Abstract
BackgroundNeck and back pain are common and often account for absenteeism at work. Factors at work as well as fear–avoidance beliefs may influence sick-leave in these patients. The aims of this study were to assess: (1) how sick-listed patients in specialised care perceive demand, control, support, effort, reward, and overcommitment at work compared to a general reference group of workers; (2) if women and men report demand, control, support, effort, reward, and overcommitment differently; and (3) the association between psychological and social factors at work and fear–avoidance beliefs about work.MethodsA cross-sectional multicentre study was carried out in 373 patients on sick leave due to neck and back pain. Psychosocial work factors were measured by demand, control, and support, (Nordic Questionnaire for Psychological and Social Factors at Work), and effort, reward and overcommitment (Effort Reward Imbalance Questionnaire). Fear avoidance beliefs about work were measured by the Fear–Avoidance Belief Questionnaire Work subscale (FABQ-W).ResultsAlthough the patients differed significantly from a reference working group regarding several subscales of demand, control, support, effort, reward, and overcommitment, the magnitude of these differences were small. The study population also reported significantly higher scores for ‘demand for physical endurance’ than the reference population, and Cohen’s d = 0.55 here indicated a medium degree of difference. Female patients reported significantly higher on support, whereas male patients reported significantly higher demand for physical endurance, quantitative demand, effort, and overcommitment. Demand for physical endurance, job control, job support, high reward, and overcommitment were significantly associated with FABQ-W.ConclusionsPerceived psychological and social factors at work were strongly associated with fear–avoidance beliefs about work in sick-listed neck and back patients. The demand for physical endurance, control, support, high reward, as well as overcommittment at work outweighed pain and added to the burden of emotional distress and disability regarding fear–avoidance beliefs.
Highlights
IntroductionFactors at work as well as fear–avoidance beliefs may influence sick-leave in these patients
Neck and back pain are common and often account for absenteeism at work
About 40% of the sick leave days were due to musculoskeletal disorders, with back pain as the predominant cause [1]
Summary
Factors at work as well as fear–avoidance beliefs may influence sick-leave in these patients. Neck and back disorders are common causes of pain and frequently lead to activity limitations and work absence. Back pain is a benign condition in most subjects, 10% are not able to resume work after 3 months [2,3]. These subjects are often referred to specialised health care and are responsible for up to 90% of medical and compensation costs attributable to low back pain (LBP) [2,3]. When trying to understand the nature of sickness absence, we need to look into the physical and psychosocial factors at work, in combination with the medical factors and the personal characteristics of each individual [6]
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