Self-efficacy beliefs predict sustained long-term sick absenteeism in individuals with chronic musculoskeletal pain

Abstract

Recovery beliefs are assumed to predict rehabilitation outcomes and return-to-work in various clinical conditions but are less frequently assessed in musculoskeletal disorders. We tested the hypothesis that recovery beliefs constitute a risk factor for sustained long-term sick absenteeism in men and women suffering from nonspecific chronic musculoskeletal disorders. A total of 233 subjects with a recent or ongoing experience of long-term sick leave were included in a prospective design. Subjects answered a postal baseline questionnaire and were followed up via register data for 1 year. Multivariate logistic regression analyses indicated that subjects with negative recovery beliefs (OR: 2.41; CI: 1.22-4.77), low sense of mastery (OR: 2.08; CI: 1.27-3.40), perceived high mental demands at work (OR: 1.77; CI: 1.05-2.99), and prior experiences of long-term sick absenteeism (OR: 1.86; CI: 1.02-3.37) had an increased probability of receiving sickness benefits at follow-up. We conclude that prolonged sickness absence contributes strongly to increase patients' sense of helplessness, lower self-efficacy, and hinder future work return. To improve work return, patients' maladaptive beliefs should be clarified and challenged early in the rehabilitation process.