Predicting return to work after long-term sickness absence with subjective health complaints: a prospective cohort study, 2020, Weerdesteijn et al

Andy

Andy

Retired committee member
Background
Long-term sickness absence results in increased risks of permanent disability and a compromised quality of life. Return to work is an important factor in reducing these risks. Little is known about return to work factors for long-term sick-listed workers with subjective health complaints. The aim of this study was to evaluate prognostic factors for partial or full return to a paid job for at least 28 days for long-term sick-listed workers with subjective health complaints, and to compare these factors with those of workers with other disorders.

Methods
Data from a prospective cohort study of 213 participants with subjective health complaints and 1.037 reference participants were used. The participants answered a questionnaire after 84 weeks of sickness absence. Return to work was measured after one and two years. Univariable logistic regression analyses were performed (P ≤ 0.157) for variables per domain with return to work (i.e. demographic, socio-economic and work-related, health-related, and self-perceived ability). Subsequently, multivariable logistic regression analyses with backward selection (P ≤ 0.157) were performed. Remaining factors were combined in a multivariable and final model (P ≤ 0.05).

Results
Both for workers with subjective health complaints and for the reference group, non-health-related factors remained statistically significant in the final model. This included receiving a partial or complete work disability benefit (partial: OR 0.62, 95% CI 0.26–1.47 and OR 0.69, 95% CI 0.43–1.12; complete: OR 0.24, 95% CI 0.10–0.58 and OR 0.12, 95% CI 0.07–0.20) and having a positive self-perceived possibility for return to work (OR 1.06, 95% CI 1.01–1.11 and OR 1.08, 95% CI 1.05–1.11).

Conclusions
Non-health-related factors seem to be more important than health-related factors in predicting return to work after long-term sickness absence. Receiving a work disability benefit and having negative expectations for return to work seem to complicate return to work most for workers with subjective health complaints. With respect to return to work predictors, workers with subjective health complaints do not differ from the reference group.
Click to expand...
Open access, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09203-5
 
I am very suspicious of the motivation of researchers who start their background statement with this:
Long-term sickness absence results in increased risks of permanent disability and a compromised quality of life. Return to work is an important factor in reducing these risks.
Click to expand...
That is making a massive assumption that a correlation between returning to work and better quality of life/less permanent disablity has a causal direction where it is the return to work that causes better health. Surely it's the other way around logically - the sicker and more disabled you are, the less able you are to return to work.
 
Return to work is an important factor in reducing these risks.
Click to expand...
When you definitely understand how causality works. It's only when you turn on the lights that you see the cockroaches. Therefore if the light remains closed, no cockroaches. Easy peasy.
non-health-related factors remained statistically significant in the final model. This included receiving a partial or complete work disability benefit
Click to expand...
Disability support is non-health-related. Right. OK. We are truly dealing with advanced geniuses here.

The issue here is the belief that health problems are not real unless blessed by an expert. I don't know how to explain that to people who went to medical school for years that this is not how any of this works. But apparently it truly needs to be explained to them.

Sick people are sick. What a twist.
 
strategist said:
It appears people with subjective health problems that receive specialist care and medication are much less likely to return to work than those with other health problems (which presumably means well defined, objectively measurable problems).
Click to expand...
What do you mean exactly because I thought that the main conclusion is that both the return to work rate and predictors of return to work are very similar in both groups, whether health complaints are subjective or not.
Of the 213 participants with SHC, 47 participants (22%)
returned to work.
....
In the reference group (n = 1037), 211 participants (20%)
returned to work
Click to expand...

It is peculiar that the severity of illness and factors such as depression did not predict return to work very well.
 
Michiel Tack said:
What do you mean exactly because I thought that the main conclusion is that both the return to work rate and predictors of return to work are very similar in both groups, whether health complaints are subjective or not.
Click to expand...

I was looking at table 2.

"Use of specialist care last 2 years" has an odds ratio of 0.96 for people with subjective health complaints. For the other disorders the odds ratio is 0.54.

Now that I'm looking at it again I realize I interpreted it the other way around, the lower odds ratio actually means lower return to work (I think).

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09203-5/tables/2
 
Last edited:
You must log in or register to reply here.
Back
Top Bottom