Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study
Abstract Background Group-based transdiagnostic occupational rehabilitation programs including participants with mental and somatic disorders have emerged in clinical practice. Knowledge is sparse on subsequent participation in competitive work. This study aimed to investigate trajectories for (re)e...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-08-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-018-5803-0 |
| _version_ | 1828412389369839616 |
|---|---|
| author | Karen Walseth Hara Johan Håkon Bjørngaard Henrik Børsting Jacobsen Petter C. Borchgrevink Roar Johnsen Tore C. Stiles Søren Brage Astrid Woodhouse |
| author_facet | Karen Walseth Hara Johan Håkon Bjørngaard Henrik Børsting Jacobsen Petter C. Borchgrevink Roar Johnsen Tore C. Stiles Søren Brage Astrid Woodhouse |
| author_sort | Karen Walseth Hara |
| collection | DOAJ |
| description | Abstract Background Group-based transdiagnostic occupational rehabilitation programs including participants with mental and somatic disorders have emerged in clinical practice. Knowledge is sparse on subsequent participation in competitive work. This study aimed to investigate trajectories for (re)entry to work for predefined subgroups in a diagnostically heterogeneous sample of sick-listed participants after completing occupational rehabilitation. Methods A cohort of 212 participants aged 18–69 on long-term sick leave (> 8 weeks) with chronic pain, chronic fatigue and/or common mental disorders was followed for one year after completing a 3½-week rehabilitation intervention based on Acceptance and Commitment Therapy. Self-reported, clinical and registry data were used to study the associations between predefined biopsychosocial predictors and trajectories for (re)entry to competitive work (≥ 1 day per week on average over 8 weeks). Generalized estimating equations analysis was used to investigate trajectories. Results For all biopsychosocial subgroups (re)entry to work increased over time. Baseline employment, partial sick leave and higher expectation of return to work (RTW) predicted higher probability of having (re)entered work at any given time after discharge. The odds of increasing reentry over time (statistical interaction with time) was weaker for the group receiving the benefit work assessment allowance compared with those receiving sickness benefit (OR = 0.92, p = 0.048) or for those on partial sick leave compared with full sick leave (OR 0.77, p < 0.001), but higher for those who at baseline had reported having a poor economy versus not (OR 1.16, p = 0.010) or reduced emotional functioning compared with not (OR 1.11, p = 0.012). Health factors did not differentiate substantially between trajectories. Conclusions Work participation after completing a transdiagnostic occupational rehabilitation intervention was investigated. Individual and system factors related to work differentiated trajectories for (re)entry to work, while individual health factors did not. Having a mental disorder did not indicate a worse prognosis for (re)entry to work following the intervention. Future trials within occupational rehabilitation are recommended to pivot their focus to work-related factors, and to lesser extent target diagnostic group. |
| first_indexed | 2024-12-10T12:48:17Z |
| format | Article |
| id | doaj.art-becefa9557f44464b837a0c01049322e |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T12:48:17Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-becefa9557f44464b837a0c01049322e2022-12-22T01:48:20ZengBMCBMC Public Health1471-24582018-08-0118111710.1186/s12889-018-5803-0Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort studyKaren Walseth Hara0Johan Håkon Bjørngaard1Henrik Børsting Jacobsen2Petter C. Borchgrevink3Roar Johnsen4Tore C. Stiles5Søren Brage6Astrid Woodhouse7Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs University Hospital, Trondheim University HospitalNorwegian Advisory Unit on Complex Symptom Disorders, St. Olavs University Hospital, Trondheim University HospitalDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Department of Psychology, Faculty of Social Sciences and Educational Sciences, Norwegian University of Science and Technology (NTNU)The Norwegian Directorate for Labour and WelfareDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU)Abstract Background Group-based transdiagnostic occupational rehabilitation programs including participants with mental and somatic disorders have emerged in clinical practice. Knowledge is sparse on subsequent participation in competitive work. This study aimed to investigate trajectories for (re)entry to work for predefined subgroups in a diagnostically heterogeneous sample of sick-listed participants after completing occupational rehabilitation. Methods A cohort of 212 participants aged 18–69 on long-term sick leave (> 8 weeks) with chronic pain, chronic fatigue and/or common mental disorders was followed for one year after completing a 3½-week rehabilitation intervention based on Acceptance and Commitment Therapy. Self-reported, clinical and registry data were used to study the associations between predefined biopsychosocial predictors and trajectories for (re)entry to competitive work (≥ 1 day per week on average over 8 weeks). Generalized estimating equations analysis was used to investigate trajectories. Results For all biopsychosocial subgroups (re)entry to work increased over time. Baseline employment, partial sick leave and higher expectation of return to work (RTW) predicted higher probability of having (re)entered work at any given time after discharge. The odds of increasing reentry over time (statistical interaction with time) was weaker for the group receiving the benefit work assessment allowance compared with those receiving sickness benefit (OR = 0.92, p = 0.048) or for those on partial sick leave compared with full sick leave (OR 0.77, p < 0.001), but higher for those who at baseline had reported having a poor economy versus not (OR 1.16, p = 0.010) or reduced emotional functioning compared with not (OR 1.11, p = 0.012). Health factors did not differentiate substantially between trajectories. Conclusions Work participation after completing a transdiagnostic occupational rehabilitation intervention was investigated. Individual and system factors related to work differentiated trajectories for (re)entry to work, while individual health factors did not. Having a mental disorder did not indicate a worse prognosis for (re)entry to work following the intervention. Future trials within occupational rehabilitation are recommended to pivot their focus to work-related factors, and to lesser extent target diagnostic group.http://link.springer.com/article/10.1186/s12889-018-5803-0Mental disordersChronic painMusculoskeletal diseasesFatigueVocational rehabilitationReturn to work |
| spellingShingle | Karen Walseth Hara Johan Håkon Bjørngaard Henrik Børsting Jacobsen Petter C. Borchgrevink Roar Johnsen Tore C. Stiles Søren Brage Astrid Woodhouse Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study BMC Public Health Mental disorders Chronic pain Musculoskeletal diseases Fatigue Vocational rehabilitation Return to work |
| title | Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study |
| title_full | Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study |
| title_fullStr | Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study |
| title_full_unstemmed | Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study |
| title_short | Biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders: a cohort study |
| title_sort | biopsychosocial predictors and trajectories of work participation after transdiagnostic occupational rehabilitation of participants with mental and somatic disorders a cohort study |
| topic | Mental disorders Chronic pain Musculoskeletal diseases Fatigue Vocational rehabilitation Return to work |
| url | http://link.springer.com/article/10.1186/s12889-018-5803-0 |
| work_keys_str_mv | AT karenwalsethhara biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT johanhakonbjørngaard biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT henrikbørstingjacobsen biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT pettercborchgrevink biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT roarjohnsen biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT torecstiles biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT sørenbrage biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy AT astridwoodhouse biopsychosocialpredictorsandtrajectoriesofworkparticipationaftertransdiagnosticoccupationalrehabilitationofparticipantswithmentalandsomaticdisordersacohortstudy |