M O15 (Oral Presentation):
Can we influence return-to-work self-efficacy in workers sick-listed with common mental disorders?

Presented by: Karlijn Marieke van Beurden

Authors

Van Beurden KM¹, Van der Klink JJL², Brouwers EPM¹, Joosen MCW¹, Mathijssen JJP¹, Terluin B³, Van Weeghel J^1,4,5

Abstract

Background

Sickness absence due to common mental disorders (CMD) is a problem in many western countries as it can lead to long-term work disability. Since a higher level of self-efficacy in CMD is predictive for earlier return-to-work (RTW), it would be worthwhile to know if self-efficacy can be increased by occupational professionals. After confirming the predictive value of return-to-work self-efficacy (RTW-SE) in our sample and examining if guideline-based care modified this association, the aim of this study is to evaluate if guideline-based care leads to an increase of RTW-SE three months later.

Methods

Occupational physicians (OPs) received training to enhance adherence to a Dutch guideline with an emphasision on strategies that are supposed to enhance self-efficacy in workers with CMD. The 66 OPs were allocated to an intervention and a control group. In 128 sick-listed workers, the RTW-SE scale (range 1-6) and RTW were measured at baseline and three months later. Generalized linear mixed models analysis was used to evaluate the association between RTW-SE at baseline and RTW three months later. Linear mixed models analysis was used to evaluate if guideline-based care leads to increased RTW-SE three months later.

Results

Workers with a higher RTW-SE score at baseline, compared to workers with a lower RTW-SE score, had significantly more often full RTW three months later than no RTW (OR 2.18, 95%CI 1.18 - 4.02). Guideline-based care did not influence this association. In workers who received guideline-based care the mean RTW-SE score at baseline was 3.3, which increased with 15% three months later. In workers receiving care as usual the mean RTW-SE score at baseline was 3.5, which increased with 8% three months later. Guideline-based care significantly increased return-to-work self-efficacy compared to care as usual (t=-2.30, p≤.05).

Conclusions

This study shows that during the first months of sickness absence RTW-SE of workers was positively influenced in a real life Dutch occupational health care setting. This insight is helpful for optimizing the recovery and RTW process, and to understand the role of RTW-SE in this process. Future research should focus on the circumstances under which RTW-SE can best be influenced and how effective interventions and guidance can be developed.