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主观健康抱怨的部分病假工人继续工作的预后因素:一项前瞻性队列研究。

Prognostic Factors for Staying at Work for Partially Sick-Listed Workers with Subjective Health Complaints: A Prospective Cohort Study.

机构信息

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), PO Box 7057, 1007 MB Amsterdam, The Netherlands.

出版信息

Int J Environ Res Public Health. 2020 Sep 30;17(19):7184. doi: 10.3390/ijerph17197184.

Abstract

Examination of prognostic factors for staying at work for long-term sick-listed workers with subjective health complaints (SHC) who partially work in a paid job, and to evaluate whether these factors are comparable with those of workers with other disorders. We used data of 86 partially sick-listed workers with SHC (57 females, 29 males, mean age 47.1 years) and 433 with other disorders (227 females, 206 males, mean age 50.9 years), from an existing prospective cohort study consisting of 2593 workers aged 18-65 years and registered as sick-listed with different health complaints or disorders for at least 84 weeks in the database of the Dutch Social Security Institute. We performed univariable logistic regression analyses ( ≤ 0.157) for all independent variables with the dependent variable staying at work for the workers with SHC. We then performed multivariable logistic regression analyses with forward selection ( ≤ 0.157) and combined the remaining factors in a final, multivariable model ( ≤ 0.05), which we also used for logistic regression analysis in the workers with other disorders. The following factors were significant prognostic factors for staying at work for workers with SHC: full work disability benefits (odds ratio (OR) 0.07, 95% confidence interval (95% CI) 0.01-0.64), good mental health (OR 1.08, 95% CI 1.02-1.14), positive expectations for staying at work (OR 6.49, 95% CI 2.00-21.09), previous absenteeism for the same health complaint (OR 0.31, 95% CI 0.10-0.96) and good coping strategies (OR 1.13, 95% CI 1.04-1.23). For workers with other disorders, full work disability benefits, good mental health and positive expectations for staying at work were also prognostic factors for staying at work. Individual and policy factors seem to be important for staying at work of sick-listed workers with SHC and those with other disorders alike, but several biopsychosocial factors are particularly important for workers with SHC.

摘要

检查有主观健康抱怨(SHC)的长期请病假工人继续工作的预后因素,这些工人部分时间从事有偿工作,并评估这些因素是否与其他疾病的工人相似。我们使用了现有前瞻性队列研究的数据,该研究由荷兰社会保障研究所数据库中登记的 2593 名年龄在 18-65 岁之间的工人组成,他们患有不同的健康抱怨或疾病,至少 84 周请病假。该研究包括 86 名有 SHC 的部分请病假工人(57 名女性,29 名男性,平均年龄 47.1 岁)和 433 名患有其他疾病的工人(227 名女性,206 名男性,平均年龄 50.9 岁)。我们对所有与 SHC 工人继续工作相关的独立变量进行了单变量逻辑回归分析(≤0.157)。然后,我们进行了多变量逻辑回归分析,并采用向前选择(≤0.157)将剩余因素合并到最终的多变量模型中(≤0.05),我们还将该模型用于其他疾病工人的逻辑回归分析。对于 SHC 工人继续工作的以下因素是显著的预后因素:完全丧失工作能力福利(优势比(OR)0.07,95%置信区间(95%CI)0.01-0.64),良好的心理健康(OR 1.08,95%CI 1.02-1.14),对继续工作的积极期望(OR 6.49,95%CI 2.00-21.09),同一健康抱怨的先前缺勤(OR 0.31,95%CI 0.10-0.96)和良好的应对策略(OR 1.13,95%CI 1.04-1.23)。对于患有其他疾病的工人,完全丧失工作能力福利、良好的心理健康和对继续工作的积极期望也是继续工作的预后因素。个人和政策因素似乎对 SHC 病假工人和其他疾病工人的继续工作都很重要,但一些生物心理社会因素对 SHC 工人尤为重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/817f/7578951/7497ed64cb14/ijerph-17-07184-g001.jpg

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