Assessing the work-role quality and its significance in predicting return to work

Non-medical factors such as age, years of schooling, and job satisfaction play an important role in determining whether patients resume their work after rehabilitation treatment. One element is the way the work situation is perceived by the patient. Usually, aspects of strain or job concerns are assessed. But employment does also include positive and rewarding aspects, though, such as meaning or social contact. According to the concept of work-role quality, theoretically these are independent constructs: someone may perceive job concerns and job rewards at the same time. In this study a short questionnaire (FRQ-B), broadly adapted from Barnett, Davidson and Marshall (1991), measuring job concerns and job rewards was developed and administered to a sample of cardiac rehabilitation patients. Psychometric analysis shows the factorial validity, consistency and construct validity of the instrument. Prediction of the return to work status three months after discharge from rehabilitation could be achieved on the item and subscale level. The effect sizes were comparable to other significant variables (e. g. psychological status, NYHA-status, wish to work). Specificities vary from 30 to 60 percent. The best predictor seems to be the Fear Avoidance Belief Questionnaire (FABQ), assuming a causal relationship be-tween work and illness. An analysis of subgroups using the FRQ-B reveals patients who experience little job rewards as well as many job concerns as a group with a high risk of not returning to work. The results of this study demonstrate the importance of assessing work related variables when dealing with return to work after rehabilitation treatment. Interventions to change the perception of the working place situation should be initialized and focussed early in rehabilitation treatment. The need for further research integrating the concept of work-role quality is discussed.