Coronel Institute of Occupational Health, Research Center for Insurance Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 Amsterdam, The Netherlands.
Int Arch Occup Environ Health. 2010 Aug;83(6):595-605. doi: 10.1007/s00420-010-0506-6. Epub 2010 Feb 4.
Self-regulatory processes play an important role in mediating between the disease and the health outcomes, and potentially also work outcomes. This systematic review aims to explore the relationship between illness perceptions and work participation in patients with somatic diseases and complaints.
The bibliographic databases Medline, PsycINFO and Embase were searched from inception to March 2008. Included were cross-sectional or longitudinal studies, patients with somatic diseases or complaints, illness perceptions based on at least four dimensions of the common sense model of self-regulation, and work participation.
Two longitudinal and two cross-sectional studies selected for this review report statistically significant findings for one or more illness perception dimensions in patients with various complaints and illnesses, although some dimensions are significant in one study but not in another. Overall, non-working patients perceived more serious consequences, expected their illness to last a longer time, and reported more symptoms and more emotional responses as a result of their illness. Alternatively, working patients had a stronger belief in the controllability of their condition and a better understanding of their disease.
The limited number of studies in this review suggests that illness perceptions play a role in the work participation of patients with somatic diseases or complaints, although it is not clear how strong this relationship is and which illness perception dimensions are most useful. Identifying individuals with maladaptive illness perceptions and targeting interventions toward changing these perceptions are promising developments in improving work participation.
自我调节过程在调节疾病与健康结果之间起着重要作用，并且可能也与工作结果有关。本系统评价旨在探讨躯体疾病和躯体不适患者的疾病感知与工作参与之间的关系。
从建库开始至 2008 年 3 月，检索 Medline、PsycINFO 和 Embase 这三个文献数据库。纳入标准为：横断面或纵向研究；研究对象为患有躯体疾病或躯体不适的患者；基于自我调节的共同感知模型的至少四个维度来评估疾病感知；以及评估工作参与。
本研究共纳入了 2 项纵向研究和 2 项横断面研究，这些研究报告了患有各种躯体不适和躯体疾病的患者的一个或多个疾病感知维度存在统计学显著差异，尽管某些维度在一项研究中有统计学意义，但在另一项研究中则没有。总的来说，非工作患者认为疾病的后果更严重，预计疾病持续时间更长，而且由于疾病而出现更多的症状和更多的情绪反应。相比之下，工作患者对自身疾病的可控性有更强的信念，对疾病的理解也更好。
本综述纳入的研究数量有限，表明疾病感知在躯体疾病或躯体不适患者的工作参与中起一定作用，但是尚不清楚这种关系的强度如何，以及哪些疾病感知维度最有用。识别出具有适应不良疾病感知的个体，并针对改变这些感知的干预措施进行靶向治疗，这可能是改善工作参与的一种很有前景的发展方向。
