BACKGROUND: High rates of sickness absence is a challenge within the healthcare sector, highlighting the need for effective interventions. Despite this, limited research has been conducted on the impact of such interventions within the healthcare context. This study evaluates an intervention aimed at improving the work environment influences sickness absence rates in Norwegian hospital units. The intervention is a comprehensive framework for discovering and tailoring solutions to each units\' specific needs, with a focus on employee involvement and collaboration between leader, union representatives and safety delegates.
METHODS: We employed two methodological approaches. Method 1 involved using HR-registered sickness absence data to track changes in sickness absence across all intervention units and matched control groups over a three-year period. In Method 2, we used a pre- and post-survey design in 14 intervention units, focusing on employees\' job satisfaction and self-reported health.
RESULTS: The results of the intervention were mixed. There was a significant decrease in total sickness absence in the intervention units the first year after the intervention, and a significant decrease in long-term sickness absence both in the first and second year after the intervention, measured with HR registries. However, we did not see a significant larger decrease in total sickness absence in the intervention units compared to the control units and only partial support for a larger decrease in long-term absence in the intervention units. In the subsample of units that also participated in the survey, we observed significant improvements in employee job satisfaction post intervention.
CONCLUSIONS: There is a need for research on effective interventions to reduce sickness absence in the healthcare sector. \"Where the shoe pinches\" provides a potential methodological framework for reducing sickness absence by addressing challenges in the work environment, however with uncertain results. Further exploration is warranted to refine strategies for effectively managing sickness absence within healthcare organizations.

OBJECTIVE: Studies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of work-related factors and pain perceptions.
METHODS: Cross-sectional study.
METHODS: Belgian companies that are under supervision of IDEWE, an external service for prevention and protection at work.
METHODS: In total, 249 employees experiencing pain for at least 6 weeks were included and filled out an online survey.
RESULTS: Latent profile analysis was used to differentiate profiles of work-related factors (physical demands, workload, social support and autonomy) and pain perceptions (catastrophising, fear-avoidance beliefs and pain acceptance). Subsequently, profiles were compared on sociodemographics (age, gender, level of education, work arrangement, duration of complaints, multisite pain and sickness absence in the previous year) and predictors of sickness absence (behavioural intention and perceived behavioural control).
RESULTS: Four profiles were identified. Profile 1 (38.2%) had favourable scores and profile 4 (14.9%) unfavourable scores across all indicators. Profile 2 (33.3%) had relatively high physical demands, moderate autonomy levels and favourable scores on the other indicators. Profile 3 (13.7%) showed relatively low physical demands, moderate autonomy levels, but unfavourable scores on the other indicators. Predictors of profiles were age (OR 0.93 and 95% CI (0.89 to 0.98)), level of education (OR 0.28 and 95% CI (0.1 to 0.79)) and duration of sickness absence in the previous year (OR 2.29 and 95% CI (0.89 to 5.88)). Significant differences were observed in behavioural intention (χ2=8.92, p=0.030) and perceived behavioural control (χ2=12.37, p=0.006) across the four profiles.
CONCLUSIONS: This study highlights the significance of considering the interplay between work-related factors and pain perceptions in employees. Unfavourable scores on a single work factor might not translate into maladaptive pain perceptions or subsequent sickness absence, if mitigating factors are in place. Special attention must be devoted to employees dealing with unfavourable working conditions along with maladaptive pain perceptions. In this context, social support emerges as an important factor influencing sickness absence.

UNASSIGNED: Police activity exposes the workers to several conditions that can cause physical and mental health problems, leading to sickness absenteeism.
UNASSIGNED: To describe the reasons for sickness absenteeism in Federal Highway Patrol Officers in the state of Rio Grande do Sul, Brazil.
UNASSIGNED: We used secondary data from official records of sickness absenteeism of Federal Highway Patrol Officers in Rio Grande do Sul. Sickness absenteeism was classified according to the International Classification of Diseases - 10th Revision. The variables analyzed were: reasons for sickness absenteeism, by code and category of the International Classification of Diseases - 10th Revision, and days absent from work by International Classification of Diseases - 10th Revision code. Descriptive data were reported using frequency distribution and measures of central tendency and dispersion. We used the Kruskal-Wallis test to compare the days absent from work between the International Classification of Diseases - 10th Revision codes.
UNASSIGNED: The most common reason for sickness absenteeism was diseases of the musculoskeletal system and connective tissue (24.6%). Mental and behavioral disorders were associated with the highest number of days absent from work (32.6 ± 19.9 days). Within the most prevalent disease groups, depressive disorders (30%), fractures (30%), and low back pain (15.9%) were the disease categories with the highest frequencies.
UNASSIGNED: Sickness absenteeism among Federal Highway Patrol Officers is predominantly related to diseases of the musculoskeletal system and connective tissue, and prolonged sick leave is due mainly to mental and behavioral disorders. Therefore, this police organization needs to promote and implement prevention programs to manage the main morbidities.
UNASSIGNED: A atividade policial expõe seus trabalhadores a diversas condições que podem ocasionar problemas de saúde tanto físicos quanto mentais e consequente absenteísmo do profissional.
UNASSIGNED: Descrever os motivos de absenteísmo-doença em agentes da Polícia Rodoviária Federal do Rio Grande do Sul.
UNASSIGNED: Utilizamos dados secundários de registros oficiais de absenteísmo do trabalho de agentes da Polícia Rodoviária Federal do Rio Grande do Sul. Os absenteísmos-doença foram classificados conforme a Classificação Internacional de Doenças - 10ª Revisão. As variáveis analisadas foram: motivos de absenteísmo-doença, por grupo e categoria da Classificação Internacional de Doenças - 10ª Revisão e dias de afastamento por grupo da Classificação Internacional de Doenças - 10ª Revisão. Dados descritivos foram reportados através de distribuição de frequências e de tendência central e dispersão. Utilizamos o teste de Kruskall-Wallis para comparação dos dias de afastamento entre os grupos de Classificação Internacional de Doenças - 10ª Revisão.
UNASSIGNED: A maior prevalência de afastamentos foi por doenças do sistema osteomuscular e do tecido conjuntivo (24,6%). O grupo de doenças dos transtornos mentais e de comportamento foi o que apresentou maior número de dias de afastamento (32,6 ± 19,9 dias). Entre os grupos mais prevalentes, transtornos depressivos (30%), fraturas (30%) e dor lombar (15,9%) foram as categorias de doença que apresentaram maiores frequências.
UNASSIGNED: O absenteísmo-doença entre os agentes da Polícia Rodoviária Federal predomina por doenças do sistema osteomuscular e do tecido conjuntivo, bem como possui elevada duração por transtornos mentais e de comportamento. Assim, existe uma necessidade dessa organização policial de promover a prevenção e implementação de programas de gerenciamento dessas principais morbidades.

OBJECTIVE: To assess the potential impact of targeted therapies for psoriatic arthritis (PsA) on symptomatic treatments (non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, opioid analgesics), methotrexate and mood disorder treatments and on hospitalisation and sick leave.
METHODS: Using the French health insurance database, this nationwide cohort study included adults with PsA who were new users (not in the year before the index date) of targeted therapies for ≥9 months during 2015-2021. Main endpoints were difference in proportion of users of associated treatments, hospitalisations and sick leaves between 3 and 9 months after and 6 months before targeted therapy initiation. Logistic regression models adjusted for sex, age, psoriasis, inflammatory bowel disease and Charlson Comorbidity Index compared the impact of biologics initiation (tumour necrosis factor inhibitor (TNFi)/interleukin 17 inhibitor (IL17i)/IL12/23i) on associated treatment discontinuation.
RESULTS: Among 9793 patients initiating targeted therapy for PsA (mean age: 51±13 years, 47% men), 62% initiated TNFi, 14% IL17i, 10% IL12/23i, 1% Janus kinase inhibitor, 12% phosphodiesterase-4 inhibitor. After treatment initiation, the proportion of treatment users was significantly reduced for NSAIDs (-15%), opioid analgesics (-9%), prednisone (-9%), methotrexate (-15%) and mood disorder treatments (-2%), along with decreased hospitalisations (-12%) and sick leaves (-4%). TNFi had a greater sparing effect on NSAIDs and prednisone use than IL17i (ORa=1.04, 95% CI=1.01 to 1.07; 1.04, 1.02 to 1.06) and IL12/23i (1.07, 1.04 to 1.10; 1.06, 1.04 to 1.09). Odds of methotrexate discontinuation was reduced with TNFi versus IL17i (0.96, 0.94 to 0.98) and IL12/23i (0.94, 0.92 to 0.97).
CONCLUSIONS: Targeted therapy initiation for PsA reduced the use of associated treatment and healthcare, with TNFi having a slightly greater effect than IL17i and IL12/23i, except for methotrexate discontinuation.

OBJECTIVE: To explore frontline employees\' experiences of how to create a purposeful sick leave and rehabilitation process (SRP) with the best interest of patients\' long-term health in focus.
METHODS: Qualitative design based on focus group interviews in a primary care context in Region Västra Götaland, Sweden. Strategically selected professionals from different SRP organizations discussed sick leave outcomes and the rehabilitation process. Analysis was performed with Systematic text condensation.
METHODS: General practitioners (n = 6), rehabilitation coordinators and/or healthcare professionals from primary healthcare (n = 13), caseworkers from the Social Insurance Agency, the Employment Agency, and Social Services (n = 12).
RESULTS: The outcome of the SRP was described to depend upon the extent to which the process meets patients\' bio-psycho-social needs. Aspects considered crucial were: 1) early bio-psycho-social assessments, including medical specialist consultations when needed, 2) long-term realistic planning of sick leave and rehabilitation alongside medical treatment, 3) access to a wide range of early rehabilitative and supportive interventions, including situation-based, non-medical practical problem solving, and 4) trusting relationships over time for all involved professions and roles to maximize process quality and person-centeredness. A gap between the desired scope of the SRP and existing guidelines was identified.
CONCLUSIONS: Interviewees perceived that successful outcomes from the sick leave and rehabilitation process in a primary care context depend on consensus, person-centeredness, and relationship continuity for all involved professions. An extended process scope and relationship continuity for all involved professionals were suggested to improve process outcomes.

UNASSIGNED: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women.
UNASSIGNED: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline.
UNASSIGNED: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure.
UNASSIGNED: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity.
UNASSIGNED: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment.
UNASSIGNED: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.
About 75% of around 500 middle-aged women reported mental stress in 2016/17. Low decision latitude and conflicts at work predicted incident sick leave independent of general mental stress and previous periods of sick leave. Efforts to improve the work environment may be essential for interventions aiming to reduce absenteeism among working women.

OBJECTIVE: Several predictors have been identified for mental sickness absence, but those for recurrences are not well-understood. This study assesses recurrence rates for long-term mental sickness absence (LTMSA) within subgroups of common mental disorders (CMDs) and identifies predictors of recurrent LTMSA.
METHODS: This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan-Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors.
RESULTS: 15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure.
CONCLUSIONS: Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.

OBJECTIVE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our centre and to investigate factors that might delay return to work following this surgery.
METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability.
RESULTS: A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not.
CONCLUSIONS: Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.

BACKGROUND: Stress-induced exhaustion disorder (SED) is the most common reason for long-term sick leave in Sweden and the recovery process may be long and troublesome. This study explores the symptoms of burnout, depression and anxiety among patients with SED 10 years after termination of a multimodal rehabilitation program. Another aim of the study was to investigate work situation, work functioning, and any remaining exhaustion and sleeping disorders among those who were gainfully employed at the 10-year follow-up.
METHODS: This longitudinal study included 107 patients (91 women and 16 men), who had been diagnosed with SED 10 years prior to the study. After establishing the diagnosis they all underwent and completed an multimodal rehabilitation program. Data on symptoms of burnout, anxiety and depression were collected before and after the multimodal rehabilitation program, and at follow-ups after additional 1 year and an additional 10 years. At the 10-year follow-up, work situation, work functioning, and symptoms of exhaustion and sleep disorders were assessed in those who were gainfully employed (89 patients).
RESULTS: Symptoms of burnout, anxiety, and depression remained stable from the 1- to the 10-year follow-up after completed rehabilitation. Among participants who were gainfully employed, 73% had changed workplaces, and 31.5% had reduced their working hours. Common reasons for these changes were lack of energy or because they had chosen to prioritise their lives differently. Work functioning was rated as moderate, one third self-reported SED to some extent, and one fifth reported moderate-to-severe insomnia.
CONCLUSIONS: A relatively large proportion of former patients with SED have residual health problems 10 years after rehabilitation and some have not been able to return to full-time work. Preventive and early rehabilitative interventions with adjustments and measures at the organisational level are probably needed to achieve a more sustainable working life.

BACKGROUND: Depression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work.
METHODS: The sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses.
RESULTS: A total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS.
CONCLUSIONS: The sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited.
CONCLUSIONS: People with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.