Influence of self-reported work conditions and health on full, partial and no return to work after long-term sickness absence.

OBJECTIVES This study aimed at describing the frequency of full, partial, and no return to work after long-term sick leave and at ascertaining the influence of psychosocial work conditions, work ability and health, reported before the onset of sick leave, on full and partial return to work. METHODS Altogether 853 public-sector employees in Sweden, mainly women, with at least one sick leave lasting > or = 28 days, were studied. The outcome was the level of sick leave 2 years after the sick leave began. Potential predictors were self-rated health, work ability, and psychosocial work conditions assessed by questionnaire before the sick leave. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated by multinomial regression analyses. RESULTS Altogether 41% of the participants went directly from full sick leave to full return to work; 21% had periods of partial return to work, but, at the 2-year follow-up, were fully back to work; 15% had partial return to work; and 23% were still not working. A relaxed work situation, a combination of low demands and high decision latitude, increased the odds for full (OR 2.72, 95% CI 1.60-4.62) and partial (OR 2.42, 95% CI 1.21-4.85) return to work. Negative consequences of organizational changes were associated with decreased odds for full return to work (OR 0.54, 95% CI 0.38-0.77). Good self-rated health and work ability were associated with full return to work. CONCLUSIONS Partial return to work often precedes full return to work, but also operates as a long-term solution for remaining occupationally active. Promoting relatively low demands and high decision latitude at work may support both full and partial return to work after long sick leaves.

[1]  R Nordemar,et al.  Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs. Stockholm MUSIC I Study Group. , 1997, Scandinavian journal of work, environment & health.

[2]  F. Nijhuis,et al.  The Demand–Control–Support model as a predictor of return to work , 2003, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[3]  T. J. Sullivan,et al.  Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. , 2001, American journal of industrial medicine.

[4]  M. Josephson,et al.  Positive and negative consequences of sick leave for the individual, with special focus on part-time sick leave , 2009, Scandinavian journal of public health.

[5]  M. Marmot,et al.  Socioeconomic position, health, and possible explanations: a tale of two cohorts. , 2002, American journal of public health.

[6]  H. Goodin.  The nursing shortage in the United States of America : an integrative review of the literature , 2003 .

[7]  L. Alfredsson,et al.  The same factors influence job turnover and long spells of sick leave--a 3-year follow-up of Swedish nurses. , 2008, European journal of public health.

[8]  T. Theorell,et al.  Assessment of psychological and social current working conditions in epidemiological studies: experiences from the MUSIC-Norrtälje study , 2002, Scandinavian journal of public health.

[9]  L Rudolph,et al.  Psychosocial job factors and return-to-work after compensated low back injury: a disability phase-specific analysis. , 2001, American journal of industrial medicine.

[10]  P. Bongers,et al.  "The very best of the millennium": longitudinal research and the demand-control-(support) model. , 2003, Journal of occupational health psychology.

[11]  J. Groothoff,et al.  Self-rated health as a predictor of return to work among employees on long-term sickness absence , 2006, Disability and rehabilitation.

[12]  U. Bültmann,et al.  Return to work among sickness-absent Danish employees: prospective results from the Danish Work Environment Cohort Study/National Register on Social Transfer Payments , 2006, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[13]  L. Alfredsson,et al.  Long-term sick-listing among women in the public sector and its associations with age, social situation, lifestyle, and work factors: A three-year follow-up study , 2005, Scandinavian journal of public health.

[14]  B. Gerdle,et al.  Women with fibromyalgia: Work and rehabilitation , 2005, Disability and rehabilitation.

[15]  O. Lundberg,et al.  Return to work and adjustment latitude among employees on long-term sickness absence , 2006, Journal of Occupational Rehabilitation.

[16]  Thomas Lund,et al.  Multilevel Analysis of Individual and Contextual Factors as Predictors of Return to Work , 2006, Journal of occupational and environmental medicine.

[17]  Johannes R. Anema,et al.  A Developmental Conceptualization of Return to Work , 2005, Journal of Occupational Rehabilitation.

[18]  S. Marklund,et al.  What is healthy work for women and men? - A case-control study of gender- and sector-specific effects of psycho-social working conditions on long-term sickness absence. , 2006, Work.

[19]  C. Edlund,et al.  Factors relevant to a return to work: a multivariate approach. , 2006, Work.

[20]  J. Groothoff,et al.  Work-related determinants of return to work of employees on long-term sickness absence , 2005, Disability and rehabilitation.

[21]  Lennart Bodin,et al.  Patterns of working and living conditions: A holistic, multivariate approach to occupational health studies , 2003 .

[22]  I. Jensen,et al.  Return to work expectation predicts work in chronic musculoskeletal and behavioral health disorders: Prospective study with clinical implications , 2006, Journal of Occupational Rehabilitation.