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  • 1.
    Rashid, Mamunur
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Women on sick leave for long-term musculoskeletal pain: Factors associated with work ability, well-being and return to work2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Taking sick leave (SL) for long-term musculoskeletal pain (MSP), predominantly in the neck, shoulders and back, is common among women in Sweden. Long-term MSP affects their daily life and causes impaired work ability and long-term SL. Therefore, it is necessary to work from a multidimensional perspective to generate knowledge about factors that may obstruct or promote work ability and well-being in the return-to-work (RTW) process among women on SL for MSP. The aim of the thesis was to identify factors of importance for work ability, well-being and RTW among women on SL for long-term neck/shoulder and/or back pain.

          Methods: Study I is a narrative systematic review. An extensive systematic search was performed through the databases Medline, CINAHL and PsycINFO, from their inception until February 2016. The inclusion criteria for the articles were: study population of men and women aged 18-65 years, work absence ≥ 2 weeks, and neck/shoulder or back pain. The outcome variable was RTW. An additional search through reference lists and citations of the included articles was performed in Scopus. A total of 10 studies were selected for the methodological quality assessment and synthesis of the results. Data were synthesized through analysis of the content according to similarities of factors. For Study II-IV, a postal survey was sent to 600 women in central and northern Sweden who were receiving time-loss benefits during the spring of 2016. The inclusion criteria were women aged 18-65 years, ≥ 50% SL from service, SL ≥ 1 month due to neck/shoulder and/or back pain (≥ 3 months), and understanding the Swedish language. The exclusion criteria were rheumatoid arthritis, multiple sclerosis, stroke, cancer, Parkinson, bipolar disease, schizophrenia, and pregnancy. A follow-up survey was sent out in spring 2017 to the 208 women who answered the survey at baseline; 141 responded. Study II was cross-sectional; a multiple linear regression was conducted to determine the association between the factors and work ability and well-being, respectively. Study III had  a prospective design with a 1-year follow-up. A multiple logistic regression was conducted to determine whether work ability and well-being predicted RTW. To assess the discriminative ability of the Work Ability Index (WAI) and Life Satisfaction questionnaire (LiSat-11) regarding women who did RTW and those who did not RTW (NRTW), Receiver Operating Characteristic (ROC) curves were used. Study IV also had a prospective design with a 1-year follow-up. Cluster analysis was performed to identify potential predictors, and a multiple logistic regression model was used to identify significant predictors of RTW.

          Results: Study I suggested that recovery beliefs, health-related factors and work capacity may be important areas to target in interventions for women and men with long-term neck or back pain. The review also showed that there is a lack of high-quality studies. Study II showed that believing one would return to the same work within 6 months, pain intensity and job strain were associated with work ability among women on SL for long-term neck/shoulder and/or back pain. Self-efficacy and depression were associated with well-being. The findings from Study III indicated that work ability was important for RTW in this group of women. The WAI adequately discriminated between RTW and NRTW. The LiSat-11 did not predict RTW or discriminate between RTW and NRTW. The results from Study IV indicated that coping through increasing behavioral activities, believing one would return to the same work within 6 months, and social support outside work predicted RTW in this group of women.

          Conclusions: The results from the empirical studies on women only were partly in agreement with results found in the narrative systematic review on men and women. In light of this, future studies may benefit from investigating prognostic factors for RTW among men and women separately. Factors that emerged in the empirical studies would need to be tested in a weighted model to identify whether any of them mediate or moderate the outcome variable RTW.

  • 2.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Do work ability and well-being matter for return to work?: Cut-off points for Work Ability Index and Life Satisfaction questionnaire among women with long-term musculoskeletal painManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To determine whether work ability and well-being predict return to work (RTW) among women with long-term neck/shoulder and/or back pain at a 1-year follow-up, and to assess the ability of the Work Ability Index (WAI) and Life Satisfaction questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW. 

    Methods: A survey was sent to 600 women receiving time-loss benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and well-being predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and LiSat-11 for women who did RTW and those who did not RTW, Receiver Operating Characteristic curves were fitted.  

    Results: Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04-1.22). Well-being was not significant. The WAI at baseline adequately discriminated between RTW and no RTW after one year (AUC 0.78, 95% CI 0.70-0.86), but the LiSat-11 did not.

    Conclusions: Our results indicate that work ability is an important factor for RTW among women on SL for long-term neck/shoulder and/or back pain. The WAI has adequate discriminatory ability in this population, but the LiSat-11 has not.  

     

    Keywords: Life satisfaction, Musculoskeletal pain, Sickness absence, Work status

  • 3.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
    Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 672Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back.

    METHODS:

    A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively.

    RESULTS:

    Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively.

    CONCLUSIONS:

    The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

  • 4.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Predictors of return to work among women with long-term neck/shoulder and/or back pain: a 1-year prospective studyManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to identify predictors of return to work (RTW) among women on sick leave due to long-term neck/shoulder and/or back pain.

    Methods: The study was a prospective survey with a 1-year follow-up. Data on predictors and outcome were collected using a self-administrated questionnaire containing eight instruments – Coping Strategies Questionnaire, General Self-Efficacy scale, Sense of Coherence, Multidimensional Pain Inventory, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Work Ability Index, and Life Satisfaction questionnaire, as well as a set of background questions. A total of 208 women, aged 23-63 years, were included at baseline, and 141 responded at the 1-year follow-up. Multiple logistic regression analyses were performed to identify predictors of RTW.

    Results: Of the 141 women, 94 had RTW and 47 had not at the 1-year follow-up. Women who engaged in more coping by increasing behavioral activities, such as leisure activities, reading and socialization, (OR 1.12, 95% CI 1.02-1.22) and those who more strongly believed they would return to the same work within 6 months (OR 1.24, 95% CI 1.12-1.38) had an increased probability of RTW. Getting more social support outside work (OR 0.49, 95% CI 0.26-0.90) decreased the odds of RTW at the 1-year follow-up.

    Conclusions: The findings suggested that behavioral activities, belief in returning to the same work and social support were predictors of RTW at the 1-year follow-up. Healthcare professionals should consider these predictors in efforts to prevent prolonged sick leave and to promote RTW among women with long-term neck/shoulder and/or back pain.

     

     

    Key terms: Follow-up study, musculoskeletal pain, prognostic factors, sickness absence, return to work.

     

  • 5.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Predictors of work ability among women on long-term sick leave due to musculoskeletal pain2017In: NES2017 conference proceedings / [ed] Anna-Lisa Osvalder, Mikael Blomé and Hajnalka Bodnar, 2017, p. 140-Conference paper (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is one of the leading causes of sick leave (SL), especially among women in Sweden and in other western countries. It is, therefore, important to know which health- and work-related factors are associated with work ability (WA) among women with long-term musculoskeletal pain.

         Purpose: The aim of this study was to determine whether there is any association between self-efficacy, anxiety, depression, sense of coherence, job strain, support at work, pain intensity, physical activity, beliefs to be back at the same work, coping strategies, and WA.

         Methods: A cross-sectional study was conducted on women with long-term pain who were on SL. Inclusion criteria: (i) age 18-65 years, (ii) SL: ≥ 1 months, (iii) SL: ≥ 50%, (iv) pain in neck, shoulder or back (≥ 3 months), and (v) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. In spring 2016, self-administered questionnaires were sent out to 600 women who were receiving time-loss benefits according to the Swedish Social Insurance registers. Out of these, a total of 208 participants responded and were included in the analysis. For assessing the predictors and the outcome, seven instruments were used: General Self-Efficacy, Hospital Anxiety and Depression Scale, Demand-Control-Support Questionnaire, Sense of Coherence, Multidimensional Pain Inventory, Coping Strategy Questionnaire and Work Ability Index. Two of the predictors, physical activity and beliefs to be back at the same work, were measured by single questions. Multiple linear regression analyses were performed to detect which of the factors were associated with WA.

         Results: Women who more strongly believed that they would return to the same work within 6 months had higher WA (β= 0.39, p < .001), whereas women with higher pain intensity (β= -0.28, p < .001) and higher job strain (β= -0.12, p < .05) had lower WA. The results did not change when age, cohabitant, economic situation and social support were controlled for in the analysis. The regression model was significant (p < .0001), and its adjusted R- square was 48%.

         Discussion and practical implications: Women’s positive beliefs are associated with higher WA in accordance with previous studies. Our study also found that pain intensity and high job strain are associated with reduced WA. The results suggest that health care providers and employers should take women’s beliefs to be back at the same work into account for supporting them to return to work. Furthermore, the focus of rehabilitation program should be on women suffering from high pain intensity to increase WA.

         Conclusion: This study showed that beliefs to be back at the same work, pain intensity and job strain might be predictors of WA. Further studies are needed to identify if these predictors are also important for WA among women with long-term pain who are at work.

     

    Key words: Factors, ability to work, sickness absence, women and pain

  • 6.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Faculty of Medicine, Uppsala University, Sweden .
    Work ability, well-being and return-to-work among women in Gävleborg on sick leave due to long-term pain in the neck/shoulders and/or back2018In: FALF KONFERENS 2018 Arbetet – problem eller potential för en hållbar livsmiljö?   10-12 juni 2018 Gävle: Program och abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 68-Conference paper (Refereed)
    Abstract [en]

    Background

    Sickness absence due to long-term musculoskeletal pain (MSP) is a common phenom-enon in Sweden as well as in other European countries. Sick leave due to MSP (i.e. pain in the neck/shoulders and/or back) is higher among women than among men; therefore, women can be considered as a vulnerable group.

    Aim

    The overall aim is to identify factors of importance for work ability, well-being and return to work among women of working age who are on sick leave due to long-term pain in the neck/shoulders and/or back. The project includes three empirical studies.

    Methods

    The project was a result of a joint collaboration between the University of Gävle and the Swedish Social Insurance Agency in Gävleborg. Initially, a postal survey was sent to 600 women in Gävleborg who were receiving time-loss benefits during spring 2016. The inclusion criteria were: women aged 18-65 years, ≥ 50% sick leave from service, sick leave ≥ 1 month due to pain in the neck/shoulders and/or back (≥ 3 months) and understanding the Swedish language. The exclusion criteria were: rheumatoid arthritis, multiple sclerosis, stroke, cancer, Parkinson, bipolar disease, schizophrenia and preg-nancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline, and 141 responded.

    Results

    Study-I aimed to identify factors associated with work ability and well-being among women on sick leave. The results showed that beliefs to be back at the same work, pain intensity and job strain correlated with work ability. Self-efficacy and depression correlated with well-being. Study-II aimed to compare work ability and well-being over time, among women who returned to work (RTW) versus women who remained on sick leave in one year. The findings indicated that out of 141 women, 94 did RTW and 47 remained on sick leave. The group that RTW improved in work ability as well as well-being over time, whereas the group that remained on sick leave tended to decline over time in well-being. Study-III aims to identify predictors of RTW among women on sick leave. The analysis is under way. This project highlights factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave in this vulnerable group.

  • 7.
    Rashid, Mamunur
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Kristofferzon, Marja-Leena
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala University, Uppsala, Sweden.
    Heiden, Marina
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Factors associated with return-to-work among people on work absence due to long-term neck or back pain: a narrative systematic review2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 6, article id e014939Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE:

    The purpose of this narrative systematic review was to summarise prognostic factors for return to work (RTW) among people with long-term neck/shoulder or back pain.

    METHODS:

    A systematic literature search was performed through three databases (Medline, CINAHL and PsycINFO) for studies published until February 2016. Only observational studies of people on work absence (≥2 weeks) due to neck/shoulder or back pain were included. The methodological quality of the included studies was assessed using guidelines for assessing quality in prognostic studies on the basis of Framework of Potential Biases. Factors found in the included studies were grouped into categories based on similarities and then labelled according to the aspects covered by the factors in the category.

    RESULTS:

    Nine longitudinal prospective cohort studies and one retrospective study fulfilled the inclusion criteria. From these, five categories of factors were extracted. Our findings indicate that recovery beliefs, health-related factors and work capacity are important for RTW among people with long-term neck or back pain. We did not find support for workplace factors and behaviour being predictive of RTW.

    CONCLUSIONS:

    Our findings suggest that recovery beliefs, perceived health and work capacity may be important targets of intervention for people with long-term neck or back pain. However, more high-quality prospective studies are needed to confirm the results and improve our understanding of what is needed to facilitate RTW in this population.

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