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Archer L, Peat G, Snell KIE, Hill JC, Dunn KM, Foster NE, Bishop A, van der Windt D, Wynne-Jones G. Musculoskeletal Health and Work: Development and Internal-External Cross-Validation of a Model to Predict Risk of Work Absence and Presenteeism in People Seeking Primary Healthcare. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10223-w. [PMID: 38963652 DOI: 10.1007/s10926-024-10223-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/22/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE To develop and validate prediction models for the risk of future work absence and level of presenteeism, in adults seeking primary healthcare with musculoskeletal disorders (MSD). METHODS Six studies from the West-Midlands/Northwest regions of England, recruiting adults consulting primary care with MSD were included for model development and internal-external cross-validation (IECV). The primary outcome was any work absence within 6 months of their consultation. Secondary outcomes included 6-month presenteeism and 12-month work absence. Ten candidate predictors were included: age; sex; multisite pain; baseline pain score; pain duration; job type; anxiety/depression; comorbidities; absence in the previous 6 months; and baseline presenteeism. RESULTS For the 6-month absence model, 2179 participants (215 absences) were available across five studies. Calibration was promising, although varied across studies, with a pooled calibration slope of 0.93 (95% CI: 0.41-1.46) on IECV. On average, the model discriminated well between those with work absence within 6 months, and those without (IECV-pooled C-statistic 0.76, 95% CI: 0.66-0.86). The 6-month presenteeism model, while well calibrated on average, showed some individual-level variation in predictive accuracy, and the 12-month absence model was poorly calibrated due to the small available size for model development. CONCLUSIONS The developed models predict 6-month work absence and presenteeism with reasonable accuracy, on average, in adults consulting with MSD. The model to predict 12-month absence was poorly calibrated and is not yet ready for use in practice. This information may support shared decision-making and targeting occupational health interventions at those with a higher risk of absence or presenteeism in the 6 months following consultation. Further external validation is needed before the models' use can be recommended or their impact on patients can be fully assessed.
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Affiliation(s)
- Lucinda Archer
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK
| | - George Peat
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Centre for Applied Health and Social Care Research (CARe), Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Kym I E Snell
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK
| | - Jonathan C Hill
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Kate M Dunn
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Nadine E Foster
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Hospital and Health Service, St Lucia, QLD, Australia
| | - Annette Bishop
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
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Ceulemans D, Moens M, Reneman M, Callens J, De Smedt A, Godderis L, Goudman L, Lavreysen O, Putman K, Van de Velde D. Biopsychosocial rehabilitation in the working population with chronic low back pain: a concept analysis. J Rehabil Med 2024; 56:jrm13454. [PMID: 38226563 PMCID: PMC10802789 DOI: 10.2340/jrm.v56.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/29/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE To identify the essential attributes of biopsychosocial rehabilitation for chronic low back pain in the working population. DESIGN A concept analysis was conducted according to the 8-step method of Walker and Avant. This framework provides a clear concept and theoretical and operational definitions. METHODS Five databases were searched, followed by a systematic screening. Subsequently, attributes, illustrative cases, antecedents, consequences and empirical referents were formulated. RESULTS Of the 3793 studies identified, 42 unique references were included. Eleven attributes were identified: therapeutic exercise, psychological support, education, personalization, self-management, participation, follow-up, practice standard, goal-setting, social support, and dietary advice. Subsequently, illustrative cases were described. Antecedents, such as motivation, preparedness and a multidisciplinary team, were found, together with consequences such as decreased pain, less sick-leave and increased function and work status. Finally, examples of empirical referents were given. CONCLUSION This study identified the attributes that are necessary to develop biopsychosocial rehabilitation intervention programmes for chronic low back pain. The defined concept of biopsychosocial rehabilitation for chronic low back pain may serve as a solid base to further develop and apply interventions. Future research should focus on the objectification of biopsychosocial rehabilitation and conceptualization regarding how personalization is done.
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Affiliation(s)
- Dries Ceulemans
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium; STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium.
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Michiel Reneman
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Jonas Callens
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Ann De Smedt
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium; Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Olivia Lavreysen
- STIMULUS Research Group, Vrije Universiteit Brussel, Jette, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Jette, Belgium
| | - Dominique Van de Velde
- Faculty of Medicine and Healthcare Sciences, Department of Rehabilitation Sciences, Occupational Therapy Research Group, Ghent University, Ghent, Belgium
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Nyberg ST, Elovainio M, Pentti J, Frank P, Ervasti J, Härmä M, Koskinen A, Peutere L, Ropponen A, Vahtera J, Virtanen M, Airaksinen J, Batty GD, Kivimäki M. Predicting long-term sickness absence with employee questionnaires and administrative records: a prospective cohort study of hospital employees. Scand J Work Environ Health 2023; 49:610-620. [PMID: 37815247 PMCID: PMC10882516 DOI: 10.5271/sjweh.4124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE This study aimed to compare the utility of risk estimation derived from questionnaires and administrative records in predicting long-term sickness absence among shift workers. METHODS This prospective cohort study comprised 3197 shift-working hospital employees (mean age 44.5 years, 88.0% women) who responded to a brief 8-item questionnaire on work disability risk factors and were linked to 28 variables on their working hour and workplace characteristics obtained from administrative registries at study baseline. The primary outcome was the first sickness absence lasting ≥90 days during a 4-year follow-up. RESULTS The C-index of 0.73 [95% confidence interval (CI) 0.70-0.77] for a questionnaire-only based prediction model, 0.71 (95% CI 0.67-0.75) for an administrative records-only model, and 0.79 (95% CI 0.76-0.82) for a model combining variables from both data sources indicated good discriminatory ability. For a 5%-estimated risk as a threshold for positive test results, the detection rates were 76%, 74%, and 75% and the false positive rates were 40%, 45% and 34% for the three models. For a 20%-risk threshold, the corresponding detection rates were 14%, 8%, and 27% and the false positive rates were 2%, 2%, and 4%. To detect one true positive case with these models, the number of false positive cases accompanied varied between 7 and 10 using the 5%-estimated risk, and between 2 and 3 using the 20%-estimated risk cut-off. The pattern of results was similar using 30-day sickness absence as the outcome. CONCLUSIONS The best predictive performance was reached with a model including both questionnaire responses and administrative records. Prediction was almost as accurate with models using only variables from one of these data sources. Further research is needed to examine the generalizability of these findings.
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Affiliation(s)
- Solja T Nyberg
- University of Helsinki, Clinicum, Faculty of Medicine, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Finland.
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Christensen MR, Nabe-Nielsen K, Holtermann A, Gupta N. Does it matter for health if steps are taken during work or leisure? A prospective accelerometer study using register-based long-term sickness absence. Int J Behav Nutr Phys Act 2023; 20:69. [PMID: 37296445 DOI: 10.1186/s12966-023-01468-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Walking is known to be good for health. However, it is unknown whether it matters if steps are taken during work or leisure. Therefore, we aimed to examine the prospective association between accelerometer-measured steps taken during work or leisure and register-based long-term sickness absence (LTSA). METHODS We included 937 blue- and white-collar workers from the PODESA cohort who wore a thigh-based accelerometer over four days to measure number of steps during work and leisure. Steps were divided into domain based on diary data. First event of LTSA was retrieved from a national register with four years' follow-up. We used Cox proportional hazard models to analyze the association between domain-specific and total daily steps and LTSA, adjusted for age, sex, job type, smoking, and steps in the other domain (e.g., work/leisure). RESULTS We found more steps at work to be associated with a higher LTSA risk [Hazard Ratio (HR):1.04; 95% CI: 1.00-1.08 per 1000 steps]. No significant association was found between steps during leisure and LTSA (HR: 0.97; 95% CI: 0.91-1.02), nor between total daily steps and LTSA (HR: 1.01; CI 95% 0.99-1.04). CONCLUSIONS More steps at work were associated with higher risk of LTSA, while steps during leisure was not clearly associated with LTSA risk. These findings partly support 'the physical activity paradox' stating that the association between physical activity and health depends on the domain.
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Affiliation(s)
- Marie Raunkjær Christensen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark.
| | - Kirsten Nabe-Nielsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Nidhi Gupta
- The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, 2100, Denmark
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Lork K, Holmgren K, Hultqvist J. Does the Number of Reasons for Seeking Care and Self-Rated Health Predict Sick Leave during the Following 12 Months? A Prospective, Longitudinal Study in Swedish Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:354. [PMID: 35010614 PMCID: PMC8744800 DOI: 10.3390/ijerph19010354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sick leave has major social and economic consequences for both individuals and society. Primary Health Care (PHC) meets people who seek care before they risk going on sick leave. This study examined the impact of self-perceived health on sick leave within 12 months for workers seeking care in PHC. METHODS The study had a prospective longitudinal design with 271 employed, non-sick-listed patients aged 18-64 years seeking care for physical and/or mental symptoms at PHC. In a logistic regression, an estimation of the odds ratio (OR) for belonging to the group workers with >14 days of sick-leave (W-SL) was made. RESULTS A high number of reasons when seeking care, with an OR of 1.33 (confidence interval 1.14 to 1.56), and lower self-rated health, with an OR of 1.45 (confidence interval 1.10 to 1.91), were determinants for sick leave at 12 months after adjusting for covariates and confounders. Mental symptoms constituted the main reason for seeking care, followed by musculoskeletal pain, and significant differences in proportions regarding most symptoms were shown between the groups with and without sick-leave >14 days. CONCLUSION Health care professionals in PHC need to be aware of the risk of future sick leave at comorbidity and low self-perceived health. Preventive rehabilitation interventions should be offered to improve health and prevent sick leave for this group.
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