Prognostic factors associated with return to work following multidisciplinary vocational rehabilitation

• Published in: Journal of rehabilitation medicine 2008-07, Vol.40 (7), p.548-554
• Main Authors: Oyeflaten, Irene, Hysing, Mari, Eriksen, Hege R
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Avoidance; Cohort Studies; Complaints; Coping; Female; Follow-Up Studies; Humans; Male; Mental Disorders - psychology; Mental Disorders - rehabilitation; Middle Aged; Musculoskeletal Diseases - psychology; Musculoskeletal Diseases - rehabilitation; Outcome Assessment (Health Care); Perceptions; Prognosis; Prospective Studies; Rehabilitation, Vocational - methods; Return to work; Sick Leave; Surveys and Questionnaires; Vocational rehabilitation
• ISSN: 1650-1977
• DOI: 10.2340/16501977-0202

The number of people in Western countries on long-term sick-leave and disability pension due to musculoskeletal complaints and psychological health problems is increasing. The main objective of this study was to examine whether fear-avoidance beliefs, illness perceptions, subjective health complaints, and coping are prognostic factors for return to work after multidisciplinary vocational rehabilitation, and to assess the relative importance and inter-relationship of these factors. A prospective cohort study with a 1-year follow-up period was performed. A total of 135 individuals on long-term sick-leave (87 women, mean age 45 years) participated in a 4-week inpatient multidisciplinary vocational rehabilitation programme. The participants had been out of work for an average of 10.5 months. Fear-avoidance beliefs about work was the most important risk factor for not returning to work, both at 3 months (odds ratio (OR) 3.8; confidence interval (CI) 1.30-11.32) and 1 year (OR 9.5; CI 2.40-37.53) after the intervention. Forty-eight percent of the variance in fear-avoidance beliefs was explained by subjective health complaints, illness perceptions and education. Coping explained only 1% of the variance. These findings indicate that interventions for these patients should target fear of returning to work and illness perceptions about subjective health complaints.