Studies in occupational epidemiology and the risk of overadjustment (original) (raw)
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Journal of rehabilitation medicine, 2021
OBJECTIVE To assess the effects of adding a workplace intervention to inpatient occupational rehabilitation on return-to-work self-efficacy, and whether changes in return-to-work self-efficacy were associated with future work outcomes. DESIGN Randomized clinical trial. SUBJECTS Individuals aged 18-60 years, sick-listed 2-12 months were randomized to multimodal inpatient rehabilitation with (n = 88) or without (n = 87) a workplace intervention. METHODS Between-group differences for 4 months follow-up were assessed using linear mixed models. Associations between self-efficacy scores and future sickness absence days during 12 months of follow-up were assessed by linear regression. RESULTS There were no statistically significant between-group differences in self-efficacy during follow-up. Participants with high or medium self-efficacy scores at the end of rehabilitation had fewer sickness absence days during follow-up compared with participants with low scores. Participants with consist...
Journal of Occupational Rehabilitation, 2011
Introduction We report on the development and validation of a 10-item scale assessing self-efficacy within the return-to-work context, the Return-to-Work Self-Efficacy (RTWSE) scale. Methods Lost-time claimants completed a telephone survey 1 month (n = 632) and 6 months (n = 446) after a work-related musculoskeletal injury. Exploratory (Varimax and Promax rotation) and confirmatory factor analyses of self-efficacy items were conducted with two separate subsamples at both time points. Construct validity was examined by comparing scale measurements and theoretically derived constructs, and the phase specificity of RTWSE was studied by examining changes in strength of relationships between the RTWSE Subscales and the other constructs at both time measures. Results Factor analyses supported three underlying factors:
Cognitive work hardening for return to work following depression: An intervention study
Canadian Journal of Occupational Therapy, 2018
Background. Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. Purpose. This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention. Method. A single group (n ¼ 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data. Findings. Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements. Implications. Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research. Abré gé Description. Les absences au travail en raison d'une dépression sont fréquentes; toutefois, il existe peu d'interventions pour aborder les difficultés liées au retour au travail à la suite d'un épisode dépressif. But. Cette étude basée sur une approche méthodologique mixte visait à (a) évaluer l'efficacité du réentraînement cognitif au travail pour préparer des personnes dépressives à retourner au travail et (b) identifier les éléments clés de l'intervention. Mé thodologie. Une étude prétest postest à groupe unique (n ¼ 21) a été utilisée; cette étude comportait des mesures d'autoévaluation (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) et des entrevues à la fin de l'intervention et lors d'un suivi, après trois mois. Des statistiques descriptives, un test de t d'échantillons appariés et une analyse du contenu ont été utilisés pour analyser les données. Ré sultats. À la suite de l'intervention, des améliorations significatives ont été observées face à la capacité de travail, la fatigue et la sévérité de la dépression. Les participants ont indiqué que la structure, les simulations de travail, le réalisme du milieu de travail simulé, le soutien et l'éducation étaient des éléments clés de l'intervention. Consé quences. Les résultats indiquent qu'une intervention axée sur le retour au travail et l'occupation à l'intention des personnes se rétablissant d'une dépression pourrait être adoptée plus largement et faire l'objet de futures recherches.
Journal of Occupational Rehabilitation
Purpose This study aimed to evaluate the validity of the Return-to-Work Self-efficacy Questionnaire (RTW-SE) in a Norwegian sample of patients with common mental disorders. The secondary aim was to provide validated cut-off scores for the RTW-SE. Methods Among patients receiving work-focused therapy (N = 626), the RTW-SE was measured pre-and post-treatment, and work status was assessed up to one-year post-treatment. The factor structure, internal consistency and construct validity were assessed. Furthermore, post-treatment cut-off scores were calculated using receiver operating characteristic (ROC) analysis for patients on sick leave at baseline (n = 314) and at the end of treatment (n = 145). The predictive ability of the suggested RTW-SE cut-off scores were investigated longitudinally. Results Exploratory principal component analysis identified a one-factor solution with high internal consistency (0.91). RTW-SE exhibited small to moderate negative correlations with measures of dep...
Identifying Return to Work Self-Efficacy Trajectories in Employees with Mental Health Problems
Journal of Occupational Rehabilitation, 2021
Purpose Return to work self-efficacy (RTW-SE) is a strong predictor of return to work (RTW) in employees with mental health problems (MHPs). However, little is known about the development of RTW-SE during the RTW process. In this study, we aimed to identify RTW-SE trajectories in the year following sick leave in employees with MHPs and provided a description of the trajectories in terms of personal and work characteristics, and RTW status. Methods This multi-wave study included 111 employees with MHPs. RTW-SE was measured at baseline, and at 3, 6, and 12 months follow-up with the RTW-SE scale for employees with MHPs. Results Latent class growth analysis revealed six trajectories. In three trajectories employees had increasing RTW-SE scores, namely (class 1) low start, moderate increase, (class 3) moderate start, small increase and (class 5) moderate start, steep increase. The other trajectories were defined by (class 2) persistently high, (class 6) persistently low, and (class 4) de...
Journal of Occupational Rehabilitation, 2010
Background The aim of the present study was to conduct subgroup-analyses in a prospective cohort of workers on long-term sickness absence to investigate whether associations between perceived work attitude, selfefficacy and perceived social support and time to RTW differ across different health conditions. Methods The study was based on a sample of 926 workers on sickness absence (6-12 weeks). The participants filled out a baseline questionnaire and were subsequently followed until the tenth month after listing sick. Perceived work attitude was measured with a Dutch language version of the Work Involvement Scale. Perceived social support was measured with a self-constructed standardized scale reflecting a person's perception of social support regarding RTW. Self-efficacy was measured with the standardised Dutch version of the General self-efficacy scale, assessing the subjects' expectations of their general capacities. The sample was divided into three subgroups: musculoskeletal health conditions, other physical health conditions and mental health conditions. Anova analyses and Cox proportional hazards regression analyses were used to identify differences in association between the three factors and the time to RTW between different subgroups. Results The associations between the perceived work attitude, self-efficacy and perceived social support and the time to RTW vary across different health condition subgroups, not only with regard to the strength of the association but also for the type of factor. In the multivariate model, hazard ratios (HRs) of 1.33 (95% CI 1.01-1.75) in the musculoskeletal subgroup, and 1.26 (95% CI 0.89-1.78) in the other physical subgroup were found in perceived work attitude. With regard to perceived social support HRs of 1.39 (95% CI 1.12-1.99) respectively 1.51 (1.05-2.17) in the same subgroups were found. Only selfefficacy remained in the multivariate model in all subgroups with HRs of 1.49 (95% CI 1.12-1.99) in the musculoskeletal subgroup, 1.53 (95% CI 1.07-2.18) in the other physical subgroup and 1.60 (1.07-2.40) in the mental subgroup.
Return to work perceptions and actual return to work in workers with common mental disorders
Journal of occupational rehabilitation, 2013
Return to work (RTW) perceptions have been found to predict actual RTW of workers with common mental disorders. This study aims to (1) assess the relative value of RTW self-efficacy (RTW-SE) and RTW expectation in predicting actual RTW and (2) explore the role of mental health symptoms, work characteristics and their interaction as determinants of these RTW perceptions at baseline and over time. Workers (N = 179) with common mental disorders were included at the start of their sick leave and followed-up at 3, 6, 9, and 12 months. RTW self-efficacy, RTW expectation, mental health and RTW were assessed by self-report. Kaplan-Meier survival analysis was used to test the predictive value of RTW-SE and RTW expectation against the actual RTW. Linear regression was used to study the associations of mental health symptoms, work characteristics and their interaction with RTW-SE at baseline. Mental health symptoms in relation to RTW-SE over the first 6 months were analyzed using Linear Mixed ...