Prognostic Factors for Duration of Sickness Absence due to Musculoskeletal Disorders
Prognostic Factors for Duration of Sickness Absence due to Musculoskeletal Disorders
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肌肉骨骼疾病导致缺勤持续时间的预后因素
DOI：
10.1097/01.ajp.0000154047.30155.72
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
A. Burdorf
中科院分区：
文献类型：
--
作者：
F. Lötters;A. Burdorf
目的：本前瞻性队列研究随访1年，旨在确定因肌肉骨骼疾病而缺勤时间的预后因素。方法：工人包括因肌肉骨骼疾病而病假2至6周。采用自填式问卷收集个人和工作相关因素、疼痛、功能障碍和一般健康感知。使用考克斯比例风险回归进行统计分析，其中每个关注的风险因素的相互作用变量与时间。单变量和多变量分析进行了肌肉骨骼疾病，并分别为腰痛。结果：与长期病假相关的主要因素是年龄较大，性别，感知的体力劳动，颈部，肩部和上肢疾病，功能障碍，坐骨神经痛，工人自己的感知能力的返回工作，和慢性腰痛的投诉较差的一般健康。随着时间的推移，身体工作负荷高的工人恢复工作的速度比预期的要慢，而功能残疾程度高的工人恢复工作的速度越来越快。结论：高强度疼痛是疾病缺勤时间的主要预后因素，尤其是在腰痛中。长期病假的不同疾病特异性风险特征表明，在应用干预策略以早日重返工作岗位时，腰痛和上肢疾病需要不同的方法。感知的体力工作量与时间的相互作用表明，感知的体力工作量将越来越妨碍重返工作岗位，因此，支持需要工作场所的工人长期下班。
Objective:The purpose of this prospective cohort study with 1-year follow-up was to determine prognostic factors for duration of sickness absence due to musculoskeletal disorders. Methods:Workers were included when on sickness absence of 2 to 6 weeks due to musculoskeletal disorders. A self-administered questionnaire was used to collect personal and work-related factors, pain, functional disability, and general health perceptions. Statistical analysis was done with Cox proportional hazard regression with an interaction variable with time for every risk factor of interest. Univariate and multivariate analyses were performed on musculoskeletal disorders and, separately, for low back pain. Results:The main factors that were associated with longer sickness absence were older age, gender, perceived physical workload, and poorer general health for neck, shoulder and upper extremity disorders, and functional disability, sciatica, worker's own perception of the ability of return to work, and chronic complaints for low back pain. Workers with a high perceived physical work load returned to work increasingly slower over time than expected, whereas workers with a high functional disability returned to work increasingly faster over time. Conclusions:High pain intensity is a major prognostic factor for duration of sickness absence, especially in low back pain. The different disease-specific risk profiles for prolonged sickness absence indicate that low back pain and upper extremity disorders need different approaches when applying intervention strategies with the aim of early return to work. The interaction of perceived physical workload with time suggests that perceived physical workload would increasingly hamper return to work and, hence, supports the need for workplace interventions among workers off work for prolonged periods.