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