2012-04-01 12:00 - Messages
Dellve, Lotta et Tone Ahlborg (2012). Partner relationships and long-term sick leave among female workers: consequences and impact on dimensions of health and return to work. Scandinavian Journal of Caring Sciences.
Few efforts have been made to prospectively identify resources and obstacles outside work that may predict regained work ability and return to work when workers are on sick leave. This study investigates the association between partner relationships and sick leave. Our research questions were as follows: (i) What is the influence of sick leave, pain, stress and domestic strain on the quality of the dyadic partner relationship?, and (ii) What is the influence of the partner and social relationship on pain, stress, work ability, self-rated health and return to work? A cohort of female workers (n = 225) on long-term sick leave (>60 days), all in a partner relationship, at 6-month intervals completed a questionnaire based on the Quality of Dyadic Relationship (QDR) instrument, the Interview Schedule of Social Interaction (ISSI), the Work Ability Index (WAI) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Univariate and multivariate analyses of baseline and prospective data were performed. The results showed that decreased partner relationship quality was related to having major responsibility for household work despite being on sick leave, having pain and having decreased social integration. Among younger individuals on sick leave, a reduction in the quality of the partner relationship was shown already at the first (6-month) follow-up, while among middle-aged women, such a reduction was seen only at the 12-month follow-up. No dimensions of partner relationship quality at baseline were related to dimensions of return to work, either as a resource or as an obstacle. Consequently, our results show that a good relationship does not keep the woman from returning to work. Having main responsibility for household work, which implies domestic strain while on sick leave, predicts lower partner relationship quality. The practical implications are that healthcare professionals treating women on sick leave should emphasize the importance of keeping a social network as well as making sufficient adjustments at home for the relationship quality to be safeguarded. Special attention should be given to the young woman on sick leave as being on sick leave seems to influence her partner relationship considerably.
Introduction In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee's health and participation in labour. Methods We performed a keyword search (systematic literature review) in seven databases (period: 1994–2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Results Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Conclusions Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.
A randomized controlled trial
Objective : Previously we reported that early part-time sick leave enhances return to work (RTW) among employees with musculoskeletal disorders (MSD). This paper assesses the health-related effects of this intervention.
Methods : Patients aged 18–60 years who were unable to perform their regular work due to MSD were randomized to part- or full-time sick leave groups. In the former, workload was reduced by halving working time. Using validated questionnaires, we assessed pain intensity and interference with work and sleep, region-specific disability due to MSD, self-rated general health, health-related quality of life (measured via EuroQol), productivity loss, depression, and sleep disturbance at baseline, 1, 3, 8, 12, and 52 weeks. We analyzed the repeated measures data (171–356 observations) with the generalized estimating equation approach.
Results : The intervention (part-time sick leave) and control (full-time sick leave) groups did not differ with regard to pain intensity, pain interference with work and sleep, region-specific disability, productivity loss, depression, or sleep disturbance. The intervention group reported better self-rated general health (adjusted P=0.07) and health-related quality of life (adjusted P=0.02) than the control group. In subgroup analyses, the intervention was more effective among the patients whose current problem began occurring <6 weeks before baseline and those with ≤30% productivity loss at baseline.
Conclusions : Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability, but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD.
Source : Shiri R, Kausto J, Martimo K-P, Kaila-Kangas L, Takala E-P, Viikari-Juntura E. Scand J Work Environ Health. 2012.
A Systematic Review
Objectives. We systematically reviewed the literature on the impact of returning to work on health among working-aged adults.
Methods. We searched 6 electronic databases in 2005. We selected longitudinal studies that documented a transition from unemployment to employment and included a comparison group. Two reviewers independently appraised the retrieved literature for potential relevance and methodological quality.
Results. Eighteen studies met our inclusion criteria, including 1 randomized controlled trial. Fifteen studies revealed a beneficial effect of returning to work on health, either demonstrating a significant improvement in health after reemployment or a significant decline in health attributed to continued unemployment. We also found evidence for health selection, suggesting that poor health interferes with people's ability to go back to work. Some evidence suggested that earlier reemployment may be associated with better health.
Conclusions. Beneficial health effects of returning to work have been documented in a variety of populations, times, and settings. Return-to-work programs may improve not only financial situations but also health.
Source : Sergio Rueda, Lori Chambers, Mike Wilson, Cameron Mustard, Sean B. Rourke, Ahmed Bayoumi, Janet Raboud, John Lavis. American Journal of Public Health: March 2012, Vol. 102, No. 3: 541–556.
Une évaluation de leur impact
Cet article traite de l'impact des maladies chroniques et des accidents sur les performances individuelles sur le marché du travail. Nous utilisons l'enquête Santé Itinéraires Professionnels (SIP) réalisée en France en 2006-2007 et mettons en oeuvre la méthode du score de propension de manière à évaluer l'impact des maladies chroniques et des accidents sur la participation aux marchés de travail et les revenus. Nous constatons que les maladies chroniques tout comme les accidents ont un effet négatif sur la carrière et les revenus. Concernant les femmes, les accidents ont un impact plus important sur les revenus et salaires.
Source : http://www.cee-recherche.fr/fr/doctrav/155-maladies-chroniques-accidents-evaluation-impact-parcours-professionnel-revenus.pdf
Risk of suicide has been associated with trauma and negative life events in several studies. Our aim was to investigate the prevalence and risk factors of suicidal ideation, and the population attributable risk among workers after occupational injuries. We investigated workers who had been hospitalized for ?3days after occupational injuries between February 1 and August 31, 2009. A self-reported questionnaire including demographic data, injury condition, and the question of suicidal ideation was sent to 4498 workers at 3months after their occupational injury. A total of 2001 workers (45.5%) completed the questionnaires and were included in final analysis. The prevalence of reporting suicidal ideation was 8.3%. After mutual adjustment, significant risk factors for suicidal ideation higher than "serious" in a self-rated severity scale (adjusted odds ratio, aOR=2.31; adjusted population attributable risk, aPAR=34.7%), total hospital stay for 8days or longer (OR=1.98; aPAR=20.5%), intracranial injury (OR=2.30; aPAR=10.2%), and marriage status of being divorced/separated/widowed (OR=2.70; aPAR=10.0%). Three months after occupational injury, a significant proportion of workers suffered from suicidal ideation. Significant predictors of suicidal ideation after occupational injury included broken marriage, intracranial injury, injury severity, and total hospital stay. Identification of high risk subjects for early intervention is warranted.
Source : Kuo CY, Liao SC, Lin KH, Wu CL, Lee MB, Guo NW, Guo YL. Psychiatry Res. 2012.
A longitudinal, register-linked study
Objective : The aim of this study was to examine the joint association of sleep duration and insomnia symptoms with subsequent disability retirement.
Methods : Baseline survey data were collected in 2000–2002 from 40–60-year-old employees of the City of Helsinki, all working at baseline. Baseline data were linked with disability retirement data until the end of 2010, obtained from the Finnish Centre for Pensions registers (N=6042). Sleep duration and self-reported insomnia symptoms (difficulties in initiating and maintaining sleep and non-restorative sleep) were derived from the baseline surveys. All-cause disability retirement (N=561) and the most prevalent diagnostic groups – musculoskeletal diseases (43%) and mental disorders (26%) – were examined. Cox regression analysis was used to yield hazard ratios (HR) with 95% confidence intervals (CI).
Results : A joint association of sleep duration and insomnia symptoms with disability retirement was found, implying a higher risk for those with frequent insomnia symptoms. HR for all-cause disability retirement ranged among those with frequent symptoms from 2.02 (95% CI 1.53–2.68, sleeping 7 hours) to 3.92 (95% CI 2.57–5.97, sleeping ≤5 hours). Adjusting for sociodemographic, work-related factors and health attenuated the associations, which nevertheless remained. The associations were similar for the two diagnostic groups, although stronger for those with mental disorders.
Conclusion : Frequent insomnia symptoms dominate the joint association of sleep duration and insomnia symptoms with subsequent disability retirement. Examining exclusively sleep duration would provide an incomplete understanding of the consequences of poor sleep.
Source : Haaramo P, Rahkonen O, Lahelma E, Lallukka T. Scand J Work Environ Health. 2012.