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Workers’ Beliefs and Expectations Affect Return to Work Over 12 Months

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Abstract

Background: Successful management of workers on sick leave due to low back pain depends on the identification by the occupational physician of modifiable prognostic factors in the early phase of sick-leave. The prognostic value of factors which influence the course of low back pain and return to work in occupational health care is unclear. Methods: Secondary data analysis in a cohort of 299 workers on sick leave between 3 and 6 weeks due to low back pain was applied. We investigated the association of a broad set of prognostic indicators related to characteristics of worker, job, low back pain and psychosocial issues on return to work lasting at least 4 weeks (lasting-RTW) and minimally 1 day of first return to work (first-RTW). Relationships were studied using Cox regression analysis and covered a follow-up period of 12 months. The explained variation of the models was also calculated. Results: The median time to return to work using lasting-RTW and first-RTW was 76 and 71 days respectively. In addition to individual analysis of potential predictive factors a backward selection procedure resulted in the following multivariable model: self-predicted timing of return to work, pain intensity, job satisfaction, social support, pain radiation, expectations of treatment succes of the occupational physician. Similar results were found for first-RTW. The explained variance of the multivariate model of lasting-RTW was 18%. Conclusions: Factors concerning the expectations and beliefs of the worker affected the RTW process. Knowledge of these factors by the occupational physician in the early phase of low back pain and sick-leave may contribute to solutions to promote return to work.

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Author information

Authors and Affiliations

  1. Body@Work, Research Center Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands

    Martijn W. Heymans, Paulien M. Bongers & Willem van Mechelen

  2. Department of Public and Occupational Health, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081, BT, The Netherlands

    Martijn W. Heymans, Paulien M. Bongers & Willem van Mechelen

  3. Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Martijn W. Heymans, Henrica C. W. de Vet, Paulien M. Bongers & Willem van Mechelen

  4. Department of Clinical Epidemiology and Biostatistics VU University Medical Center, Amsterdam, The Netherlands

    Dirk L. Knol

  5. Quality of Life, Hoofddorp, The Netherlands

    Paulien M. Bongers

  6. Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands

    Bart W. Koes

Authors
  1. Martijn W. Heymans
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  2. Henrica C. W. de Vet
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  3. Dirk L. Knol
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  4. Paulien M. Bongers
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  5. Bart W. Koes
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  6. Willem van Mechelen
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Correspondence to Martijn W. Heymans.

Additional information

This study is granted by: The Netherlands Organization for Health Research and Development (Zon/Mw), Dutch Ministries of Health, Welfare and Sports and of Social Affairs and Employment. The funding organizations had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The study protocol was approved by the Medical Ethics Committee of the VU University Medical Center in Amsterdam.

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Heymans, M.W., de Vet, H.C.W., Knol, D.L. et al. Workers’ Beliefs and Expectations Affect Return to Work Over 12 Months. J Occup Rehabil 16, 685–695 (2006). https://doi.org/10.1007/s10926-006-9058-8

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  • DOI: https://doi.org/10.1007/s10926-006-9058-8

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