Factors Affecting Return To Work After Injury Or Illness: Best Evidence Synthesis of Systematic Reviews
SOURCE: Chiropractic & Manual Therapies 2016 (Sep 8)
Carol Cancelliere, James Donovan,
Mette Jensen Stochkendahl, Melissa Biscardi,
Carlo Ammendolia, Corrie Myburgh and J. David Cassidy
Institute of Health Policy,
Management and Evaluation,
Dalla Lana School of Public Health,
University of Toronto,
Toronto, Ontario Canada
BACKGROUND: Work disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research.
OBJECTIVES: To identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes.
METHODS: Medline, 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.
RESULTS: Of 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.
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