Abstract
Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy, for women on long-term sick leave ≥ 1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either (1) a multidisciplinary team assessment and multimodal intervention (TEAM), (2) acceptance and commitment therapy (ACT), or (3) control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the intervention period, the women in the TEAM group’s self-efficacy mean increased from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed increased self-efficacy for those in the TEAM intervention at 12 months (B = 0.25, 95% CI 0.10–0.41). ACT intervention had no effect on self-efficacy at 12 months (B = 0.02, 95% CI − 0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B = 0.68, 95% CI 0.54–0.81). Conclusion A multidisciplinary team assessment and multimodal intervention increased self-efficacy in women on sick leave for an extremely long time (mean 7.8 years) who had a low mean level of self-efficacy prior to inclusion. Thus, self-efficacy needs to be addressed in vocational rehabilitation.
Highlights
Self-efficacy is a component of social cognitive theory, believed to operate through motivation, actions and thoughts
The team assessment and multimodal intervention (TEAM) intervention group increased in self-efficacy at 12 months (B = 0.23, 95% confidence intervals (CIs) 0.03–0.44), whereas the ACT intervention had no effect on self-efficacy at 12 months (B = 0.11, 95% CI − 0.12 to 0.34)
The women who participated in this study had been on sick leave for an extremely long time and had a low mean level of self-efficacy prior to inclusion
Summary
Self-efficacy is a component of social cognitive theory, believed to operate through motivation, actions and thoughts. The concept of self-efficacy was initially outlined by Albert Bandura and is described as being central to human behaviour. Self-efficacy can briefly be described as belief in one’s own ability to handle or perform a specific task or activity and is, related to an individual’s expectations of an outcome. Journal of Occupational Rehabilitation (2018) 28:691–700 low self-efficacy will not expect their actions to achieve much and will give up faster if difficulties arise, instead of facing them. According to Bandura, individuals with low self-efficacy needs interactive support and guidance to overcome these obstacles [2]. An individual’s self-efficacy influences the direction of their lives, there are other factors of influence [1]. One such factor may be sick leave, which has been shown to affect self-efficacy negatively [3, 4] and may prolong sick leave duration [5]
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