Presentation T P20
T P20 (Poster Presentation):
Predictors of return to work in a cohort of sick listed with common mental disorders
- National Centre for Work and Rehabilitation, Dept. of Medicine and Health, Linköping University
- Helix Vinn Excellence Centre, Linköping university
- Intervention and Implementation Research Unit, Inst. of Environmental medicine, KI
- Dept. of Occupational and Environmental Medicine, County Council of Östergötland
- Division of Health Care Analysis, Dept. of Medicine and Health, Linköping university
- Division of Physiotherapy, Dept. of Medicine and Health, Linköping University, Sweden
Common mental disorders (CMD) are increasing as a reason for sick leave. It is important to prevent the transition of short term sickness absence into long term disability.The study aims to identify predictive factors for sustainable return to work (RTW) within a year and within three months, in a prospective cohort of newly sick listed patients with mental disorders.
Patients granted sick leave due to CMD at primary and occupational health care centers were recruited in their second to third week of sick leave during 2008-2009. Sick leave records at the Social Insurance Office were followed for one year after inclusion. A baseline questionnaire was sent to n= 533, 354 responded (66%). Exclusion of unemployed left n=320. The baseline questionnaire comprised questions on demographic data, and instruments on health and work ability, personal resources, and work conditions. Analyses of predictors for duration until sustainable RTW (>four weeks) were performed with Cox proportional hazard models to estimate hazard ratios and 95% confidence intervals.
In total 195 (61 %) returned to work within three months. There was no difference due to demographics, life style,expectations to work in six months, distribution of diagnoses, or self-reported sick leave days one year before recruitment between those with RTW within 12 months and within three months. Those with early RTW had better health and work ability.Work conditions did not differ between early and late returners. In multiple regression analyses lower education, less need for work place adjustments (HR= 0.46, 95% CI =0.30-0.70), and better self-rated work ability (HR=1.14, 95% CI=1.08-1.20) were significant predictors of RTW independent of duration of sick leave. The work place factors differed between early and late returners. Low perceived interactional justice with managers (HR= 0.82, 95% CI = 0.71-9.95) was associated with RTW within three months, and lower Effort-Reward Imbalance (better psychosocial work conditions) was associated with later RTW (HR=1.70, 95% CI=0.71-0-95).
The study highlights the importance of considering work place conditions and relations at the work place for promoting RTW. Early RTW among sick listed with CMD may be due to job insecurity and risk of work place marginalization.
Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Disability management