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Improved Expectations About Length of Sick Leave During Occupational Rehabilitation Is Associated with Increased Work Participation

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Abstract

Objectives To assess changes in participants’ expectations about length of sick leave during Acceptance and Commitment Therapy (ACT)-based occupational rehabilitation, and whether the change in expectations was associated with future work participation. Methods Cohort study with 9 months follow-up including sick listed workers who took part in one of two randomized controlled trials. The change in expectations about length of sick leave were assessed using a test of marginal homogeneity. Furthermore, linear and logistic regression evaluated associations between changes in expectations and sustainable return to work (RTW) and work participation days. Results During rehabilitation, there was a statistically significant improvement in participants’ (n = 168) expectations about length of sick leave. During 9 months follow-up, participants with consistently positive expectations had the highest probability of RTW (0.81, 95% CI 0.67–0.95) and the most work participation days (159, 95% CI 139–180). Participants with improved expectations had higher probability of sustainable RTW (0.68, 95% CI 0.50–0.87) and more work participation days (133, 95% CI 110–156) compared to those with reduced (probability of RTW: 0.50, 95% CI 0.22–0.77; workdays: 116, 95% CI 85–148), or consistently negative expectations (probability of RTW: 0.23, 95% CI 0.15–0.31; workdays: 93, 95% CI 82–103). Conclusions During ACT-based occupational rehabilitation, 33% improved, 48% remained unaltered, and 19% of the participants reduced their expectations about RTW. Expectations about RTW can be useful to evaluate in the clinic, and as an intermediary outcome in clinical trials. The changes were associated with future work outcomes, suggesting that RTW expectations is a strong predictor for RTW.

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Acknowledgements

The authors thank project coworker Guri Helmersen for valuable assistance, Tryggve Skylstad at the Norwegian Welfare and Labor Service for providing lists of sick-listed individuals and Ola Thune at the Norwegian Welfare and Labor Service for providing sick leave data and insight to the National Social Security System Registry. The authors also thank clinicians and staff at Hysnes Rehabilitation Center and the Department of Physical Medicine and Rehabilitation at St. Olavs Hospital, and the participants who took part in the study.

Author Contributions

LA and MSF conceived the initial idea for this article. All authors contributed to developing the idea. LA and KP performed the analyses. LA wrote the first draft of the article. All authors critically reviewed the manuscript and approved the article.

Funding

The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology (Grant No. 46056821); The Research Council of Norway (Grant No. 238015/H20); and allocated government funding through the Central Norway Regional Health Authority.

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Authors and Affiliations

  1. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, MTFS, 7491, Trondheim, Norway

    Lene Aasdahl, Kristine Pape, Ottar Vasseljen, Roar Johnsen & Marius Steiro Fimland

  2. Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Lene Aasdahl & Marius Steiro Fimland

  3. Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Marius Steiro Fimland

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  1. Lene Aasdahl
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Correspondence to Lene Aasdahl.

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Conflict of interest

Marius Steiro Fimland has been employed at Hysnes Rehabilitation Center, St. Olavs Hospital. Lene Aasdahl and Marius Steiro Fimland have been employed at the Department of Physical Medicine and Rehabilitation, St. Olavs Hospital. The other authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Aasdahl, L., Pape, K., Vasseljen, O. et al. Improved Expectations About Length of Sick Leave During Occupational Rehabilitation Is Associated with Increased Work Participation. J Occup Rehabil 29, 475–482 (2019). https://doi.org/10.1007/s10926-018-9808-4

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