Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, the Netherlands.
Research Center for Insurance Medicine, Amsterdam, the Netherlands.
BMC Public Health. 2022 Feb 8;22(1):259. doi: 10.1186/s12889-022-12676-1.
Treatment adherence is important to improve return to work in sick-listed workers. Especially in long-term sick-listed workers who apply for a disability benefit and therefore have not (fully) returned to work, it is of great value to gain insight in the adherence to advice of physicians. Non-adherence could be one of the main reasons why they have not returned to work and are sick-listed for a long-term. The aim of the study is to explore treatment adherence and possible associated factors to advice from medical and occupational health physicians in long-term sick-listed workers.
The study is a cross-sectional survey study among 561 long-term (partly) sick-listed workers applying for a disability benefit. Associations of sociodemographic characteristics, disease related factors, coping strategies (Utrecht Coping List, UCL), illness perception (Illness Cognition Questionnaire, ICQ) and perceived health (Short-Form 12, SF12) with treatment adherence (measured with the Medical Outcomes Study Measures of Patient Adherence, MOS-MPA) were analysed separately for adherence to medical advice (n = 348, mean age 51.3 ± 9.1 years, 55.9% female) and adherence to occupational advice (n = 229, mean age 50.4 ± 9.5 years, 54.1% female).
Among participants, 63.3% to 76.4% reported they were able to do what the physician told them to do. However, about half of the participants found it easy to follow-up and implement the suggestions of the physician (54.3% for medical advice and 50.2% for occupational advice). Having a mental health disorder was negatively associated with adherence to medical advice. An active coping strategy, acceptance of the disease, and perceiving positive long-term consequences of the disease were associated with a higher adherence, whereas focusing on the negative consequences was associated with a lower adherence, both for medical and occupational advice.
The tendency to adhere to medical and occupational advice in long-term sick-listed workers is relatively low. In order to increase return to work in this population, medical and occupational health physicians should especially be aware of the adherence of sick-listed workers with mental health disorders, but also on those who focus on the negative consequences of their (physical or mental health) disorder.
治疗依从性对于改善请病假工人重返工作岗位非常重要。特别是在申请残疾福利且尚未（完全）重返工作岗位的长期请病假工人中，深入了解他们对医生建议的依从性具有重要价值。不依从可能是他们未返回工作岗位且长期请病假的主要原因之一。本研究的目的是探讨长期请病假且正在申请残疾福利的工人对医生建议的治疗依从性及其可能的相关因素。
这是一项横断面调查研究，纳入了 561 名长期（部分）请病假且正在申请残疾福利的工人。采用医疗结局研究患者遵医行为测量量表（MOS-MPA）分别评估社会人口统计学特征、疾病相关因素、应对策略（乌得勒支应对清单，UCL）、疾病认知（疾病认知问卷，ICQ）和感知健康（健康调查简表 12 项，SF12）与对医疗建议（n=348，平均年龄 51.3±9.1 岁，55.9%为女性）和职业建议（n=229，平均年龄 50.4±9.5 岁，54.1%为女性）的依从性之间的关联。
在参与者中，63.3%至 76.4%的人报告他们能够按照医生的要求去做。然而，约一半的参与者发现很难跟进和实施医生的建议（54.3%的医疗建议和 50.2%的职业建议）。患有精神健康障碍与对医疗建议的依从性呈负相关。积极的应对策略、对疾病的接受程度以及感知疾病的积极长期后果与更高的依从性相关，而关注疾病的消极后果则与更低的依从性相关，这两者对医疗和职业建议都是如此。
长期请病假工人对医疗和职业建议的依从性相对较低。为了增加这一人群的工作返岗率，医疗和职业健康医生应特别注意患有精神健康障碍的请病假工人的依从性，也要注意那些关注自身（身体或精神）健康障碍消极后果的工人。
