Reiso H, Nygård J F, Brage S, Gulbrandsen P, Tellnes G
Department of General Practice and Community Medicine, University of Oslo, Norway.
Scand J Public Health. 2001 Sep;29(3):218-25.
The aim of this study was to examine the association between assessed work ability and the duration of certified sickness absence.
A total of 549 patients and 52 doctors provided questionnaire data about 549 episodes of absence. The episodes were classified as new, one month, or three months according to their duration at the time of questionnaire completion. Their duration after that was used as outcome. Uni-and multivariate Cox regression analyses were performed.
In the multivariate analyses, a "very much reduced" work ability assessed by patients was associated with a longer duration than a "moderately reduced" work ability, in both one- and three-month episodes. Musculoskeletal and psychological disorders were associated with a longer duration, and respiratory disorders with a shorter duration than other disorders in new episodes. Patient age above 50 years was associated with a longer duration than lower age in new and three-month episodes. The doctors' use of referral and tests in the consultations, and the presence of non-medical factors as judged by the patients, were associated with a longer duration than the absence of those factors in new episodes. The patients' degree of job satisfaction, and non-medical factors as judged by doctors. were significantly associated with duration only in univariate Cox regression analyses in new episodes. Work demands were not significantly associated with duration in any of the analyses.
Work ability assessed by patients may be a useful prognostic indicator of duration in prolonged episodes of certified sickness absence. Further studies using other outcomes, such as disability pensioning, would be of interest to enlighten the concepts of work ability.
本研究旨在探讨评估的工作能力与经认证的病假时长之间的关联。
共有549名患者和52名医生提供了关于549次缺勤情况的问卷数据。根据问卷填写时的缺勤时长，这些缺勤情况被分类为新发病例、一个月病例或三个月病例。之后的缺勤时长被用作研究结果。进行了单因素和多因素Cox回归分析。
在多因素分析中，无论是一个月还是三个月的病例，患者评估为“大幅下降”的工作能力与比“中度下降”的工作能力更长的病假时长相关。在新发病例中，肌肉骨骼和心理障碍与更长的病假时长相关，而呼吸系统疾病与比其他疾病更短的病假时长相关。在新发病例和三个月病例中，50岁以上患者的病假时长比年龄较小者更长。在新发病例中，医生在会诊中使用转诊和检查以及患者判断存在非医疗因素与比不存在这些因素更长的病假时长相关。仅在新发病例的单因素Cox回归分析中，患者的工作满意度程度以及医生判断的非医疗因素与病假时长显著相关。在任何分析中，工作需求与病假时长均无显著关联。
患者评估的工作能力可能是经认证的长期病假时长的一个有用的预后指标。使用其他结果（如残疾抚恤金）的进一步研究对于阐明工作能力的概念将是有意义的。
