Medical and Health Care Services Division, Mutual Midat Cyclops (MC-MUTUAL), Barcelona, Spain.
J Occup Rehabil. 2012 Mar;22(1):15-26. doi: 10.1007/s10926-011-9313-5.
Despite suggestions that worker perception might be the best predictor of return to work (RTW), there still is limited research on time to RTW in workers with lengthy non-work-related sick leave.
Prospective cohort study of 663 workers with a current long-term non-work-related sick leave episode recruited during the first medical visit in a mutua (Spanish health insurance company) and followed until their sick leave episode ended. Workers completed a baseline questionnaire regarding their perceptions of sick leave episode and expectations of RTW (i.e., health status, work ability, expectations and time required to RTW, self-efficacy and self-perceived connection between health and job). Time to RTW was established based on the mutua's register. Cox regression models were used to examine the associations of worker perception and expectation of RTW with time to RTW within the study population as a whole as well as in three diagnostic subgroups (i.e., musculoskeletal disorders, mental disorders and other physical conditions).
As a whole, time to RTW was longer for workers reporting poor health [hazard ratio (HR) = 0.71, 95%CI 0.59-0.85], extremely reduced work ability (HR = 0.69, 95%CI 0.53-0.88), a longer period of time required to RTW (HR = 0.36, 95%CI 0.25-0.52) and lack of expectation of returning to the same job (HR = 0.13, 95%CI 0.06-0.31). Workers with musculoskeletal and other physical conditions showed a similar pattern to whole study population, while workers with mental disorders did not.
Self-required time and RTW expectations are important prognostic factors in sick listed workers by all types of health conditions certified as non-work-related. Questioning the workers on their perceptions and expectations of RTW during medical visits could help health care professionals to identify individuals at risk of long-term sickness absence and facilitate triage and management of the patient.
尽管有研究表明，员工的感知可能是预测重返工作岗位（RTW）的最佳指标，但对于长期非工作相关病假员工的 RTW 时间仍缺乏研究。
这是一项对 663 名当前长期非工作相关病假员工的前瞻性队列研究，他们在 mutua（西班牙健康保险公司）的首次就诊期间被招募，并随访至病假结束。员工在基线时完成了一份关于他们对病假期间的看法和对 RTW 的期望（即健康状况、工作能力、期望和 RTW 所需时间、自我效能和自我感知的健康与工作之间的联系）的问卷。根据 mutua 的登记，确定 RTW 的时间。使用 Cox 回归模型来检查整个研究人群以及三个诊断亚组（即肌肉骨骼疾病、精神障碍和其他身体状况）中员工感知和 RTW 期望与 RTW 时间之间的关联。
总体而言，报告健康状况较差的员工 RTW 时间较长[风险比（HR）=0.71，95%CI 0.59-0.85]，工作能力极度降低（HR=0.69，95%CI 0.53-0.88），需要较长的 RTW 时间（HR=0.36，95%CI 0.25-0.52），并且对返回相同工作没有期望（HR=0.13，95%CI 0.06-0.31）。患有肌肉骨骼和其他身体状况的员工与整个研究人群表现出相似的模式，而患有精神障碍的员工则没有。
无论健康状况如何，自我要求的时间和 RTW 期望都是病假员工的重要预后因素。在就诊期间询问员工对 RTW 的看法和期望，可以帮助医疗保健专业人员识别出长期病假风险较高的个体，并有助于分诊和管理患者。
