Common Psychosocial Factors Predicting Return to Work After Common Mental Disorders, Cardiovascular Diseases, and Cancers: A Review of Reviews Supporting a Cross-Disease Approach

Abstract

Purpose This systematic review aimed at identifying the common psychosocial factors that facilitate or hinder the return to work (RTW) after a sick leave due to common mental disorders (CMDs), cardiovascular diseases (CVDs), or cancers (CAs). Methods We conducted a review of reviews searching 13 databases from 1994 to 2016 for peer-reviewed, quantitative, cohort studies investigating factors influencing RTW after a CMD, CVD, or CA. Then, for each disease we identified additional cohort studies published after the date of the latest review included. Data were extracted following a three steps best-evidence synthesis method: the extraction of results about each predictor from studies within each single review and in the additional papers; the synthesis of results across the reviews and additional papers investigating the same disease; and the synthesis of results across the diseases. Results The search strategy identified 1029 unique records from which 27 reviews and 75 additional studies underwent comprehensive review. 14 reviews and 32 additional cohort studies met eligibility criteria. Specific predictors of RTW with different levels of evidence are provided for each disease. We found four common facilitators of RTW (job control, work ability, perceived good health and high socioeconomic status), and six barriers of RTW (job strain, anxiety, depression, comorbidity, older age and low education). Conclusion This is the first review to systematically analyze commonalities in RTW after CMDs, CVDs, or CAs. The common factors identified indicate that the RTW process presents many similarities across various diseases, thus supporting the validity of a cross-disease approach.

Assessment of psychosocial dimensions of return to work after a cancer diagnosis: Current perspectives and future opportunities

“…1 However, we aimed to discuss further considerations that should be taken into account in studies assessing psychosocial determinants of cancer survivors' RTW that include (a) measure prospectively psychological factors within the first year of In epidemiological studies, variables such as cancer-related fatigue or perceived social support have often been assessed using a visual analogue scale or a dichotomous item. 3 These studies do not distinguish how the multiple dimensions of cancer-related fatigue (emotional, physical, and mental fatigue) and perceived social support (emotional, esteem, instrumental, informative, and negative support) could differentially impact cancer survivors' RTW. A recent longitudinal and prospective study, which included 68 women with breast cancer employed at the time of diagnosis, investigated the associations between the multidimensional aspects of fatigue and perceived social support-measured within the year of the breast cancer diagnosis-with RTW.…”

“…First, most such studies assessed psychosocial determinants of RTW between the second and the fifth year after the cancer diagnosis while the majority of patients returned to work within the first year of diagnosis . This retrospective assessment of psychological factors may lead to memory biases which could be avoided if psychological changes due to cancer were assessed prospectively within the first year of diagnosis . Negative memory biases might also be exacerbated following traumatic events, such as a cancer diagnosis .…”

“…In epidemiological studies, variables such as cancer‐related fatigue or perceived social support have often been assessed using a visual analogue scale or a dichotomous item . These studies do not distinguish how the multiple dimensions of cancer‐related fatigue (emotional, physical, and mental fatigue) and perceived social support (emotional, esteem, instrumental, informative, and negative support) could differentially impact cancer survivors' RTW.…”

“…In addition, due to the multiplication of observational studies, systematic reviews have been produced and have allowed the emergence of conceptual models of cancer survivors' RTW. 2,3 However, those models hardly describe the psychosocial determinants underlying this outcome. Most such studies limit their analyses to exploring direct predictors of RTW, which, unfortunately, do not take…”

Helping patients with common mental health problems return to work

“…There was moderate evidence that supervisor/co-worker support, work ability, positive RTW expectations, and higher socioeconomic status were facilitators. 13 A small qualitative study reported additional barriers, that is, patients disliking their work, fear of further illness, caring responsibilities at home, employer's sick pay incentivising absence, and inability to contact an occupational physician.…”