Toropova Anna, Björk Brämberg Elisabeth, Bergström Gunnar
Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute, 171 77, Stockholm, Sweden.
School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
J Occup Rehabil. 2024 Jun 22. doi: 10.1007/s10926-024-10216-9.
Recent research has emphasized that return to work (RTW) is a dynamic, gradual and often uneven process with a great degree of individual variation. This study aimed to identify RTW trajectories of Swedish employees on sick-leave due to common mental disorders (CMDs). The second aim was to explore which demographic, employment, health-related and work environment characteristics predicted RTW trajectory membership.
Data comes from two 2-armed cluster-randomized controlled trials (RCT) with a 12-month follow-up. A participative problem-solving intervention aimed to reduce sick-leave was compared to care as usual (CAU) involving any kind of work-directed interventions. Participants on sick-leave due to CMDs at baseline (N = 197) formed the study sample. Latent growth mixture modeling and logistic regression were the main analytical approaches.
Five distinct RTW trajectories of Swedish employees were identified: Early RTW (N = 65), Delayed RTW (N = 50), Late RTW (N = 39), Struggling RTW (N = 21) and No RTW (N = 22). RTW trajectories differed consistently with regard to previous sick-leave duration and social support at work. More unique predictors of RTW trajectories included gender, rewards at work, work performance impairment due to health problems, home-to-work interference and stress-related exhaustion disorder.
The study may have important clinical implications for identifying patients belonging to a particular RTW trajectory. Knowledge on the modifiable work environment factors that differentiated between the RTW trajectories could be useful for designing effective workplace interventions, tailored to particular needs of employees with CMDs. However, in a first step, the results need to be replicated.
近期研究强调，重返工作岗位（RTW）是一个动态、渐进且往往不均衡的过程，存在很大程度的个体差异。本研究旨在确定因常见精神障碍（CMD）而休病假的瑞典员工的RTW轨迹。第二个目的是探讨哪些人口统计学、就业、健康相关和工作环境特征可预测RTW轨迹类别。
数据来自两项双臂整群随机对照试验（RCT），随访期为12个月。将旨在减少病假的参与式问题解决干预措施与涉及任何工作指导干预措施的常规护理（CAU）进行比较。基线时因CMD休病假的参与者（N = 197）构成研究样本。潜在增长混合模型和逻辑回归是主要分析方法。
确定了瑞典员工的五种不同RTW轨迹：早期RTW（N = 65）、延迟RTW（N = 50）、晚期RTW（N = 39）、艰难RTW（N = 21）和未RTW（N = 22）。RTW轨迹在既往病假时长和工作中的社会支持方面始终存在差异。RTW轨迹更独特的预测因素包括性别、工作奖励、因健康问题导致的工作绩效受损、家庭对工作的干扰以及与压力相关的疲惫障碍。
该研究对于识别属于特定RTW轨迹的患者可能具有重要的临床意义。了解区分RTW轨迹的可改变工作环境因素，可能有助于设计有效的工作场所干预措施，以满足患有CMD员工的特定需求。然而，首先需要对结果进行重复验证。
