Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the theory of planned behaviour

Abstract

Background Long-term sick leave due to common mental disorders (CMDs) is a great burden in society today, especially among women. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour. Methods The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (> 2 months) due to CMDs were included in the study. The questionnaires for data collection were: “RTW Beliefs Questionnaire”, the “General Health Questionnaire -12” and the “EuroQol Visual Analogue Scale”. Standard multiple regression analysis was performed both with and without adjustment for potential confounders. Results The results showed that a more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. Conclusion The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs.

Predictors of return to work and psychological well‐being among women during/after long‐term sick leave due to common mental disorders ‐ a prospective cohort study based on the theory of planned behaviour

“…Studies of other samples in other contexts have shown that social support (Santini et al, 2020 ), resilience (Mayordomo et al, 2016 ), self‐efficacy (Xie et al, 2020 ), physical function and optimism (Avis et al, 2021 ) are predictors of psychological well‐being. A previous cross‐sectional study conducted by the authors of this study revealed a moderate correlation between perceived health and psychological well‐being among women on long‐term sick leave due to CMDs (Hedlund et al, 2021 ). However, it is an open question whether RTW beliefs and perceived health are predictors of psychological well‐being over time.…”

“…Furthermore, theory‐based research is requested in the area (Nigatu et al, 2017 ). In a previous cross‐sectional study (Hedlund et al, 2021 ), based on the Theory of Planned Behaviour (TPB), our research group found that RTW beliefs were positively associated with RTW intention among women on long‐term sick leave for CMDs. The beliefs were attitude toward RTW, social pressure regarding RTW and perceived behavioural control over RTW, where attitude toward RTW was the strongest determinant of RTW intention.…”

“…Examples include time to when sick leave benefits stop, full RTW for a number of weeks and being at work after a year (de Vries et al, 2018 ). If participants are on part‐time sick leave at baseline, this might affect the outcome by encompassing multiple behaviours (continuing to work/staying at work vs. returning to work) (Dunstan et al, 2013 ; Hedlund et al, 2021 ). However, this has rarely been taken into account in previous studies.…”

Development and psychometric evaluation of a theory-based questionnaire measuring women’s return-to-work beliefs after long-term sick leave for common mental disorders

“…Internal consistency (Cronbach's alpha) was therefore calculated for each of the scales for direct measures. This is partly presented in a previous study [3]. Desirable score for alpha is according to Francis manual [29] 0.6 or above.…”

“…Half from Europe and half from other parts of the world 2. More than half had no children 3. Six lived alone, but had a partner.…”