Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews

Abstract

BackgroundWork disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research.ObjectivesTo identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes.MethodsMedline, Embase, PsychINFO, Cinahl, and Cochrane Database of Systematic Reviews and the grey literature were searched from January 1, 2004 to September 1, 2013. Systematic reviews addressing return-to-work in various conditions and injuries were selected. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria to identify low risk of bias reviews.ResultsOf the 36,193 titles screened and the 94 eligible studies reviewed, 56 systematic reviews were accepted as low risk of bias. Over half of these focused on musculoskeletal disorders, which were primarily spine related (e.g., neck and low back pain). The other half of studies assessed workers with mental health or cardiovascular conditions, stroke, cancer, multiple sclerosis or other non-specified health conditions. Many factors have been assessed, but few consistently across conditions. Common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations.ConclusionsExpectations of recovery and return-to-work, pain and disability levels, depression, workplace factors, and access to multidisciplinary resources are important modifiable factors in progressing return-to-work across health and injury conditions. Employers, healthcare providers and other stakeholders can use this information to facilitate return-to-work for injured/ill workers regardless of the specific injury or illness. Future studies should investigate novel interventions, and other factors that may be common across health conditions.

Return to Work in Patients with Hematological Cancers 1 Year after Treatment: A Prospective Longitudinal Study

“…On the other hand, employers and managers may be more willing to make adjustments for employees that are highly qualified and thus difficult to replace. Education and socioeconomic position in general have been found to be predictors of RTW after any injury or illness and are thus not specific to hematological cancer patients [24]. …”

We Need to Talk about Lumbar Total Disc Replacement

“…Given that chronic pain is causal to depression, 663 social isolation, 664 and work disability, 665 and since improved physical capability (in a way that is subjectively appreciated) is reported following implantation of the ProDisc-L, 358 it is unsurprising that successful LTDR has a profound and positive impact on a patient's quality of life by alleviating these psychosocial consequences of LDDD. Indeed, sex life and sexual function in men and women with symptomatic LDDD has been observed to improve following LTDR in a way that is commensurate with reduction in LBP, but this is not the case for men following LIF.…”

Employments effects of Vocational Rehabilitation in Germany

“…Empirical results on the effects of gender are consistent, demonstrating that males exhibit better return-to-work outcomes than females, everything else being equal (Cancelliere et al, 2016;Cornelius, Van Der Klink, Groothoff, & Brouwer, 2011;Feuerstein, Berkowitz, Haufler, Lopez, & Huang, 2001;Giesen J. & Cavenaugh Brenda, 2013;Saltychev, Tenovuo, & Laimi, 2013;Stergiou-Kita, Mansfield, & Sokoloff, 2016).…”

“…These two results do not come as a surprise since the complex relationship between demographic and work factors in relation to employment outcomes has been evident in rehabilitation and disability research for quite some time. In particular, age and return-to-work outcomes are negatively correlated (Blackwell, Leierer, Haupt, Kampitsis, & Wolfson, 2004;Cancelliere et al, 2016;Dodoo-Schittko et al, 2017;Valentin et al, 2016;Van Muijen et al, 2013). A possible explanation is that older workers are less likely to adapt to new situations and have poorer labor market chances than younger applicants.…”

“…Various studies have also detected that education is a useful predictor of return-towork outcomes (Blackwell et al, 2004;Cancelliere et al, 2016;Giesen J. & Cavenaugh Brenda, 2013).…”