Brouwer Sandra, Krol Boudien, Reneman Michiel F, Bültmann Ute, Franche Renée-Louise, van der Klink Jac J L, Groothoff Johan W
Department of Health Sciences, Section of Social Medicine, Work & Health, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Building 3217, Room 620, 9713 AV, Groningen, The Netherlands.
J Occup Rehabil. 2009 Jun;19(2):166-74. doi: 10.1007/s10926-009-9172-5. Epub 2009 Mar 31.
The aim of this prospective, longitudinal cohort study was to analyze the association between the three behavioral determinants of the theory of planned behavior (TPB) model--attitude, subjective norm and self-efficacy--and the time to return-to-work (RTW) in employees on long-term sick leave.
The study was based on a sample of 926 employees on sickness absence (maximum duration of 12 weeks). The employees filled out a baseline questionnaire and were subsequently followed until the tenth month after listing sick. The TPB-determinants were measured at baseline. Work attitude was measured with a Dutch language version of the Work Involvement Scale. Subjective norm was measured with a self-structured scale reflecting a person's perception of social support and social pressure. Self-efficacy was measured with the three subscales of a standardised Dutch version of the general self-efficacy scale (ALCOS): willingness to expend effort in completing the behavior, persistence in the face of adversity, and willingness to initiate behavior. Cox proportional hazards regression analyses were used to identify behavioral determinants of the time to RTW.
Median time to RTW was 160 days. In the univariate analysis, all potential prognostic factors were significantly associated (P < 0.15) with time to RTW: work attitude, social support, and the three subscales of self-efficacy. The final multivariate model with time to RTW as the predicted outcome included work attitude, social support and willingness to expend effort in completing the behavior as significant predictive factors.
This prospective, longitudinal cohort-study showed that work attitude, social support and willingness to expend effort in completing the behavior are significantly associated with a shorter time to RTW in employees on long-term sickness absence. This provides suggestive evidence for the relevance of behavioral characteristics in the prediction of duration of sickness absence. It may be a promising approach to address the behavioral determinants in the development of interventions focusing on RTW in employees on long-term sick leave.
这项前瞻性纵向队列研究的目的是分析计划行为理论（TPB）模型的三个行为决定因素——态度、主观规范和自我效能——与长期病假员工的复工时间之间的关联。
该研究基于926名休病假员工（最长病假时长为12周）的样本。员工填写了一份基线调查问卷，随后进行跟踪，直至登记病假后的第十个月。TPB决定因素在基线时进行测量。工作态度采用荷兰语版的工作投入量表进行测量。主观规范采用反映个人对社会支持和社会压力感知的自编量表进行测量。自我效能采用荷兰语标准化版一般自我效能量表（ALCOS）的三个子量表进行测量：在完成行为时付出努力的意愿、面对逆境时的坚持性以及发起行为的意愿。采用Cox比例风险回归分析来确定复工时间的行为决定因素。
复工的中位时间为160天。在单变量分析中，所有潜在的预后因素均与复工时间显著相关（P < 0.15）：工作态度、社会支持以及自我效能的三个子量表。以复工时间为预测结果的最终多变量模型包括工作态度、社会支持以及在完成行为时付出努力的意愿作为显著预测因素。
这项前瞻性纵向队列研究表明，工作态度、社会支持以及在完成行为时付出努力的意愿与长期病假员工较短的复工时间显著相关。这为行为特征在预测病假时长方面的相关性提供了提示性证据。在制定针对长期病假员工复工的干预措施时，解决行为决定因素可能是一种有前景的方法。
