Experience of Health Complaints and Help Seeking Behavior in Employees Screened for Depressive Complaints and Risk of Future Sickness Absence

Introduction The aim of this study was to examine the associations between on the one hand depressive complaints and risk of future sickness absence and on the other hand experience of health complaints and help seeking behavior in the working population. Methods Cross-sectional data were used from employees working in the banking sector (n = 8,498). The screening instrument included measures to examine the risk of future sickness absence, depressive complaints and help seeking behavior. Results Of employees reporting health complaints, approximately 80% had already sought help for these complaints. Experience of health complaints and subsequent help seeking behavior differed between employees with mild to severe depressive complaints and employees at risk of future sickness absence. Experience of health complaints was highest in employees identified with both concepts (69%) compared with employees identified at risk of future sickness absence only (48%) and with mild to severe depressive complaints only (57%). In those employees identified with one or both concepts and who had not sought help already, intention to seek help was about 50%. Conclusions From a screening perspective, employees who do not experience health complaints or who do not have the intention to seek help may refuse participation in early intervention. This might be a bottleneck in the implementation of preventive interventions in the occupational health setting.     

Sickness Absence Among Railway Clerical Staff

This paper examines in detail the sickness absence experience within one well-defined railway occupation, identified in a previous paper for further study, namely clerks. The clerks consist of three hierarchical grades. The differences between them are described. The measures of sickness absence are identical with those of the previous communication. A gradient of sickness experience between the three grades is demonstrated. This occurs in inverse relation to the amount of responsibility associated with the posts. The gradient is accounted for by a small number of diagnostic categories. The implication of this is discussed. Comparisons are made with a similar population in London Transport and the results discussed. It is concluded that psychological factors might provide some explanation of the striking differences in sickness experience operating within one sub-class of the Registrar General's classification (IIIc) and within a limited salary scale.     

Structured Early Consultation with the Occupational Physician Reduces Sickness Absence Among Office Workers at High Risk for Long-Term Sickness Absence: a Randomized Controlled Trial

Objective To examine the efficacy of structured early consultation among employees at high risk for future long-term sickness absence, in the prevention and/or reduction of sickness absence. The focus of the experiment was the timing of the intervention, that is, treatment before sickness absence actually occurs. Methods In the current prospective randomized controlled trial (RCT), employees at high risk for long-term sickness absence were selected based on responses to a 34-item screening questionnaire including demographic, workplace, health and psychosocial factors associated with long-term sickness absence (>28 days). A total of 299 subjects at risk for future long-term sickness absence were randomized in an experimental group (n = 147) or in a control group (n = 152). Subjects in the experimental group received a structured early consult with their occupational physician (OP), in some cases followed by targeted intervention. The control group received care as usual. Sickness absence was assessed objectively through record linkage with the company registers on sickness absence over a 1 year follow-up period. Results Modified intention-to-treat analysis revealed substantial and statistically significant differences (p = 0.007) in total sickness absence duration over 1 year follow-up between the experimental (mean 18.98; SD 29.50) and control group (mean 31.13; SD 55.47). Per-protocol analysis additionally showed that the proportion of long-term sickness absence spells (>28 days) over 1 year follow-up was significantly (p = 0.048) lower in the experimental (9.1%) versus control group (18.3%). Conclusions Structured early consultation with the OP among employees at high risk for future long-term sickness absence is successful in reducing total sickness absence.     

Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review

Purpose To present an overview of the existing evidence on prognostic factors of (recurrent) sickness absence (SA) and return to work (RTW) among workers with a common mental disorder (CMD). This scoping review provides information about determinants for SA and RTW, which could be used to develop better interventions aimed at the prevention of SA and promotion of RTW among workers with a CMD. Methods Relevant articles were identified in PubMed, Embase, PsycINFO, PSYNDEX, and SINGLE up to October 2016. In order to be included, studies should provide insight into prognostic factors of SA or RTW of workers with a CMD. We classified all factors according to the domains of the International Classification of Functioning, Disability and Health. Results Our searches identified 2447 possible relevant articles, of which 71 were included for data extraction. There is consistent evidence in ≥3 studies that previous episodes of CMD, higher symptom severity, previous absenteeism, co-morbidity, high job demands, low job control, high job strain, female gender, lower educational level, smoking behavior, and low perceived general health are predictors of SA in people with CMDs. Earlier RTW is consistently predicted by lower symptom severity, having no previous absenteeism, younger age, and positive expectations concerning sick-leave duration or RTW. Conclusions The amount of research on determinants for SA and RTW in workers with CMD has increased dramatically in recent years, although most studies are from the Netherlands and Scandinavia. There are some research gaps identified in this scoping review that need further attention in primary and secondary studies. Based on the summary of the evidence, we provide guidance for policy, practice and research.     

Experiences of Work and Sickness Absence in Employees with Depression: An Interpretative Phenomenological Analysis

Purpose: The experience of employment with depression is explored to develop understanding of the mediators that may influence the management of depression-related sickness absence and improve theoretical understanding. Method: Data were collected from seven semi-structured interviews and Interpretative Phenomenological Analysis used to explore the data. Results: Three interrelated themes were drawn from the participants’ accounts: (1) the interaction between depression and work; (2) illness beliefs; and (3) organisational context and depression. The analysis revealed that participants appeared to hold five key perceptions about their depression and work: low control in the workplace; lack of line manager support; diminishing ability to work; the need to address depressive symptoms; and perceptions of depression. Their strength resulted in individuals reaching sickness absence thresholds. The themes and participants’ accounts of their work and sickness absence and return to work behaviour are discussed in relation to relevant theory and evidence to understand how these perceptions and beliefs mediate behaviour. Conclusion: Individuals’ health (illness representations) and work beliefs (outcome expectancies and self-efficacy for work tasks and management of health at work) appear to influence individuals’ sickness absence decisions and experiences and these are mediated by individuals’ experiences of organisational policies, line manager support and the messages and actions of GPs.     

Work Characteristics and Return to Work in Long-Term Sick-Listed Employees with Depressive Symptoms

Purpose The present study investigated the relations between work characteristics, depressive symptoms and duration until full return to work (RTW) among long-term sick-listed employees. This knowledge may add to the development of effective interventions and prevention, especially since work characteristics can be subjected to interventions more easily than many disorder-related or personal factors. Methods this prospective cohort study with a two-year follow-up employs a sample of 883 Dutch employees who had been sick-listed for at least 13 weeks at baseline, who filled out three questionnaires: at 19 weeks, 1 and 2 years after the start of sick leave. The dependent measure was duration until full RTW. Results not working (partially) at baseline, low decision authority, high psychological demands, low supervisor support and low RTW self-efficacy were related to more depressive symptoms. The duration until full RTW was longer for employees with depressive symptoms. Low physical exertion, high RTW self-efficacy, working partially at baseline, being married or cohabiting, and young age were related to less time until full RTW. Other work characteristics appeared no independent predictors of RTW. Conclusions although the role of job demands and job resources in the RTW process is limited for long-term sick-listed employees with depressive symptoms, a few work characteristics are prognostic factors of full RTW. Focus on these elements in the selection or development of interventions may be helpful in preventing sickness absence, and in supporting long-term sick-listed employees towards full RTW.     

体力与脑力劳动者伤病缺勤及影响因素的对比研究

[目的]比较体力与脑力劳动者因伤病导致缺勤的情况,探讨危险因素,为预防伤病减少缺勤提供依据。[方法]随机整群抽样法选择3896名体力劳动者与2719名脑力劳动者,调查其伤病缺勤及影响因素。[结果]体力劳动者年均缺勤天数（5.4d）比脑力劳动者（20.8d）低,体力劳动者随年龄增高而增加。体力劳动者的年缺勤率（24.0%）比脑力劳动者（65.6%）低。logistic回归分析结果,性别和教育程度是影响体力劳动者伤病缺勤的背景因素,急性胃肠炎、恶性肿瘤、泌尿系感染等是导致缺勤的主要伤病;而婚姻状况、教育程度和年龄是影响脑力劳动者伤病缺勤的背景因素,肥胖、上呼吸道感染和糖尿病等是引起缺勤的主要疾病。[结论]导致体力与脑力劳动者缺勤的主要伤病存在差异,应根据不同劳动类型制定相应措施,预防疾病,减少缺勤。     

Long-Term Effects of Chronic Depressive Symptoms Among Low-Income Childrearing Mothers

Objectives: Longitudinal studies of maternal depression in the postpartum period have demonstrated that a chronic state of depressive symptoms is not rare. In spite of this, however, the characteristics of chronically depressed mothers have rarely been studied. This study examines the demographic and socioenvironmental characteristics across time of childrearing women with chronic depressive symptoms. Methods: A cohort of 476 childrearing lower-income mothers was interviewed from the first trimester of pregnancy through the tenth year postpartum. The Center for Epidemiologic Studies-Depression Scale (CES-D; Radloff, L. (1977) Appl Psychol Meas 1:385–401) was used to define depressive symptomatology. Four groups were defined based on the CES-D scores at 18 months, 3, 6 and 10 years: never-depressed (CES-D < 16), depressed only at one phase (CES-D ≥ 16), chronically mildly depressed (CES-D > 16 and ≤24 at three or more phases), and chronically severely depressed (CES-D ≥ 25 at three or more times). Demographic and socioenvironmental characteristics of the groups were evaluated across time. Results: Chronically depressed women compared to never-depressed women were less likely to be married, had less education, had lower family income, and were more likely to use substances. They reported more frequent arguments with close family members or friends, separation/divorce with partners, financial problems, less social support, and more financial strain. Conclusions: Women who continue to be depressed across the 10 postpartum years have less optimal outcomes compared to women who are not depressed and those who are only intermittently depressed. Pregnancy and delivery and subsequent pediatric visits are important times to identify women who are depressed.     

Sickness Absence Among Forestry Workers in the North of Scotland, 1958

The sickness absence records of 1,115 forest workers in the highlands of Scotland during 1958 were examined. Only absences of four days or more were considered. Two hundred and seventy of the workers were established and were therefore entitled to retirement pensions. There was a high proportion of older men among the established workers; but the sickness record of these men was generally better than that of the unestablished workers except in respect of cardiovascular disease, rheumatism, and arthritis.

Among forest workers as a whole, accidents off duty accounted for more sickness absence than accidents on duty, a reversal of the finding in the male working population at large. The second most important cause of sickness absence was back troubles of all kinds. Among the male working population at large the second most important cause of absence was bronchitis, a disease which among forest workers comes 13th on the list.

A comparison was made between the sickness absence record of the highland forest workers and a group of telephone construction gang hands performing broadly comparable work (as regards health hazards) in the same area but whose members were drawn from more urban homes. In general fewer forest workers than telephone gang hands went sick in 1958 for all common ailments except cardiovascular disease, a finding perhaps related to the greater average age of forest workers. When this difference in age was allowed for it was found that the greatest difference between the two groups of sickness records was in bronchitis, cardiovascular disease, and peptic ulcer and gastritis, in that order, and was to the advantage of the forest workers. Next came the upper respiratory tract infections. The least difference was in accidents, septic conditions, and rheumatism and arthritis.

     

Sickness-Related Absence Among Employees at a Tertiary Care Center in Lebanon

The authors studied the rate of sickness-related absence of employees at a tertiary care center. They examined sickness-related absence records of employees, including nurses, food service workers, housekeeping, and security personnel, in a university teaching hospital in Lebanon over a period of 1 year. These departments included 1,010 employees, of which 47% took sickness absences during the study period. In all, 49.02% of the nursing employees, 43.67% of the food service workers, 37.79% of the housekeeping employees, and 47.5% of the protection/security workers took sickness-related absences. Employees in younger age groups took the majority of sicknessrelated absences; in general, these constituted short-duration sickness-related absences (relative to those taken by emploees in older age groups; dietary personnel were the exception to this pattern). Principal causes of sickness-related absences were respiratory illness and musculoskeletal problems. The authors observed that distribution of sickness-related absences among the departments studied was similar to the actual distribution of employees. They considered reasons for sicknessrelated absences as pertinent to each category.     

Prediction of Sickness Absence in Patients with Chronic Low Back Pain: A Systematic Review

OBJECTIVES: To provide evidence of predictors for sickness absence in patients with non-specific chronic low back pain (CLBP), distinguishing predictors aimed at the decision to report sick (absence threshold) and decision to return to work (return to work threshold). METHODS: Medical and psychological databases were searched, as well as citations from relevant reviews. In- and exclusion criteria were applied. Two reviewers assessed the methodological quality of the papers independently. RESULTS: Many different predictors were studied, and few factors were studied more than once. Consistent evidence was found for own expectations of recovery only as predictor for the decision to return to work. Patients with higher expectations had less sickness absence at the moment of follow-up measurement. As expected, different predictors were found aiming at the absence threshold or the return to work threshold. Furthermore, predictors varied also with the measurement instruments used, timing of follow-up measurements, and definition of outcomes. Until now, too few studies are available to overcome several potential sources of heterogeneity. CONCLUSIONS: No core set of predictors exists for sickness absence in general. The characteristics of the study including the decision to report sick or to return to work determined the influence of several predictors on sickness absence in patients with CLBP. Further research and use of a core set of measurements and uniform definitions are needed to predict sickness absence and return to work in patients with CLBP.     

Factors Related to Depressive Symptoms Among Long-Term Survivors of Cervical Cancer

In this article we describe depressive symptoms among survivors of cervical cancer. Study participants were previously diagnosed and treated with cervical cancer 5 to 25 years prior to the completion of a telephone survey. Through a population-based survey of women identified via a state tumor registry in southern New England, the investigators learned that depressive symptoms are prevalent among a subgroup of long-term survivors long after diagnosis and treatment. The at-risk participants included those who were at a lower economic status and whose marital status and ability to work had changed, and who continued to experience pain and diarrhea caused by radiotherapy. Findings from this study warrant additional research with this potentially vulnerable group of women.     

Personal Factors Associated with Sickness Absence: A Study of 194 Men with Contrasting Sickness Absence Experience in a Refinery Population

Men with different patterns of sickness absence behaviour have been identified from a refinery population by simple epidemiological techniques. A detailed clinical study is described of four groups: 56 men with five or more sickness spells in 1964 and a matched control of 56 men; 35 men who had 60 or more days of sickness absence in 1964; and finally 47 men who had not had one day off sick for at least eight years.

Whereas the men who were frequently sick tended to be younger and mostly on day work, those with long periods of sickness were reasonably representative of the whole population, and the men without any sickness absence were older and mostly on shift work. An analysis of records both before and since 1964 showed that the groups had maintained a consistent pattern of sickness absence, but when individuals were considered their behaviour was less consistent. Nevertheless there appeared to be states of sickness absence `liability' and also `resistance' which persisted for a variable length of time from a year or two up to many years.

The pre-employment medical examination proved in retrospect to have been of little predictive value. Absenteeism, lateness, and also occupational injuries were all strongly associated with sickness spells, although the level of overtime was not. Previous episodes of neurotic illness, peptic ulceration, and loss of work due to back pain were also associated with frequent sickness spells, so also were frequent colds and troublesome constipation. An unexpected finding from the physical examination was that over one quarter of those who were never sick had some organic disease.

Although neither the social nor economic circumstances differed between the groups, the attitude of the men towards themselves and their work proved to be of major importance. A memory of an unhappy childhood was more common in both groups with a lot of sickness absence, whilst dislike of the job or frustrated ambition was common in men with frequent spells. Those who were never sick denied all such problems as they denied illness. Personality testing revealed that extroversion was more marked in the frequently sick group, neuroticism in the long sick, and introversion in the never sick.

The validity and significance of the results are discussed and suggestions are made for further investigation.

     

Recurrence of Medically Certified Sickness Absence According to Diagnosis: A Sickness Absence Register Study

Introduction Sickness absence is a major public health problem. Research on sickness absence focuses on interventions aimed at expediting return to work. However, we need to know more about sustaining employees at work after return to work. Therefore, this study investigated the recurrence of sickness absence according to diagnosis. Methods We analyzed the registered sickness absence data of 137,172 employees working for the Dutch Post and Telecom. Episodes of sickness absence were medically certified, according to the ICD-10 classification of diseases, by an occupational physician. The incidence density (ID) and recurrence density (RD) of medically certified absences were calculated per 1,000 person-years in each ICD-10 category. Results Sickness absence due to musculoskeletal disorders had the highest recurrence (RD = 118.7 per 1,000 person-years), followed by recurrence of sickness absence due to mental disorders (RD = 80.4 per 1,000 person-years). The median time to recurrent sickness absence due to musculoskeletal disorders was 409 days after the index episode. Recurrences of sickness absence due to musculoskeletal disorders accounted for 37% of the total number of recurrent sickness absence days. For recurrences of sickness absence due to mental disorders this was 328 days and 21%, respectively. Unskilled employees with a short duration (<5 years) of employment had a higher risk of recurrent sickness absence. Conclusions Interventions to expedite return to work of employees sick-listed due to musculoskeletal or mental disorders should also aim at reducing recurrence of sickness absence in order to sustain employees at work.     

Differences in Predictors of Return to Work Among Long-Term Sick-Listed Employees with Different Self-Reported Reasons for Sick Leave

Introduction The present study aimed to gain insight in the predictors of full return to work (RTW) among employees on long-term sick leave due to three different self-reported reasons for sick leave: physical, mental or co-morbid physical and mental problems. This knowledge can be used to develop diagnosis-specific interventions that promote earlier RTW. Methods This prospective cohort study with a two-year follow-up employs a sample of 682 Dutch employees, sick-listed for 19?weeks (SD?=?1.68), who filled out two questionnaires: at 19?weeks and 2?years after the start of sick leave. The dependent measure was duration until full RTW, the independent measures were cause of sick leave, health characteristics, individual characteristics and work characteristics. Results Reporting both physical and mental problems as reasons for sick leave was associated with a longer duration until full RTW. Nonparametric Cox survival analysis showed that partial RTW at baseline and lower age were strong predictors of earlier RTW in all three groups, and that RTW self-efficacy predicted earlier RTW in two groups. Other predictors of full RTW varied among groups. Conclusions Tailoring for different reasons for sick leave might improve the effects of new interventions because the predictors of full RTW differ among groups. Enhancement of partial RTW and RTW self-efficacy may be relevant components of any intervention, as these were predictors of full RTW in at least two groups.     

Patterns of Sickness Absence in a Railway Population

This investigation was carried out in order to obtain morbidity statistics in a large industrial population with special reference to the effects of ageing.

The population chosen, the “railway research population,” consisted of a sample of Scottish railwaymen, drawn from five of the eight areas in the Scottish Region of British Railways. Only certain occupational grades were studied.

Information was obtained over a period of one year by means of a detailed monthly return of (a) sickness absence data and (b) job changes. Indices of sickness absence were defined. The sickness absence experience of the railway research population was compared with that of other populations. It is a healthier group than the total insured population but differs in some respects from that of London Transport.

The nature of sickness absence within the railway research population was then studied. It was shown in all but one measure used that sickness tends to increase with age, the most important factor being the increase of long episodes. Examination of the frequency distribution of the duration of sickness episodes revealed that sickness absence tends to be taken in terms of weeks off rather than days off.

Analysis of the daily variation in sickness absence showed that the total absence rate increased from Monday to Friday. There was a well defined tendency for sickness to start on Mondays, and in longer episodes an additional tendency to start on Fridays. This was interpreted in terms of morale, both positive and negative.

Marked differences of the same order of magnitude as those due to age were noted in the sickness experience of the various grades, related to both conditions of work and responsibility.

The reasons for job changes were analysed and the grades to which men were transferred were identified. The choice of suitable grades for older workers was discussed.

It was concluded that working conditions might be important factors in the type of sickness absence experienced and that comparisons with other populations might be helpful in this context. More detailed work was also called for on the psychological as well as physical aspects of the work situation for both the individual and the grade.

     

The Effect of Medical Marijuana on Sickness Absence

Utilizing the Current Population Survey, the study identifies that absences due to sickness decline following the legalization of medical marijuana. The effect is stronger in states with ‘lax’ medical marijuana regulations, for full‐time workers, and for middle‐aged males, which is the group most likely to hold medical marijuana cards. Copyright © 2016 John Wiley & Sons, Ltd.