such as air pollution, relative humidity, time trends, and holidays. RESULTS Increasing daily temperature tended to be associated with decreased overall cumulative risk of sick leaves and short sick leaves over a 21-day lag period. In addition, heatwaves and prolonged heatwaves were associated with decreased overall cumulative risk of sick leaves compared to all other summer days: RR 0.87 (95 % CI 0.78 to 0.97) and RR 0.83 (95 % CI 0.70 to 0.98), respectively. CONCLUSIONS This research suggests that summertime daily temperatures that are high for this northern location have protective effects on the health of the working population.
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Affiliation(s)
- Anne H Lipponen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Kuopio, Finland; Finnish Institute for Health and Welfare, Environmental Health Unit, Kuopio, Finland.
| | - Santtu Mikkonen
- University of Eastern Finland, Department of Environmental and Biological Sciences, Kuopio, Finland; University of Eastern Finland, Department of Technical Physics, Kuopio, Finland
| | - Virpi Kollanus
- Finnish Institute for Health and Welfare, Environmental Health Unit, Kuopio, Finland
| | - Pekka Tiittanen
- Finnish Institute for Health and Welfare, Environmental Health Unit, Kuopio, Finland
| | - Timo Lanki
- Finnish Institute for Health and Welfare, Environmental Health Unit, Kuopio, Finland; University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Kuopio, Finland
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19
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Ståhl C, Karlsson E, Wenemark M, Sandqvist J, Årestedt K. The Social Insurance Literacy Questionnaire (SILQ): Development and Psychometric Evaluation. J Occup Rehabil 2023:10.1007/s10926-023-10159-7. [PMID: 38159124 DOI: 10.1007/s10926-023-10159-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE For clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory. METHODS The development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020. RESULTS Overall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively. CONCLUSION This study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties.
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Affiliation(s)
- Christian Ståhl
- Division of Education and Sociology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
| | - Elin Karlsson
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marika Wenemark
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Unit for Public Health and Statistics, East Region, Linköping, Sweden
| | - Jan Sandqvist
- Division of Prevention, Department of Health, Medicine and Caring Sciences, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Kalmar, Kalmar County, Sweden
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Krotz A, Sosnowsky-Waschek N, Bechtel S, Neumann C, Lohkamp M, Kovacs G, Genser B, Fischer JE. Reducing sick leave, improving work ability, and quality of life in patients with mild to moderate Long COVID through psychosocial, physiotherapeutic, and nutritive supportive digital intervention (MiLoCoDaS): study protocol for a randomized controlled trial. Trials 2023; 24:798. [PMID: 38066618 PMCID: PMC10709981 DOI: 10.1186/s13063-023-07819-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Following SARS-CoV-2 infection, a relevant proportion of patients suffer from persistent or recurring sequela, even after initially mild primary illness. Many patients experience exhaustion and fatigue, rendering them incapable of working. Long COVID exerts a substantial burden on society and the healthcare system: at least 65 million people are currently affected worldwide. The underlying pathobiology is a complex derangement in several organ systems. To date, causal pharmaceutical therapies remain elusive. Waiting lists for specialist care are long. Rapidly scalable digital interventions offering support for the frequent subgroup of patients with mild to moderate impairment from Long COVID are urgently needed. The MiLoCoDaS study compares three intensities of a potentially rapidly scalable digital intervention aiming to accelerate recovery. The overall objective is to figure out if there is a difference in the effect sizes between these modalities. METHODS The online intervention uses a learning platform (LMS, TYPO3 framework) comprising 12 sessions of medical, psychological, physiotherapeutic, and nutritional content. The three modalities differ as follows: patient information only (sham intervention, control), information plus interactive digital workbook including practical exercises (digital intervention), and the digital workbook augmented by once-weekly online seminars and discussion groups (person and peer-contact). Eligible patients are 18-67 years old satisfying Long COVID diagnostic criteria. Patients are recruited through primary care physicians and randomly allocated. The primary endpoint is the number of sick leave days during the 6-month observation period; secondary endpoints are patient-reported symptoms, quality of life, and work ability. The study size provides a power of 80% at a type I error of < 0.05 to show an effect size of Cohen = 0.3 between the augmented and the sham intervention (N = 152 per arm, total accounting for attrition N = 600). DISCUSSION If one of the two interventions is superior to providing information alone, MiLoCoDaS would provide the starting point for a rapidly scalable digital intervention for the frequent and currently underserved patient group with mild to moderate impairment from Long COVID. Several caveats pertain to the heterogeneity of Long COVID manifestation and duration prior to inclusion. It is conceivable that the possible effect of the intervention may differ across subgroups. Therefore, a priori defined secondary analysis will be conducted. TRIAL REGISTRATION German Clinical Trials Register (DRKS) DRKS00028964. Registered on 24 August 2022.
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Affiliation(s)
- Adrian Krotz
- Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
| | - Nadia Sosnowsky-Waschek
- School of Applied Psychology, SRH University of Applied Sciences Heidelberg, Heidelberg, Germany
| | - Stephanie Bechtel
- Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Christine Neumann
- Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Monika Lohkamp
- School of Therapeutic Sciences, SRH University of Applied Sciences Heidelberg, Heidelberg, Germany
| | - Gabor Kovacs
- Department of Applied Digital Product Development, SRH Berlin University of Applied Sciences, Berlin, Germany
| | | | - Joachim E Fischer
- Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
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21
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Geipel M, Pelizäus A, Hamann J. Returning-to-work after mental health-associated sick leave: a qualitative interview study exploring the experiences of general practitioners in Germany. BMC Prim Care 2023; 24:261. [PMID: 38042796 PMCID: PMC10693165 DOI: 10.1186/s12875-023-02219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/21/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND AND AIM Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. METHODS This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. RESULTS GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. CONCLUSION We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context.
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Affiliation(s)
- Martina Geipel
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Straße 1, 86156, Augsburg, Germany
| | - Anna Pelizäus
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Johannes Hamann
- Department of Psychiatry and Psychotherapy, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
- Bezirkskrankenhaus Mainkofen, Mainkofen A 3, 94469, Deggendorf, Germany.
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22
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Salonen L, Hartikainen E, Solovieva S, Viikari-Juntura E, Leinonen T. Contribution of compositional changes in the workforce to sickness absence trends in Finland. SSM Popul Health 2023; 24:101525. [PMID: 37808232 PMCID: PMC10550613 DOI: 10.1016/j.ssmph.2023.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/23/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
In this study, we assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce. Utilizing register-based panel data on Finnish wage earners aged 30-62, we examined the annual onset of compensated sickness absence (granted after 10 weekdays) in the period 2005-2016. We applied random effects models adjusting for changes in the observed sociodemographic and occupational characteristics of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for the unobserved time-invariant characteristics of the study population over the years. Of the observed characteristics, increasing educational level partly explained the decreasing trend in sickness absences, and the further contribution of the occupational class was weak. Additionally, accounting for unobserved individual characteristics further explained the decreasing trend in sickness absences among those aged 30-47 years and led to a reverse increasing trend among those aged 48-62 years irrespective of sex and employment sector. Particularly for those over 47 years old, the decrease in sickness absences appeared to be more strongly influenced by compositional changes in characteristics that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Sickness absence trends fluctuated during economic cycles, which did not appear to be explained by immediate changes in the observed or unobserved characteristics. Different mechanisms are likely to explain long-term sickness absence trends and trends around economic cycles. Attempts to improve work ability and labour market inclusion in long-term should rely more on increasing educational levels among the workforce and on interventions carried out early during the life course.
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Affiliation(s)
- Laura Salonen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
| | - Elli Hartikainen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
| | | | | | - Taina Leinonen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
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Hällås E, Skoglund I, Nordeman L. "That's probably how you would want care to be" - experiences of sick leave teams at a health center, a mixed method study. BMC Prim Care 2023; 24:243. [PMID: 37978438 PMCID: PMC10655286 DOI: 10.1186/s12875-023-02192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The health center where this study was performed the management wanted to test whether a sick leave team provided the physicians with better conditions for the task of assessing sick leave. The goals were to ensure the quality of the assessment of patients with sick leave needs and to improve the work environment. The aim of this study was to take part in the staff's experiences of having access to and working in sick leave teams and how the working method affected the number of sick leave patients and sick leave pattern. METHODS A mixture of qualitative and quantitative methods. Two focus groups were conducted with a total of 11 participants. The head of the health center formed the focus groups, which consisted of 6 doctors, 3 district nurses, 1 rehab coordinator and 1 psychologist. Aggregated sick leave data for full-time and part-time sick leave of more than 90, 180 and 360 days, respectively, were obtained and compiled at project start and end, and from the corresponding period 18 months before project start. RESULTS The introduction of sick leave teams with physicians and rehabilitation coordinator for patients who turn to the health center for mental illness and / or musculoskeletal problems emerged three main categories from the analysis of the focus group discussions: working environment, clear roles and in-depth competence. The total number of people who were on sick leave more than 365 days decreased by 27% between start and the end of the project, and the proportion of women increased by 11%. CONCLUSIONS The study shows that the complex task of sick leave can be perceived as positive by physicians with the support of teamwork. The working method is similar to that applied in occupational health care, where the physician is not alone with this task. This can also be a way to make primary care a more attractive workplace.
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Affiliation(s)
- E Hällås
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden.
| | - I Skoglund
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden
- Primary Health Care/School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L Nordeman
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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24
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Tingulstad A, Maas ET, Rysstad T, Øiestad BE, Aanesen F, Pripp AH, Van Tulder MW, Grotle M. Six-month cost-effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management for workers with musculoskeletal disorders: the MI-NAV economic evaluation. J Occup Med Toxicol 2023; 18:25. [PMID: 37964240 PMCID: PMC10644648 DOI: 10.1186/s12995-023-00394-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/08/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVES This study evaluates the six-month cost-effectiveness and cost-benefits of motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) added to usual case management (UC) for workers on sick leave due to musculoskeletal disorders. METHODS This study was conducted alongside a three-arm RCT including 514 employed workers on sick leave for at least 50% for ≥ 7 weeks. All participants received UC. The UC + MI group received two MI sessions, and the UC + SVAI group received 1-4 SVAI sessions. Sickness absence days, quality-adjusted life-years (QALYs), and societal costs were measured between baseline and six months. RESULTS Adding MI to UC, resulted in incremental cost-reduction of -2580EUR (95%CI -5687;612), and a reduction in QALYs of -0.001 (95%CI -0.02;0.01). Secondly, adding MI to UC resulted in an incremental cost-reduction of -538EUR (95%CI -1358;352), and reduction of 5.08 (95%CI -3.3;13.5) sickness-absence days. Financial return estimates were positive, but not statistically significant. Adding SVAI to UC, resulted in an incremental cost-reduction of -2899 EUR (95% CI -5840;18), and a reduction in QALYs of 0.002 (95% CI -0.02;0.01). Secondly, adding SVAI to UC resulted in an statistically significant incremental cost-reduction of -695 EUR (95% CI -1459;-3), and a reduction of 7.9 (95% CI -0.04;15.9) sickness absence days. Financial return estimates were positive and statistically significant. The probabilities of cost-effectiveness for QALYs were high for adding MI or SVAI (ceiling ratio 0.90). CONCLUSIONS In comparison to UC only, adding MI to UC tends to be cost-effective. Adding SVAI to UC is cost-effective for workers on sick leave due to musculoskeletal disorders. TRIAL REGISTRATION ClinicalTrials.gov (identifier: NCT03871712).
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Affiliation(s)
- Alexander Tingulstad
- Department of Rehabilitation and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, St.Olavs Plass, P.O. Box 4, Oslo, 0130, Norway.
| | - Esther T Maas
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and the Amsterdam Movement Sciences Research Institute, de Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Tarjei Rysstad
- Department of Rehabilitation and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, St.Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
| | - Britt Elin Øiestad
- Department of Rehabilitation and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, St.Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
| | - Fiona Aanesen
- National Institute of Occupational Health, Majorstuen, P.O. Box 5330, Oslo, 0304, Norway
| | - Are Hugo Pripp
- Department of Rehabilitation and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, St.Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
| | - Maurits W Van Tulder
- Faculty Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Margreth Grotle
- Department of Rehabilitation and Health Technology, Centre for Intelligent Musculoskeletal Health, Oslo Metropolitan University, St.Olavs Plass, P.O. Box 4, Oslo, 0130, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo University Hospital, Ullevål, Building 37B, P.O. Box 4956, Oslo, Nydalen, 0424, Norway
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Murley C, Tinghög P, Teni FS, Machado A, Alexanderson K, Hillert J, Karampampa K, Friberg E. Excess costs of multiple sclerosis: a register-based study in Sweden. Eur J Health Econ 2023; 24:1357-1371. [PMID: 36418785 PMCID: PMC9685028 DOI: 10.1007/s10198-022-01547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Population-based estimates of the socioeconomic burden of multiple sclerosis (MS) are limited, especially regarding primary healthcare. This study aimed to estimate the excess costs of people with MS that could be attributed to their MS, including primary healthcare. METHODS An observational study was conducted of the 2806 working-aged people with MS in Stockholm, Sweden and 28,060 propensity score matched references without MS. Register-based resource use was quantified for 2018. Annual healthcare costs (primary, specialised outpatient, and inpatient healthcare visits along with prescribed drugs) and productivity losses (operationalised by sickness absence and disability pension days) were quantified using bottom-up costing. The costs of people with MS were compared with those of the references using independent t-tests with bootstrapped 95% confidence intervals (CIs) to isolate the excess costs of MS from the mean difference. RESULTS The mean annual excess costs of MS for healthcare were €7381 (95% CI 6991-7816) per person with MS with disease-modifying therapies as the largest component (€4262, 95% CI 4026-4497). There was a mean annual excess cost for primary healthcare of €695 (95% CI 585-832) per person with MS, comprising 9.4% of the excess healthcare costs of MS. The mean annual excess costs of MS for productivity losses were €13,173 (95% CI 12,325-14,019) per person with MS, predominately from disability pension (79.3%). CONCLUSIONS The socioeconomic burden of MS in Sweden from healthcare consumption and productivity losses was quantified, updating knowledge on the cost structure of the substantial excess costs of MS.
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Affiliation(s)
- Chantelle Murley
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Petter Tinghög
- Department of Health Sciences, Swedish Red Cross University, 141 21, Huddinge, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Fitsum Sebsibe Teni
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Alejandra Machado
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Jan Hillert
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Korinna Karampampa
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
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Abrahamsen C, Reme SE, Wangen KR, Lindbæk M, Werner EL. The effects of a structured communication tool in patients with medically unexplained physical symptoms: a cluster randomized trial. EClinicalMedicine 2023; 65:102262. [PMID: 37855023 PMCID: PMC10579279 DOI: 10.1016/j.eclinm.2023.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/20/2023] Open
Abstract
Background Medically Unexplained Physical Symptoms (MUPS) are prevalent among primary care patients and frequently lead to diminished quality of life, increased healthcare costs, and decreased work participation. We aimed to examine the effects of a work-focused structured communication tool based on cognitive-behavioral therapy in patients with MUPS. Methods In a Norwegian two-arm cluster randomized trial, the effectiveness of the structured communication tool Individual Challenge Inventory Tool (ICIT) was compared to usual care for patients with MUPS using a two-arm cluster randomized design. Enrollment period was between March 7 and April 1, 2022. Ten groups (clusters) of 103 General Practitioners (GPs) were randomized to provide the ICIT or usual care for 11 weeks. Patients received two or more sessions with their GP, and outcomes were assessed individually. Primary outcome was patient-reported change in function, symptoms, and quality of life measured by the Patient Global Impression of Change (PGIC). Secondary outcomes included sick leave, work-related self-efficacy (RTW-SE), health-related quality of life (RAND-36), and patient experiences with consultants (PEQ). The trial was registered on ClinicalTrials.gov (NCT05128019). Findings A total of 541 patients with MUPS were enrolled in the study. In the intervention group 76% (n = 223) showed a significant overall improvement in function, symptoms, and quality of life as measured by the PGIC, compared to 38% (n = 236) in the usual care group (mean difference -0.8 ([95% CI -1.0 to -0.6]; p < 0.0001). At 11 weeks, the intervention group had a 27-percentage point decrease in sick leave (from 52.0 to 25.2), compared to 4-percentage point decrease (from 49.7 to 45.7) in the usual care group. Furthermore, compared to usual care, the intervention group reported significant improvements in work-related self-efficacy, health-related quality of life, and greater satisfaction with the communication during the consultations. No adverse events were reported. Interpretation The implementation of the structured communication tool ICIT in primary care significantly improved patient outcomes and reduced sick leave among patients with MUPS. Funding The study was funded by The Norwegian Research Fund for General Practice.
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Affiliation(s)
- Cathrine Abrahamsen
- Faculty of Medicine, Department of General Practice, University of Oslo, Oslo, Norway
| | - Silje Endresen Reme
- Faculty of Social Sciences, Department of Psychology, University of Oslo, Norway
| | - Knut Reidar Wangen
- Faculty of Medicine, Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Morten Lindbæk
- Faculty of Medicine, Department of General Practice, University of Oslo, Oslo, Norway
| | - Erik Lønnmark Werner
- Faculty of Medicine, Department of General Practice, University of Oslo, Oslo, Norway
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Svärd A, Lallukka T, Oakman J, Roos E, Ervasti J, Salmela J. The Joint Contributions of Overweight/Obesity and Physical and Mental Working Conditions to Short and Long Sickness Absence among Young and Midlife Finnish Employees: A Register-Linked Follow-Up Study. Obes Facts 2023; 17:37-46. [PMID: 37879311 PMCID: PMC10836910 DOI: 10.1159/000534525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Overweight/obesity and strenuous working conditions are associated with work disability, but their joint contributions to sickness absence (SA) are unknown. We aimed to examine their joint contributions to SA periods of 1-7 and ≥8 days. METHODS Self-reported data on body mass index and working conditions, including perceived physically and mentally strenuous work and hours per day spent in heavy physical work, were linked to the employer's SA register for the City of Helsinki, Finland, employees (n = 4,323, women 78%) who were 19-39 years old at baseline. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for SA periods using negative binomial regression models among participants with healthy weight and overweight/obesity, with and without exposure to strenuous working conditions. The mean follow-up time was 2.1 years. RESULTS Participants with overweight/obesity and exposure to physically strenuous working conditions had the highest age- and gender-adjusted RRs for SA periods of both 1-7 and ≥8 days (physically strenuous work: RR: 1.38, CI: 1.25-1.52, and RR: 1.87, CI: 1.60-2.18, respectively; ≥3 h per day spent in physical work: RR: 1.40, CI: 1.26-1.55 and 2.04, CI: 1.73-2.40, respectively). The interaction between overweight/obesity and physically strenuous working conditions was additive for SA periods of 1-7 days and weakly synergistic for SA periods of ≥8 days. For mentally strenuous work, participants with overweight/obesity and exposure to mentally strenuous work had the highest age-adjusted RRs for SA periods of ≥8 days, and the interaction was additive. CONCLUSION The joint contributions of overweight/obesity and exposure to strenuous working conditions to SA should be considered when aiming to reduce employees' SA. Employers might benefit from providing employees adequate support for weight management and adherence to healthy lifestyles while improving employees' working conditions.
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Affiliation(s)
- Anna Svärd
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Eira Roos
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jatta Salmela
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Palola V, Hevonkorpi TP, Ponkilainen VT, Launonen AP, Mattila VM. Sick leave length and the costs of operatively and conservatively treated distal radius fractures in the working age population: a retrospective cohort study. BMC Musculoskelet Disord 2023; 24:842. [PMID: 37880683 PMCID: PMC10601330 DOI: 10.1186/s12891-023-06963-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Among the working population, a transient loss of working ability due to distal radius fracture (DRF) has a societal impact in terms of sick leave. Non-operative cast immobilization is the most common treatment option for DRF. However, these fractures are increasingly treated operatively. This retrospective cohort study of patients aged 20-64 with DRF compares the effects of different treatment strategies on sick leave length and overall cost of treatment. METHODS Multivariable regression analysis was used with treatment modality as an exposure and sick leave length as an outcome. Sick leave data were obtained from a national register. Costs were evaluated by adding the direct cost of the treatment modality to the mean cost of sick leave per patient in different treatment groups. RESULTS Of 614 working-age patients with a DRF who were treated at a tertiary hospital in Finland between January 2013 and December 2014, 521 were primarily treated non-operatively with cast immobilization and 93 were primarily operated. Of the primarily non-operatively treated patients, 48 were operated during follow-up. The mean follow-up was 5 years. The median time lost from work after DRF was 55 days (7.9 weeks), and the separated medians by treatment modality were 49 (7 weeks) and 70 days (10 weeks) for conservative and operative treatment, respectively. Multivariable linear regression analyses were performed for those patients who had sick leave (n = 292). Regression analysis also showed that operative treatment correlates with longer sick leave. CONCLUSIONS Operative treatment of distal radius fracture led more often to longer time lost from work than conservative treatment. Moreover, due to longer sick leave and the costs of the operation itself, operative treatment is over two times more expensive than conservative treatment. TRIAL REGISTRATION retrospectively registered.
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Affiliation(s)
- Vili Palola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland.
| | - Teemu P Hevonkorpi
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
- Department of Surgery, Central Finland Central Hospital Nova, Jyvaskyla, Finland
| | - Ville T Ponkilainen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
- Department of Surgery, Central Finland Central Hospital Nova, Jyvaskyla, Finland
| | - Antti P Launonen
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Ville M Mattila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33520, Finland
- Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland
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van de Leur JC, Buhrman M, Wallby K, Karlström A, Johansson F. Associations between improvements in psychological variables and subsequent sick leave among persons receiving a multimodal intervention for exhaustion disorder. BMC Public Health 2023; 23:1976. [PMID: 37821913 PMCID: PMC10568869 DOI: 10.1186/s12889-023-16799-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The incidence of sick leave due to stress-related disorders such as exhaustion disorder (ED) is high in many economically developed countries. Meanwhile, knowledge about facilitating return to work during clinical interventions for ED patients is still limited. The current study aimed to investigate if improvements in exhaustion symptoms, insomnia, perfectionistic behaviors, psychological flexibility, and perceived work ability during treatment of ED were associated with subsequent sick leave in the year following treatment. METHODS Using a cohort of 880 ED patients who had participated in a multimodal intervention based on Cognitive Behavior Therapy, we estimated the association between one standard deviation (SD) improvement in treatment-related variables and the rate of net days of sick leave one-year following treatment. RESULTS Our results showed that improvements in all treatment-related variables were associated with lower sick leave rates one year following treatment. Improvements in exhaustion symptoms (rate ratio (RR): 0.70 [95% CI 0.66; 0.75]) and self-perceived work ability (RR 0.56 [95% CI 0.50; 0.63]) showed the strongest associations to subsequent sick leave. CONCLUSIONS These findings suggest that interventions focusing on exhaustion symptoms, insomnia, perfectionistic behaviors, psychological flexibility, and perceived work ability can have a meaningful impact on ED patients' subsequent sick leave. TRIAL REGISTRATION Clinicaltrials.gov (Identifier: NCT03360136).
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Affiliation(s)
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Box 1225, Uppsala, 751 42, Sweden
| | - Kajsa Wallby
- Department of Psychology, Uppsala University, Box 1225, Uppsala, 751 42, Sweden
| | - Amanda Karlström
- Department of Psychology, Uppsala University, Box 1225, Uppsala, 751 42, Sweden
| | - Fred Johansson
- Department of Health Promotion Science, Sophiahemmet University, Valhallavägen 91, SE- 114 28, Stockholm, Sweden
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Heiman J, Pavia J, Bock D, Haglind E, Olofsson Bagge R. Sick leave and predictive factors for sick leave at 12 months after breast cancer surgery in the randomized controlled physical activity trial (PhysSURG-B). Surgeon 2023; 21:e229-e237. [PMID: 36599718 DOI: 10.1016/j.surge.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/25/2022] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate sick leave 12 months after breast cancer surgery, to analyze the effect of adjuvant chemotherapy and to identify predictive factors for sick leave, based on a randomized controlled trial of a non-supervised physical activity intervention (PhysSURG-B). METHODS Sick leave days (for patients age 18-67) were collected from the Swedish Social Insurance Agency, and compared between the intervention and control arm in the trial. A random forest model was used to analyze predictive factors for sick leave, including baseline patient and tumor characteristics as well as patient-reported outcomes measuring quality of life, personality traits, pain, anxiety and depression. RESULTS A total of 203 patients were analyzed, and when comparing intervention to control, there was no differences in sick leave days (117 vs 55 days, odds ratio 1.21; 95% CI 0.75-1.96). Adjuvant chemotherapy significantly increased days of sick leave (323 vs 42 days, odds ratio 17.3; 95% CI 9.15-34.2). Factors predicting prolonged sick leave were adjuvant chemotherapy, young age, previous mental health problems and low quality of life (measured as FACT-B score) at baseline. CONCLUSION A non-supervised physical activity intervention had no effect on sick leave 12 months after surgery. Significantly longer sick leave was seen in patients treated by adjuvant chemotherapy. Factors predicting prolonged sick leave can be recognized at baseline and utilized when designing future interventions.
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Affiliation(s)
- Jenny Heiman
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden
| | - John Pavia
- Jostat & Mr Sample AB, Gothenburg, Sweden
| | - David Bock
- Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Haglind
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden; Jostat & Mr Sample AB, Gothenburg, Sweden
| | - Roger Olofsson Bagge
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
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Berglund E, Friberg E, Engblom M, Svärd V. Physicians' experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden. Disabil Rehabil 2023:1-9. [PMID: 37772755 DOI: 10.1080/09638288.2023.2261851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians' experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics. MATERIALS AND METHODS Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs. RESULTS Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06-4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification. CONCLUSIONS Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs' facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians.Implications for RehabilitationThis study of physicians' experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators.The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic.These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance.
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Affiliation(s)
- Erik Berglund
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Emilie Friberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Monika Engblom
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Svärd
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Social Work in Health, Karolinska University Hospital, Stockholm, Sweden
- Department of Social Sciences, Division of Social Work, Södertörn University, Huddinge, Sweden
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Beno A, Bertilsson M, Holmgren K, Glise K, Pousette A, Segerfelt K, Björk L. Does employer involvement in primary health care enhance return to work for patients with stress-related mental disorders? a cluster randomized controlled trial. BMC Prim Care 2023; 24:195. [PMID: 37730561 PMCID: PMC10512560 DOI: 10.1186/s12875-023-02151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Stress-related disorders have become a major challenge for society and are associated with rising levels of sick leave. The provision of support to facilitate the return to work (RTW) for this patient group is of great importance. The aim of the present study was to evaluate whether a new systematic procedure with collaboration between general practitioners (GPs), rehabilitation coordinators (RCs) and employers could reduce sick leave days for this patient group. METHOD Employed patients with stress-related diagnoses seeking care at primary health care centres (PHCCs) were included in either the intervention group (n = 54), following the systematic intervention procedure, or the control group (n = 58), receiving treatment as usual (TAU). The intervention included a) a training day for participant GPs and RCs, b) a standardised procedure for GPs and RCs to follow after training, c) the opportunity to receive clinical advice from specialist physicians in the research group. Outcome measures for RTW were sick leave days. RESULTS The median number of registered gross sick leave days was lower for the control group at six, 12 and 24 months after inclusion, but the difference was not statistically significant. The control group had significantly fewer net sick leave days at three months (p = 0.03) at six months (p = 0.00) and at 12-months follow-up (p = 0.01). At 24 months, this difference was no longer significant. CONCLUSIONS The PRIMA intervention, which applied a standardized procedure for employer involvement in the rehabilitation process for patients with stress-related disorders, actually increased time to RTW compared to TAU. However, at 24 months, the benefit of TAU could no longer be confirmed. The study was registered on 16/01/2017 (ClinicalTrials.gov, NCT03022760).
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Affiliation(s)
- Anja Beno
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE-413 19, Gothenburg, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Kristina Glise
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE-413 19, Gothenburg, Sweden
| | - Anders Pousette
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- The Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Karin Segerfelt
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE-413 19, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Lisa Björk
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs Gata 22B, SE-413 19, Gothenburg, Sweden
- The Department of Work Science and Sociology, University of Gothenburg, Gothenburg, Sweden
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Hagendijk ME, Zipfel N, Oomen FJ, Hoving JL, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Melles M, van der Burg-Vermeulen SJ. Work-focused healthcare from the perspective of employees living with cardiovascular disease: a patient experience journey mapping study. BMC Public Health 2023; 23:1765. [PMID: 37697261 PMCID: PMC10494386 DOI: 10.1186/s12889-023-16486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/09/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND People living with cardiovascular diseases (CVD) often experience work participation problems. Good work-focused healthcare, defined as the received advice, treatment, and guidance focusing on work participation, can support the patient and work place. However, experiences with work-focused healthcare are generally not always positive which is a barrier for work participation. Therefore, the objective of this study is to gain insight into the work-focused healthcare journey from the perspective of patients with work participation problems due to CVD, to understand their experiences and needs, and to derive opportunities for improving work-focused healthcare service at a system level. METHODS Semi-structured interviews, preceded by preparatory assignments, were conducted with 17 patients who experience(d) work participation problems due to CVD. The patient experience journey map (PEJM) approach was used to visualize the patients' work-focused healthcare journey, including experiences and needs over time and place, from which opportunities to improve work-focused healthcare from the patient's perspective were derived. RESULTS An aggregated PEJM consisting of six phases was composed and graphically mapped. The first phase, working, represents a period in which CVD health problems and subsequent functional limitations occur. The next two phases, short- and long-term sick leave, represent a period of full sick leave. The last three phases, start-, partial-, and full vocational reintegration, focus on the process of return to work that takes place ranging from a few months up to several years after sick-listing. For each phase the touchpoints, timespan, stakeholders, activities, experiences and needs from the perspective of the patients were identified. Finally, for better work-focused healthcare nine opportunities for improvement were derived from the PEJM, e.g. emphasize the need for work adjustment prior to the medical intervention, provide more personalized advice on handling work limitations, and putting more compelling pressure on the employer to create suitable work positions for their employees. DISCUSSION/CONCLUSION This paper contributes insights to provide a more patient-centered work-focused healthcare trajectory for patients employed in paid jobs when living with CVD. The PEJM provides an understanding of the patients' perspectives throughout their work-focused healthcare journey and highlights opportunities for improvement towards a better suited and seamless patient journey, Although this research was conducted within the Dutch healthcare system, it can be assumed that the findings on integrated work-focused healthcare are largly transferable to other healthcare systems.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Floor J Oomen
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Marijke Melles
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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Helgesson M, Kjeldgård L, Björkenstam E, Rahman S, Gustafsson K, Taipale H, Tanskanen A, Ekselius L, Mittendorfer-Rutz E. Sustainable labour market participation among working young adults with diagnosed attention deficit/hyperactivity disorder (ADHD). SSM Popul Health 2023; 23:101444. [PMID: 37691973 PMCID: PMC10492158 DOI: 10.1016/j.ssmph.2023.101444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/03/2023] [Accepted: 06/05/2023] [Indexed: 09/12/2023] Open
Abstract
Background The aims were to study the sustainability of labour-market participation five years after an incident diagnosis of attention-deficit/hyperactivity disorder (ADHD) among young adults with gainful employment, and to examine the impact of sociodemographic-, work- and health-related factors on these findings. Methods Swedish registers identified 2517 individuals, 19-29 years old, with an incident diagnosis of ADHD and gainful employment during 2006-2011. Labour-market participation was measured by the core-peripheral model, a model that measures the connection to the labour market from a weak connection (peripheral) to a strong connection (core). Sequence analysis analysed clusters of labour-market participation, from one year before and up to five years after diagnosis. Odds ratios (OR) with 95% confidence intervals (CI) between sociodemographic factors, comorbid disorders, and the identified clusters were analysed by multinomial logistic regression. Results Five clusters of labour-market participation were identified: 60% of individuals belonged to a cluster that maintained labour-market participation throughout the study period (core, close to core); 20% belonged to a cluster with a transition to a weak connection to the labour market (close to peripheral, peripheral); and 20% belonged to a cluster with "middle" labour-market participation, characterised by having long periods of sick leave and unemployment. Individuals with elementary school as highest attained education (OR:4.03;CI:2.35-6.93), comorbid mental disorders (OR:2.77;CI:2.10-3.66), or living in villages/small cities (OR:1.77;CI:1.25-2.51) were most likely to belong to a cluster transitioning towards a "peripheral" labour-market participation. Men were less likely to have peripheral labour-market participation than women (OR:0.55;CI:0.40-0.75). Conclusions Over half of working individuals with ADHD maintain a strong attachment to the labour market several years after their first diagnosis of ADHD. Therefore, it is important to target those who have problems maintaining a position in the labour market, including women, those with low educational levels, and those living outside large cities.
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Affiliation(s)
- Magnus Helgesson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-752 37, Uppsala, Sweden
| | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Syed Rahman
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Klas Gustafsson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
| | - Heidi Taipale
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Antti Tanskanen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
| | - Lisa Ekselius
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-17177, Stockholm, Sweden
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Bergsten EL, Kjeldgård L, Stigson H, Farrants K, Friberg E. Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation. J Safety Res 2023; 86:357-363. [PMID: 37718063 DOI: 10.1016/j.jsr.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/29/2023] [Accepted: 07/25/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA. METHODS Data from several national registers were used that included 15,359 working age pedestrians (20-64 years) receiving healthcare after a fall or collision throughout 2014-2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration. RESULTS About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56-1.98) and long SA (≥90 days) 1.81 (95% CI 1.51-2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38-1.81), long SA 1.79 (95% CI 1.45-2.20) and for construction, short SA 1.56 (95% CI 1.24-1.96), long SA 1.75 (95% CI 1.26-2.44), compared to the sector finance, communication, & cultural service. CONCLUSIONS The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors. PRACTICAL IMPLICATIONS This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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Affiliation(s)
- Eva L Bergsten
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Faculty of Health and Occupational Studies, Department of Occupational Health Sciences and Psychology, University of Gävle, SE-801 76 Gävle, Sweden.
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Helena Stigson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Vehicle Safety Division, Department of Applied Mechanics, Chalmers University of Technology, Gothenburg, Sweden; Folksam Research, Folksam Insurance Group, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
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Aasdahl L, Fimland MS, Bjørnelv GMW, Gismervik SØ, Johnsen R, Vasseljen O, Halsteinli V. Economic Evaluation of Inpatient Multimodal Occupational Rehabilitation vs. Outpatient Acceptance and Commitment Therapy for Sick-Listed Workers with Musculoskeletal- or Common Mental Disorders. J Occup Rehabil 2023; 33:463-472. [PMID: 36949254 PMCID: PMC10495483 DOI: 10.1007/s10926-022-10085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the cost-effectiveness and cost-benefit of inpatient multimodal occupational rehabilitation (I-MORE) compared to outpatient acceptance and commitment therapy (O-ACT) for individuals sick listed due to musculoskeletal- or common mental disorders during two-years of follow-up. METHODS We conducted an economic evaluation with a societal perspective alongside a randomized controlled trial with 24 months follow-up. Individuals sick listed 2 to 12 months were randomized to I-MORE (n = 85) or O-ACT (n = 79). The outcome was number of working days. Healthcare use and sick leave data were obtained by registry data. RESULTS Total healthcare costs during the 24 months was 12,057 euros (95% CI 9,181 to 14,933) higher for I-MORE compared to O-ACT, while the difference in production loss was 14,725 euros (95% CI -1,925 to 31,375) in favour of I-MORE. A difference of 43 (95% CI -6 to 92) workdays, in favour of I-MORE, gave an incremental cost-effectiveness ratio of 278 euros for one workday, less than the cost of one day production (339 euros). Net societal benefit was 2,667 euros during two years of follow-up. CONCLUSION Despite considerable intervention costs, the lower production loss resulted in I-MORE being cost-effective when compared to O-ACT. Based on economic arguments, I-MORE should be implemented as a treatment alternative for individuals on long-term sick leave. However, more research on subgroup effects and further follow-up of participants' permanent disability pension awards are warranted.
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
| | - Marius Steiro Fimland
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gudrun M W Bjørnelv
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sigmund Østgård Gismervik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ottar Vasseljen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vidar Halsteinli
- Regional Centre for Health Care Development, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Wanger S, Weber E. Sickness absence due to mandatory COVID-19 certificates in the workplace. BMC Public Health 2023; 23:1482. [PMID: 37537556 PMCID: PMC10401870 DOI: 10.1186/s12889-023-16415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 07/27/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND As vaccines for COVID-19 became available, many countries introduced an obligation in 2021 for employees to prove their COVID-19 status at work, known in Germany as the 3G rule (vaccinated, recovered, tested). In view of the controversial debate, there was concern that employees might try to avoid providing mandatory COVID-19 certificates by taking sick leave. The aim of this study was to investigate whether mandatory COVID-19 tests in the workplace led to such an evasive response. METHOD For an empirical panel analysis, we collected data from official sources and combined aggregated health insurance data on sick leave, epidemiological data on laboratory-confirmed COVID-19 infections, and vaccination rates for the German states from September 2021 to January 2022. We used a regional panel data analysis to estimate the impact of the mandatory COVID-19 certificates at the workplace on workers' sick leave. The regional vaccination rate reflected differences in treatment intensity. RESULTS This study contributes to the limited evidence on the potential impact of introducing mandatory COVID-19 certificates at the workplace on sickness absence rates. In fact, our results showed that after controlling for infection rates, a one percentage point lower vaccination rate led to a 0.021 percentage point increase in the sickness absence rate when the 3G rule came into effect. This effect was measured with high statistical precision. In addition, in robustness checks, we controlled for a number of other possible influencing factors that may have affected sickness behaviours, such as time-varying labour market situations. However, the results remained robust. CONCLUSIONS The results of our empirical panel analysis implied that mandatory COVID-19 certificates in the workplace led to evasive responses and to additional days of sick leave of a relevant magnitude. Testing obligations were meant to help contain the epidemic. However, when introducing controversial obligations, it is important to consider evasive responses and to design the rules appropriately and communicate them convincingly.
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Affiliation(s)
- Susanne Wanger
- Research Department 'Forecasts and Macroeconomic Analyses', Institute for Employment Research (IAB), Regensburger Straße 100, 90478, Nuremberg, Germany.
| | - Enzo Weber
- Research Department 'Forecasts and Macroeconomic Analyses', Institute for Employment Research (IAB), Regensburger Straße 100, 90478, Nuremberg, Germany
- Chair of Empirical Economics, University of Regensburg, Regensburg, Germany
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Suur-Uski J, Pietiläinen O, Salonsalmi A, Pekkala J, Fagerlund P, Rahkonen O, Lallukka T. Long-term sickness absence trajectories among ageing municipal employees - the contribution of social and health-related factors. BMC Public Health 2023; 23:1429. [PMID: 37495983 PMCID: PMC10373243 DOI: 10.1186/s12889-023-16345-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The ageing work force is heterogeneous, following distinct development in work ability. This study aims to identify trajectories of long-term sickness absence (SA) in later careers and to examine potentially modifiable factors associated with the development of SA. METHODS Data comprised of municipal employees of the city of Helsinki aged 50-60 years during 2004-2018 (N = 4729, 80% women). The developmental trajectories of long-term (> 10 working days) SA were examined with Group-based trajectory modelling (GBTM) using SA records of the Social Insurance Institution of Finland during 2004-2018. All-cause and diagnosis-specific (mental disorder- and musculoskeletal disease-related) SA days were analysed. The association of social and health-related factors with trajectory membership was examined using multinomial logistic regression (odds ratios and 95% confidence intervals). RESULTS A model with three trajectories was selected for both all-cause and diagnosis-specific SA. Regarding all-cause long-term SA trajectories, 42% had no long-term SA, 46% had low levels of SA, and 12% had a high rate of SA during follow-up. Lower occupational class, reporting smoking, overweight or obesity, moderate or low leisure-time physical activity, and sleep problems were associated with a higher likelihood of belonging to the trajectory with a high rate of SA in both all-cause and diagnosis-specific models. CONCLUSIONS Most ageing employees have no or little long-term SA. Modifiable factors associated with trajectories with more SA could be targeted when designing and timing interventions in occupational healthcare.
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Affiliation(s)
- Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland.
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Johanna Pekkala
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Pi Fagerlund
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Tukholmankatu 8B, P.O. Box 20, Helsinki, 00014, Finland
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Helgesson M, Gustafsson K, Leineweber C. Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders. BMC Psychiatry 2023; 23:543. [PMID: 37495944 PMCID: PMC10373327 DOI: 10.1186/s12888-023-05020-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs. METHODS Included were respondents of the Swedish Work Environment Survey (SWES) 1993-2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days. RESULTS Low control over work (RR:1.16; CI:1.01-1.35), job strain (RR:1.25; CI:1.04-1.49), no flexible working hours (RR:1.25; CI:1.08-1.45) or no possibility to work from home (RR:1.37; CI:1.13-1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07-2.25). CONCLUSIONS A sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden.
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, Uppsala, SE-75237, Sweden.
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden
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Manipis K, Mulhern B, Haywood P, Viney R, Goodall S. Estimating the willingness-to-pay to avoid the consequences of foodborne illnesses: a discrete choice experiment. Eur J Health Econ 2023; 24:831-852. [PMID: 36074311 DOI: 10.1007/s10198-022-01512-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 08/09/2022] [Indexed: 05/20/2023]
Abstract
Lost productivity is one of the largest costs associated with foodborne illness (FBI); however, the methods used to estimate lost productivity are often criticised for overestimating the actual burden of illness. A discrete choice experiment (DCE) was undertaken to elicit preferences to avoid six possible FBIs and estimate whether ability to work, availability of paid sick leave and health-related quality of life affect willingness-to-pay (WTP) to avoid FBI. Respondents (N = 1918) each completed 20 DCE tasks covering two different FBIs [gastrointestinal illness, flu-like illness, irritable bowel syndrome (IBS), Guillain-Barre syndrome (GBS), reactive arthritis (ReA), or haemolytic uraemic syndrome (HUS)]. Attributes included: ability to work, availability of sick leave, treatment costs and illness duration. Choices were modelled using mixed logit regression and WTP was estimated. The WTP to avoid a severe illness was higher than a mild illness. For chronic conditions, the marginal WTP to avoid a chronic illness for one year, ranged from $531 for mild ReA ($1412 for severe ReA) to $1025 for mild HUS ($2195 for severe HUS). There was a substantial increase in the marginal WTP to avoid all the chronic conditions when the ability to work was reduced and paid sick leave was not available, ranging from $6289 for mild IBS to $11,352 for severe ReA. Including factors that reflect productivity and compensation to workers influenced the WTP to avoid a range of FBIs for both acute and chronic conditions. These results have implications for estimating the burden and cost of FBI.
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Affiliation(s)
- Kathleen Manipis
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Philip Haywood
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Stephen Goodall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
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Kaila-Kangas L, Haukka E, Lallukka T, Rahkonen O, Toppinen-Tanner S, Leino-Arjas P. Work-family conflicts and long-term medically certified sickness absence due to mental disorders - a follow-up study of female municipal employees. BMC Public Health 2023; 23:1137. [PMID: 37312062 DOI: 10.1186/s12889-023-16075-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/08/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND . Decreased work ability due to mental disorders is a growing concern in Europe. We studied the role of work-family conflicts in association with long-term sickness absence due to mental disorders (LTSA-MD). METHODS . Baseline data were extracted from the Helsinki Health Study for women aged 40 to 55 in full-time work in 2001 - 2002 (N = 2386). Questionnaire responses were linked with register data from the Social Insurance Institution of Finland on SA spells due to mental disorders during 2004-2010. We studied an overall question on satisfaction with combining work and family (WFS) and composite scores of work-to-family conflicts (WTFC) and family-to-work-conflicts (FTWC), and their components in association with the first certified SA spell (≥ 12 calendar days) due to a mental disorder during the follow-up. We performed Cox regression analyses with hazard ratios (HR) and their 95% confidence intervals (CI) adjusted for sociodemographic factors, work schedule, perceived mental and physical strenuousness at work, and self-rated health. First, we examined all participants, and second, only those who reported no prior mental disorder. RESULTS . Poor work-family satisfaction (WFS) was associated with subsequent LTSA-MD, adjusting for all covariates (HR 1.60; 95% CI 1.10-2.16). Both high WTFC (1.64; 1.15-2.23), and high FTWC (1.43; 1.02-2.00) increased the probability of LTSA-MD in the full model. When participants with prior mental disorder were excluded, the association between poor WFS and WTFC with LTSA-MD retained while that between FTWC and LTSA-MD attenuated; however, two items of the FTWC were still associated with LTSA-MD: 'Family worries and problems distract you from your work' and 'Family matters prevent you from sleeping enough to do your job well'. Of the WTFC items, the following remained associated with LTSA-MD: 'Problems at work make you irritable at home' and 'Your job takes so much energy you do not feel up to doing things that need attention at home'. The experience of decreased time for work or family did not associate with LTSA-MD. CONCLUSIONS . Among female municipal employees, dissatisfaction with combining work and family and both work-to-family and family-to-work conflicts were associated with subsequent long-term sickness absence due to mental disorders.
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Affiliation(s)
- Leena Kaila-Kangas
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland.
| | - Eija Haukka
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Salla Toppinen-Tanner
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
| | - Päivi Leino-Arjas
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
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Christensen MR, Nabe-Nielsen K, Holtermann A, Gupta N. Does it matter for health if steps are taken during work or leisure? A prospective accelerometer study using register-based long-term sickness absence. Int J Behav Nutr Phys Act 2023; 20:69. [PMID: 37296445 DOI: 10.1186/s12966-023-01468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Walking is known to be good for health. However, it is unknown whether it matters if steps are taken during work or leisure. Therefore, we aimed to examine the prospective association between accelerometer-measured steps taken during work or leisure and register-based long-term sickness absence (LTSA). METHODS We included 937 blue- and white-collar workers from the PODESA cohort who wore a thigh-based accelerometer over four days to measure number of steps during work and leisure. Steps were divided into domain based on diary data. First event of LTSA was retrieved from a national register with four years' follow-up. We used Cox proportional hazard models to analyze the association between domain-specific and total daily steps and LTSA, adjusted for age, sex, job type, smoking, and steps in the other domain (e.g., work/leisure). RESULTS We found more steps at work to be associated with a higher LTSA risk [Hazard Ratio (HR):1.04; 95% CI: 1.00-1.08 per 1000 steps]. No significant association was found between steps during leisure and LTSA (HR: 0.97; 95% CI: 0.91-1.02), nor between total daily steps and LTSA (HR: 1.01; CI 95% 0.99-1.04). CONCLUSIONS More steps at work were associated with higher risk of LTSA, while steps during leisure was not clearly associated with LTSA risk. These findings partly support 'the physical activity paradox' stating that the association between physical activity and health depends on the domain.
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Affiliation(s)
- Marie Raunkjær Christensen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark.
| | - Kirsten Nabe-Nielsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Nidhi Gupta
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
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Mauss D, Jarczok MN, Genser B, Herr R. Association of open-plan offices and sick leave-a systematic review and meta-analysis. Ind Health 2023; 61:173-183. [PMID: 35675991 DOI: 10.2486/indhealth.2022-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We aimed to systematically review and meta-analyze the association of employees working in various kinds of open-plan offices with sick leave data, compared to those working in traditional cell offices. Databases of PubMed, PubPsych, and Psyndex were systematically searched following the PRISMA statement. Pooled summary estimates of odds ratio (OR) were calculated comparing sick leave of employees in cell offices with those working in small open-plan offices (4-9 people), and those in various open-plan office solutions (≥4 people). We used Forest plots visualizing study-specific estimates and the pooled fixed and random effects estimators. Five studies were identified (2008-2020) with a total of 13,277 (range 469-6,328) participants. Compared with employees working in cell offices, those working in small open-plan offices were associated with higher odds of sick leave days (OR=1.27; 95% CI 0.99-1.54; p=0.046) as well as those working in various kinds of open-plan offices with ≥4 colleagues (OR=1.24; 95% CI 0.96-1.51; p=0.004). Our results are consistent with those of earlier reviews focusing on other effects of open-plan office solutions such as health and well-being. Different solutions for office design and architectural lay-out should be the focus of future studies to balance pros and cons of open-plan offices.
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Affiliation(s)
- Daniel Mauss
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Marc N Jarczok
- Institute of Medical Psychology, Center for Psychosocial Medicine, University of Ulm, Germany
| | - Bernd Genser
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Raphael Herr
- Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Germany
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Haukenes I, Hammarström A. Workplace gender composition and sickness absence: A register-based study from Sweden. Scand J Public Health 2023:14034948231176108. [PMID: 37265198 DOI: 10.1177/14034948231176108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS This study aimed to examine the association between gender composition in the workplace and sickness absence days during a one-year period. METHODS The study population was drawn from the Northern Swedish Cohort (wave 3; 2007) by Statistics Sweden and consisted of all participants belonging to a specific workplace (n=837) as well as all co-workers at the workplace of the participants (n=132,464; 67,839 women and 64,625 men). Exposure was the gender composition of the workplace, and outcome was cumulative sickness absence days (⩾90 days or not) during 2007, provided through a link to the Database for Health Insurance and Labour Marked Studies of Statistics Sweden. Covariates were gender, age, educational level and branch of industry from the same data source. We performed descriptive analyses and multivariable regression analyses. RESULTS Workers in extremely female-dominated workplaces had a significantly higher risk of cumulative sickness absence days (⩾90 days) compared with gender-equal workplaces (fully adjusted odds ratio (OR)=1.27; 95% confidence interval (CI) 1.09-1.48), whereas those working in extremely and moderately male-dominated workplaces had a significantly lower sickness absence risk (OR=0.62 and 0.66, respectively). Stratified by gender, the higher absence risk at female-dominated workplaces was fully explained by variation in branches of industry. Women working in extremely male-dominated workplaces had a significantly lower absence risk (OR=0.75), as did men working in moderately male-dominated workplaces (OR=0.78). CONCLUSIONS
Workplaces dominated by women had a significantly higher risk of days lost to sickness absence compared to gender-equal workplaces. Stratified by gender, this higher risk was explained by branch of industry.
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Affiliation(s)
- Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Research Unit for General Practice, NORCE - Norwegian Research Centre, Norway
| | - Anne Hammarström
- IMM, Karolinska Institutet, Sweden
- Department of Epidemiology and Global Health, Umeå University, Sweden
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Fagerlund P, Shiri R, Suur-Uski J, Kaartinen S, Rahkonen O, Lallukka T. Separate and joint associations of chronic pain, multisite pain and mental health with sickness absence among younger employees: a register based longitudinal study. Arch Public Health 2023; 81:97. [PMID: 37248528 DOI: 10.1186/s13690-023-01115-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Pain conditions and poorer mental health are associated with work disability. However, few studies have examined the association of concurrent pain and poorer mental health with sickness absence among younger employees. We examined separate and joint associations of chronic pain, multisite pain, and mental health with total and long-term all-cause sickness absence days among younger Finnish municipal employees. METHODS The Young Helsinki Health-study data were collected in 2017 from 19-39-year-old employees of the City of Helsinki, Finland. Chronic (≥ 3 months) and multisite (≥ 2 body sites) pain and mental health (RAND-36 emotional wellbeing subscale dichotomized by median score) were self-reported (n = 3911). Chronic pain, multisite pain and mental health were analyzed separately and combined. Register data on total (≥ 1 workdays) and long-term (≥ 11 workdays) sickness absence days during the following year were obtained. Negative binomial regression analyses were performed with sociodemographic, socioeconomic, and health-related factors as confounders. Gender interaction and synergistic indices were examined. RESULTS Chronic multisite pain was associated with long-term sickness absence days (rate ratio [RR] 2.51, 95% CI 1.17-5.42). Chronic pain (RR 5.04, 95% CI 2.14-11.87) and multisite pain (RR 4.88, 95% CI 2.30-10.33) were associated with long-term sickness absence days among employees with poorer mental health. There was a synergistic interaction between gender and multisite pain for total sickness absence days (synergy index 1.80, 95% CI 1.27-2.54), with stronger associations among women. CONCLUSIONS Chronic and multisite pain are associated with long-term sickness absence among younger employees, particularly among women and employees with concurrent poorer mental health. Consideration of this knowledge at workplaces and in healthcare could help to identify and support employees at increased risk of later sickness absence.
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Affiliation(s)
- Pi Fagerlund
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland.
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Hyvinkää, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
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Salinas Fredricson A, Krüger Weiner C, Adami J, Rosén A, Lund B, Hedenberg-Magnusson B, Fredriksson L, Svedberg P, Naimi-Akbar A. Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders - a SWEREG-TMD population-based cohort study. BMC Public Health 2023; 23:852. [PMID: 37165335 PMCID: PMC10173494 DOI: 10.1186/s12889-023-15815-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2-3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated. METHODS All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23-59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations. RESULTS TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2-3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect. CONCLUSION TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients' impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.
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Affiliation(s)
- Adrian Salinas Fredricson
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden.
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Carina Krüger Weiner
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Oral and Maxillofacial Surgery, Gävle County Hospital, Gävle, Sweden
| | | | - Annika Rosén
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Medical Unit for Reconstructive Plastic- and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Britt Hedenberg-Magnusson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, EastmaninstitutetStockholm, Sweden
| | - Lars Fredriksson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, EastmaninstitutetStockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
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Kermer P, Abdalla Y, Klein G, Lüers C. Acute adverse events of Sars-CoV2 vaccines: Experiences from a health care worker vaccination campaign in two municipal hospitals in northwest Germany. Vaccine X 2023; 13:100257. [PMID: 36590445 PMCID: PMC9794527 DOI: 10.1016/j.jvacx.2022.100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 11/18/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Vaccination is considered the best measure to overcome the Sars-Cov2 pandemic. However, changing national recommendations on sequence and time frame necessitate the collection of real-word data on adverse events of Sars-CoV2 vaccination protocols outside of pivotal trials. We report results from a survey on the adverse events and the operational consequences of a Sars-CoV2 vaccination campaign with partly mixed vaccination protocol as well as booster vaccination. While the spectrum of adverse effects in our cohort appeared to be similar to pivotal studies, there were substantial differences in both frequency and distribution with only 3 out of 10 participants staying symptom-free. In over 26% of vaccinees symptoms were so severe, that they stayed at home with mean days on sick leave being 1.5 per person using mixed vaccination protocol. Being aware, that these results might partially be attributable to nocebo effects they are of importance for future vaccination campaigns.
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Affiliation(s)
- Pawel Kermer
- Nordwest-Krankenhaus Sanderbusch, Friesland Kliniken gGmbH, Sande, Germany,University Medical Center Göttingen, Germany,Corresponding author at: Nordwest-Krankenhaus Sanderbusch, Friesland Kliniken gGmbH, Sande, Germany
| | - Yasser Abdalla
- Nordwest-Krankenhaus Sanderbusch, Friesland Kliniken gGmbH, Sande, Germany
| | - Guido Klein
- St. Johannes-Hospital, Friesland Kliniken gGmbH, Varel, Germany
| | - Claus Lüers
- Nordwest-Krankenhaus Sanderbusch, Friesland Kliniken gGmbH, Sande, Germany,Carl von Ossietzky University, European Medical School Oldenburg-Groningen, Oldenburg, Germany
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Al-Nuaimi AA, Abdeen S, Abed Alah M, AlHajri S, Semaan S, Al-Kuwari MG. Sickness absenteeism among primary health care workers in Qatar before and during the COVID-19 pandemic. J Occup Med Toxicol 2023; 18:3. [PMID: 36927778 PMCID: PMC10018637 DOI: 10.1186/s12995-023-00369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES To explore the patterns, trends, nature, and extent of changes in sickness absence among health care workers (HCWs) at the Primary Health Care Corporation (PHCC) in Qatar-during the COVID-19 pandemic compared to previous years and uncover the main associated factors. METHODS We conducted a retrospective analysis of all sick leaves' records of PHCC HCWs regardless of their profession from January 2019 till August 2021. RESULTS A total of 41,132 sick leaves were taken during the studied period. The majority of HCWs who availed sick leaves were between 30-39 years (45.9%), females (65.1%), and expatriates (65.1%). Compared with pre-COVID-19 (Jan 2019-Feb 2020), Wave 1 of COVID-19 had significantly less incidence of sick leaves per day per 1000 HCWs. While wave 2 had significantly higher incidence of sick leaves compared to both pre-COVID-19 and wave 1. The number of sick leaves per person among female HCWs was significantly higher than that of male HCWs. Moreover, the number of sick leaves per person among locals were about two times the number among expatriate HCWs. Physicians and nurses had significantly lower number of sick leave per person compared to other professions. The rates of sick leaves due to suspected or confirmed COVID-19 infection, back/neck pain and gastroenteritis were significantly higher in the second wave compared to the first wave of COVID-19. CONCLUSION Overall and cause specific sick leave rates among HCWs varied significantly across different periods of the COVID-19 pandemic. COVID-19 related sick leave rate was higher during the second wave compared to first one. By addressing the root causes of sick leaves, it is possible to reduce the burden on HCWs and ensure their continued ability to provide essential care to those in need.
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Affiliation(s)
- Asma Ali Al-Nuaimi
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Sami Abdeen
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Muna Abed Alah
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Sameera AlHajri
- Occupational Health and Safety Department, Primary Health Care Corporation, Doha, Qatar
| | - Sandy Semaan
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar
| | - Mohamed Ghaith Al-Kuwari
- Strategy and Health Intelligence Department, Primary Health Care Corporation, Doha, Qatar.,Collège of Medicine, Qatar University, Doha, Qatar
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Bränström R, Narusyte J, Svedberg P. Sexual-orientation differences in risk of health-related impaired ability to work and to remain in the paid workforce: a prospective population-based twin study. BMC Public Health 2023; 23:454. [PMID: 36890524 PMCID: PMC9996859 DOI: 10.1186/s12889-023-15384-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/06/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Studies consistently show an increased risk of poor health among sexual minorities (i.e., those identifying as lesbian, gay, bisexual [LGB] or other non-heterosexuals individuals), as compared to those identifying as heterosexual. It is largely unknown whether the increased risk of mental and physical health problems among sexual minorities is also reflected in an increased risk of health-related impaired ability to work, in terms of sickness absence (SA) and disability pension (DP), or successfully remain in the paid workforce. This study made use of a large sample of Swedish twins with self-reported information about sexual behavior in young adulthood to examine sexual orientation difference in SA and DP during a 12-year follow-up period. METHOD Data from the Swedish Twin project of Disability pension and Sickness absence (STODS), including Swedish twins born 1959-1985 was used (N = 17,539; n = 1,238 sexual minority). Self-report survey data on sexual behavior was linked to information about SA and DP benefits from the MicroData for Analysis of the Social Insurance database (MiDAS), the National Social Insurance Agency. Sexual orientation differences in SA and DP between 2006 and 2018 was analyzed, as well as, the influence of sociodemographic, social stress exposure (i.e., victimization, discrimination), mental health treatment, and family confounding on these differences. RESULTS Compared to heterosexuals, sexual minorities were more likely to having experienced SA and having been granted DP. The odds were highest for DP, where sexual minorities were 58% more likely to having been granted DP compared to heterosexuals. The higher odds for SA due to any diagnosis could largely be explained by sociodemographic factors. The higher odds of SA due to mental diagnosis could partially be explained by increased risk of being exposed to discrimination and victimization, and partially by having received treatment with antidepressant medication. The higher odds of being granted DP could also partially be explain by increased risk of being exposed to social stress and treatment with antidepressant medication. CONCLUSION To our knowledge, this is the first study to report on sexual orientation differences in risk of SA and DP in a population-based sample. We found higher period prevalence of both SA and DP among sexual minorities as compared to heterosexuals. The higher odds of SA and DP could partially or fully be explained by sexual orientation differences in sociodemographic factors, exposure to social stress, and antidepressant treatment for depression. Future studies can extend these findings by continuing to investigate risk factors for SA and DP among sexual minorities and how such factors can be reduced.
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Affiliation(s)
- Richard Bränström
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden.
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Farrants K, Head J, Alexanderson K. Trends in Associations Between Sickness Absence Before the Age of 65 and Being in Paid Work After the Age of 65: Prospective Study of Three Total Population Cohorts. J Aging Soc Policy 2023; 35:197-220. [PMID: 35114914 DOI: 10.1080/08959420.2021.2022950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The increasing workforce participation at higher ages may impact social insurance systems, however, this has hardly been studied at all. We studied associations between sociodemographic factors and prior sickness absence and disability pension, with having paid work and sickness absence after age 65, and if such associations changed over time. We used longitudinal register data regarding three cohorts of all residents in Sweden who turned 65 in 2000, 2005, or 2010 (N = 50,000, 68,000, and 99,000, respectively). Although employment rates when aged 66-71 increased between the cohorts, associations of sociodemographic factors with paid work and sickness absence, when aged 66-71 did not. Both sickness absence and disability pension when aged 60-64 were negatively associated with working past 65. Sickness absence when aged 60-64 was positively associated and disability pension was negatively associated with sickness absence after 65. Possibilities to remain in paid work with different health conditions need to be strengthened to avoid inequalities when raising the retirement age.
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Affiliation(s)
- Kristin Farrants
- Assistant Professor, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Jenny Head
- Professor, Department of Epidemiology and Public Health, University College of London, London, UK
| | - Kristina Alexanderson
- Professor, Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden
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