Villotti Patrizia, Kordsmeyer Ann-Christin, Roy Jean-Sébastien, Corbière Marc, Negrini Alessia, Larivière Christian
Department of Education and Pedagogy-Career Counseling, Université du Québec à Montréal, Montréal, Canada.
Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, Canada.
PLoS One. 2024 Jul 17;19(7):e0307284. doi: 10.1371/journal.pone.0307284. eCollection 2024.
With the overall objective of providing implication for clinical and research practices regarding the identification and measurement of modifiable predicting factors for return to work (RTW) in people with musculoskeletal disorders (MSDs) and common mental disorders (CMDs), this study 1) systematically examined and synthetized the research evidence available in the literature on the topic, and 2) critically evaluated the tools used to measure each identified factor. A systematic search of prognostic studies was conducted, considering four groups of keywords: 1) population (i.e., MSDs or CMDs), 2) study design (prospective), 3) modifiable factors, 4) outcomes of interest (i.e., RTW). Studies showing high risk of bias were eliminated. Tools used to measure prognostic factors were assessed using psychometric and usability criteria. From the 78 studies that met inclusion criteria, 19 (for MSDs) and 5 (for CMDs) factors reaching moderate or strong evidence were extracted. These factors included work accommodations, RTW expectations, job demands (physical), job demands (psychological), job strain, work ability, RTW self-efficacy, expectations of recovery, locus of control, referred pain (back pain), activities as assessed with disability questionnaires, pain catastrophizing, coping strategies, fears, illness behaviours, mental vitality, a positive health change, sleep quality, and participation. Measurement tools ranged from single-item tools to multi-item standardized questionnaires or subscales. The former generally showed low psychometric properties but excellent usability, whereas the later showed good to excellent psychometric properties and variable usability. The rigorous approach to the selection of eligible studies allowed the identification of a relatively small set of prognostic factors, but with a higher level of certainty. For each factor, the present tool assessment allows an informed choice to balance psychometric and usability criteria.
本研究的总体目标是为有关识别和测量肌肉骨骼疾病(MSD)和常见精神障碍(CMD)患者恢复工作(RTW)的可改变预测因素的临床和研究实践提供启示,该研究1)系统地检查和综合了文献中关于该主题的现有研究证据,2)批判性地评估了用于测量每个已识别因素的工具。我们进行了一项预后研究的系统检索,考虑了四组关键词:1)人群(即MSD或CMD),2)研究设计(前瞻性),3)可改变因素,4)感兴趣的结果(即RTW)。显示高偏倚风险的研究被排除。使用心理测量和可用性标准评估用于测量预后因素的工具。从符合纳入标准的78项研究中,提取了19项(针对MSD)和5项(针对CMD)达到中度或强证据的因素。这些因素包括工作调整、RTW期望、工作需求(身体方面)、工作需求(心理方面)、工作压力、工作能力、RTW自我效能感、康复期望、控制点、牵涉痛(背痛)、用残疾问卷评估的活动、疼痛灾难化、应对策略、恐惧、疾病行为、心理活力、积极的健康变化、睡眠质量和参与度。测量工具从单项工具到多项标准化问卷或分量表不等。前者通常显示出较低的心理测量特性但可用性极佳,而后者显示出良好到极佳的心理测量特性以及可变的可用性。对符合条件的研究进行严格筛选的方法使得能够识别出相对较少的一组预后因素,但确定性更高。对于每个因素,目前的工具评估允许在心理测量和可用性标准之间进行明智的选择以达到平衡。