Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Occup Rehabil. 2011 Jun;21(2):211-9. doi: 10.1007/s10926-010-9273-1.
To improve work participation in individuals with a chronic illness, insight into the role of work-related factors in the association between health and sick leave is needed. The aim of this study was to gain insight into the contribution of work limitations, work characteristics, and work adjustments to the association between health and sick leave in employees with a chronic illness.
All employees with a chronic illness, between 15 and 65 years of age (n = 7,748) were selected from The Netherlands Working Conditions Survey. The survey included questions about perceived health, working conditions, and sick leave. Block-wise multivariate linear regression analyses were performed and, in different blocks, limitations at work, work characteristics, and work adjustments were added to the model of perceived health status. Changes in regression coefficient (B) (%) were calculated for the total group and for sub-groups per chronic illness.
When work limitations were added to the model, the B between health and sick leave decreased by 18% (5.0 to 4.1). Adding work characteristics did not decrease the association between health and sick leave, but the B between work limitations and sick leave decreased by 14%, (5.3 to 4.5). When work adjustments were added to the model, the Bs between sick leave and work limitations and work characteristics changed from 4.5 to 3.4 for work limitations and from 2.1 to 1.9 for temporary contract and from -0.8 to -1.0 for supervisor support.
The association between health and sick leave was explained by limitations at work, work characteristics, and work adjustments. Paying more attention to work limitations, characteristics and adjustments offers opportunities to reduce the negative consequences of chronic illness.
为了提高慢性病患者的工作参与度，需要深入了解工作相关因素在健康与病假之间的关联中的作用。本研究旨在深入了解工作限制、工作特征和工作调整对慢性病患者健康与病假之间关联的贡献。
从荷兰工作条件调查中选择了所有年龄在 15 至 65 岁之间的慢性病患者（n=7748）。该调查包括对感知健康、工作条件和病假的问题。进行了分块多元线性回归分析，并在不同分块中，将工作限制、工作特征和工作调整添加到感知健康状况模型中。为总组和每个慢性病亚组计算了回归系数（B）的变化（%）。
当将工作限制添加到模型中时，健康与病假之间的 B 值下降了 18%（从 5.0 降至 4.1）。添加工作特征并没有降低健康与病假之间的关联，但工作限制与病假之间的 B 值下降了 14%，（从 5.3 降至 4.5）。当将工作调整添加到模型中时，病假与工作限制和工作特征之间的 B 值从工作限制的 4.5 变为 3.4，从临时合同的 2.1 变为 1.9，从主管支持的-0.8 变为-1.0。
健康与病假之间的关联可以通过工作限制、工作特征和工作调整来解释。更多地关注工作限制、特征和调整为减少慢性病的负面影响提供了机会。
