Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Research Center for Insurance Medicine (KCVG), AMC-UMCG-UWV-VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
BMC Public Health. 2020 Jul 11;20(1):1095. doi: 10.1186/s12889-020-09203-5.
Long-term sickness absence results in increased risks of permanent disability and a compromised quality of life. Return to work is an important factor in reducing these risks. Little is known about return to work factors for long-term sick-listed workers with subjective health complaints. The aim of this study was to evaluate prognostic factors for partial or full return to a paid job for at least 28 days for long-term sick-listed workers with subjective health complaints, and to compare these factors with those of workers with other disorders.
Data from a prospective cohort study of 213 participants with subjective health complaints and 1.037 reference participants were used. The participants answered a questionnaire after 84 weeks of sickness absence. Return to work was measured after one and two years. Univariable logistic regression analyses were performed (P ≤ 0.157) for variables per domain with return to work (i.e. demographic, socio-economic and work-related, health-related, and self-perceived ability). Subsequently, multivariable logistic regression analyses with backward selection (P ≤ 0.157) were performed. Remaining factors were combined in a multivariable and final model (P ≤ 0.05).
Both for workers with subjective health complaints and for the reference group, non-health-related factors remained statistically significant in the final model. This included receiving a partial or complete work disability benefit (partial: OR 0.62, 95% CI 0.26-1.47 and OR 0.69, 95% CI 0.43-1.12; complete: OR 0.24, 95% CI 0.10-0.58 and OR 0.12, 95% CI 0.07-0.20) and having a positive self-perceived possibility for return to work (OR 1.06, 95% CI 1.01-1.11 and OR 1.08, 95% CI 1.05-1.11).
Non-health-related factors seem to be more important than health-related factors in predicting return to work after long-term sickness absence. Receiving a work disability benefit and having negative expectations for return to work seem to complicate return to work most for workers with subjective health complaints. With respect to return to work predictors, workers with subjective health complaints do not differ from the reference group.
长期病假会增加永久残疾和生活质量受损的风险。重返工作岗位是降低这些风险的一个重要因素。对于有主观健康问题的长期请病假的工人来说,重返工作岗位的因素知之甚少。本研究的目的是评估有主观健康问题的长期请病假的工人部分或完全恢复有偿工作至少 28 天的预后因素,并将这些因素与其他疾病的工人进行比较。
使用 213 名有主观健康问题的参与者和 1037 名参考参与者的前瞻性队列研究数据。参与者在病假 84 周后回答了一份问卷。在一年和两年后测量重返工作岗位的情况。对每个域的变量(即人口统计学、社会经济和工作相关、健康相关和自我感知能力)进行单变量逻辑回归分析(P≤0.157)。随后,进行具有向后选择的多变量逻辑回归分析(P≤0.157)。保留的因素被组合到多变量和最终模型中(P≤0.05)。
对于有主观健康问题的工人和参考组,非健康相关因素在最终模型中仍然具有统计学意义。这包括获得部分或完全工作残疾福利(部分:OR 0.62,95%CI 0.26-1.47 和 OR 0.69,95%CI 0.43-1.12;完全:OR 0.24,95%CI 0.10-0.58 和 OR 0.12,95%CI 0.07-0.20)和对重返工作有积极的自我感知可能性(OR 1.06,95%CI 1.01-1.11 和 OR 1.08,95%CI 1.05-1.11)。
非健康相关因素似乎比健康相关因素更能预测长期病假后的重返工作岗位。获得工作残疾福利和对重返工作的消极期望似乎使有主观健康问题的工人最难重返工作岗位。就重返工作岗位的预测因素而言,有主观健康问题的工人与参考组没有区别。