Screening for the risk on long-term sickness absence

Background: Long-term sickness absence is a growing concern in Belgium and other European countries. Since 2017, Belgian physicians of the sickness funding organisations are required to assess the re-integration possibilities within the first two months of sickness absence. Given the shortage of physicians in the assessment of work disability and the growing number of people in sickness absence, there is a need for a triage tool, allowing to assign return-to work support to patients having a high-risk profile not to resume work. Methods/design: The current study comprises a comprehensive validation process of a screening tool that supports Belgian physicians in guiding people back to work. The study consists of a theoretical construct validation (face validity and content validity), and an empirical construct validation (concurrence validity, factorial validity, predictive validity, hypothesis testing validity and known- group validity). Expected impact of the study for Public Health: The screening instrument assessing the risk for long-term sickness absence is a tool developed to support physicians who work for sickness funds and for occupational health and safety organisations. Both professionals play an important role in the return to work process and the prevention of long-term sickness absence. The screening tool aims at making a distinction between people who will resume their work independently and people who will need support to do so. Generation of this prediction model will help physicians to focus effort and resources in the high-risk group. Results may also help understand the relationship between the biopsychosocial model and long-term sick-leave

Screening for the risk for long-term sickness absence: development & validation of a questionnaire to support re-integration

The center for environment and health examines the impact of environmental factors such as occupational health. An important part of this research is the prevention of long-term sickness absence. In this context, a questionnaire will be developed and implemented to promote rehabilitation and to standardise the follow-up procedure of sick-listed persons. The questionnaire will be administered to the sick listed persons during the second month of disability. The questionnaire will be evaluated in a pilot study with the aim of long-term implementation and to measure the effects on reintegration. The project will be executed in close cooperation with RIZIV and ULG university of Liège.status: publishe

VAKORGANISATIES EN VERANDERINGSTRAJECTEN NAAR INNOVATIEVE ARBEIDSORGANISATIES HOE STRUCTUREEL OMGAAN MET VERANDERINGSTRAJECTEN

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Motivation in the return to work process : a self-determination cluster approach

Purpose Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient's predictions of RTW, and health care provider estimations of patient's motivation. Materials and methods A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient's prediction of RTW, and health care provider estimations of patients' motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored. Results Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider's estimation was not related to controlled motivation. Conclusions Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided

Motivation in the return to work process: a self-determination cluster approach

PURPOSE: Motivation may predict return to work (RTW), yet the measurement of motivation needs more scientific evidence. We adopt a dimensional approach, based on the self-determination theory (SDT), distinguishing between amotivation, controlled and autonomous motivation. We seek to explore the presence of these dimensions in sick-disabled patients, and are interested in associations with quality of life, depression, patient's predictions of RTW, and health care provider estimations of patient's motivation. MATERIALS AND METHODS: A cross-sectional study in 336 patients was conducted. Motivation was assessed using the Motivation at Work Scale (MAWS) and examined in relation to patient outcomes, patient's prediction of RTW, and health care provider estimations of patients' motivation. A cluster analysis was performed, and differential associations between motivational profiles were explored. RESULTS: Cluster analysis revealed four profiles. Highly controlled profiles were most prevalent, reported poorer mental quality of life, and expected a longer time before RTW, regardless of the level of autonomous motivation. Interestingly, the health care provider's estimation was not related to controlled motivation. CONCLUSIONS: Our results show that SDT may help to differentiate people with a work disability regarding their motivation to RTW. Most notably, the devastating consequences of controlled motivation are discussed, and clinical implications are provided. Implications for Rehabilitation Assessing the different dimensions of motivation in the context of RTW will be a significant advance as the self-report measures appear to be viable tools. Controlled motivation, which indicates that people are motivated to RTW but only because they "have to", has negative consequences yet a high prevalence and should therefore be addressed by the practitioner. Practitioners should keep in mind that employees are motivated by several motives at the same time, with some being more beneficial than others. Controlled motivation can be converted into autonomous (i.e., good quality) motivation by supporting autonomy of the patient, by supporting their relationships with colleagues, managers, and health care providers and by supporting their feeling of competence in the RTW process.status: publishe

Psychosocial determinants predicting long-term sickness absence: a register-based cohort study

BACKGROUND: This study assessed the psychosocial determinants as explanatory variables for the length of the work disability period. The aim was to estimate the predictive value of a selected set of psychosocial determinants from the Quickscan questionnaire for the length of the sick leave period. A comparison was also made with the most common biomedical determinant: diagnosis. METHODS: In a cohort study of 4 981 insured Belgian patients, the length of the sick leave was calculated using Kaplan-Meier. Predictive psychosocial determinants were selected using backward conditional selection in Cox regression and using concordance index values (C-index) we compared the predictive value of the biomedical to the psychosocial model in a sample subset. RESULTS: Fourteen psychosocial determinants were significantly (p6 months).status: Published onlin

Quickscan Assesses Risk of Long-Term Sickness Absence: A Cross-Sectional Validation Study.

OBJECTIVE: Increasing long-term sickness absence in many countries asks for specific measures regarding return-to work. METHODS: The risk of long-term sickness absence was assessed using a questionnaire containing work-related, function-related, stressful life-events-related, and person-related factors. Additionally, workers' occupational health physician estimated the worker's chances for work resumption. Reliability, construct, and criterion validity of the questionnaire were measured. RESULTS: Two hundred seventy-six patients and 35 physicians participated in the study. The reliability was satisfying (alpha > 0.70) for all scales, except for perfectionism (alpha = 0.62). The results of the CFAs showed that the hypothesized factor models fitted the data well. Criterion validity tests showed that eight predictors significantly related to the estimation of the occupational physicians (rho < 0.05). CONCLUSIONS: The scales of the questionnaire are reliable and valid, and may be implemented to assess sick-listed workers at risk who might benefit from a rehabilitation program