Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, The Netherlands.
J Occup Rehabil. 2012 Dec;22(4):489-502. doi: 10.1007/s10926-012-9360-6.
Most workers with chronic nonspecific musculoskeletal pain (CMP) do not take sick leave, nor consult a health care professional or search vocational rehabilitation. Yet, the knowledge of many researchers, clinicians and policy makers is largely based on people with CMP who discontinue work. The aim of this study was to explore characteristics of workers who stay at work despite CMP, and to compare these with sick-listed workers with CMP following vocational rehabilitation.
The clinical characteristics of workers who stay at work despite CMP (n = 119) and sick-listed workers who follow vocational rehabilitation (n = 122) were described and the differences between these groups were assessed. Logistic regression analysis was used to assess differences between the groups and to determine which variables predicted group status.
Workers who stayed at work despite CMP reported significantly lower levels of fear avoidance (OR = 0.94), pain catastrophizing (OR = 0.93), perceived workload (OR = 0.93), and higher pain acceptance (OR = 1.11), life control (OR = 1.62) and pain self-efficacy (OR = 1.09) compared to sick-listed workers following rehabilitation, even after controlling for confounders. The groups did not differ on physical activity level, active coping and work satisfaction. Group status was predicted best by pain intensity, duration of pain, pain acceptance, perceived workload, mental health, and psychological distress (area under the receiver operating characteristic curve = 0.91, 95% CI = 0.87-0.95).
A wide range of characteristics of workers who stay at work despite CMP were explored. Relevant differences from sick-listed workers with CMP were observed in all domains of the bio-psycho-social model. Six main predictors were identified that best discriminate between both groups.
大多数患有慢性非特异性肌肉骨骼疼痛（CMP）的工人不会请病假，也不会咨询医疗保健专业人员或寻求职业康复。然而，许多研究人员、临床医生和政策制定者的知识主要基于因 CMP 而停止工作的人群。本研究旨在探讨尽管患有 CMP 仍继续工作的工人的特征，并将这些特征与接受职业康复的 CMP 病假工人进行比较。
描述了尽管患有 CMP 仍继续工作的工人（n=119）和接受职业康复的 CMP 病假工人（n=122）的临床特征，并评估了这些组之间的差异。使用逻辑回归分析评估了两组之间的差异，并确定了哪些变量预测了组间状态。
与接受康复治疗的病假工人相比，尽管患有 CMP 仍继续工作的工人报告的恐惧回避程度明显较低（OR=0.94）、疼痛灾难化程度（OR=0.93）、感知工作量（OR=0.93）、疼痛接受程度（OR=1.11）、生活控制程度（OR=1.62）和疼痛自我效能感（OR=1.09）更高，尽管在控制了混杂因素后，两组在身体活动水平、积极应对和工作满意度方面没有差异。组间状态最佳预测因素为疼痛强度、疼痛持续时间、疼痛接受程度、感知工作量、心理健康和心理困扰（受试者工作特征曲线下面积=0.91，95%置信区间=0.87-0.95）。
探讨了尽管患有 CMP 仍继续工作的工人的广泛特征。在生物心理社会模型的所有领域都观察到了与 CMP 病假工人的相关差异。确定了六个主要预测因素，可最好地区分两组。
