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Observational Study
. 2023 Jul 18;18(7):e0288751.
doi: 10.1371/journal.pone.0288751. eCollection 2023.

Work-related stress, reason for consultation and diagnosis-specific sick leave: How do they add up?

Anna-Maria Hultén  1 , Kristina Holmgren  1 , Pernilla Bjerkeli  2
Affiliations
Observational Study

Work-related stress, reason for consultation and diagnosis-specific sick leave: How do they add up?

Anna-Maria Hultén et al. PLoS One. .

Abstract

Work-related stress is common in Western society and disorders associated with stress are often managed in primary health care. This study was set to increase the understanding of the relationship between reason for consultation, work-related stress and diagnosis-specific sick leave for primary health care patients. The longitudinal observational study included 232 employed non-sick listed patients at seven primary health care centres in Sweden. Of these patients, 102 reported high work-related stress, as measured with the Work Stress Questionnaire, and 84 were on registered sick leave within one year after inclusion. The study showed that, compared to those who did not report high work-related stress, highly stressed patients more often sought care for mental symptoms (60/102 versus 24/130), sleep disturbance (37/102 versus 22/130) and fatigue (41/102 versus 34/130). The risk for sick leave with a mental diagnosis within a year after base-line was higher among patients reporting high work-related stress than among those who did not (RR 2.97, 95% CI 1.59;5.55). No such association was however found for the risk of sick leave with a musculoskeletal diagnosis (RR 0.55, 95% CI 0.22;1.37). Seeking care for mental symptoms, sleep disturbance and fatigue were associated with having a future mental sick leave diagnosis (p-values < 0.001), while seeking care for musculoskeletal symptoms was associated with having a future musculoskeletal sick leave diagnosis (p-value 0.009). In summary, compared to those who did not report high work-related stress, patients with high work-related stress more often sought care for mental symptoms, sleep disturbance and fatigue which lead to a mental sick leave diagnosis. Reporting high work-related stress was, however, not linked to having sought care for musculoskeletal symptoms nor future sick leave due to a musculoskeletal diagnosis. Hence, both patients and general practitioners seem to characterize work-related stress as a mental complaint.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Summary of the four associations and the related research questions (RQ 1–4).
Number 1–3 describe the bivariate associations, while number 4 includes all three variables (work-related stress, reason for consultation and diagnosis-specific sick leave).
Fig 2
Fig 2. Frequency of mental diagnoses for patients seeking care for mental or others reasons.
Separate graphs for patients perceiving high versus low work-related stress.
Fig 3
Fig 3. Frequency of musculoskeletal diagnoses for patients seeking care for musculoskeletal or other reasons with separate graphs for patients perceiving high versus low work-related stress.
Fig 4
Fig 4. Summary of the study findings for the three variables work-related stress, reason for consultation and diagnosis-specific sick leave.
The text boxes describe the main results for the associations marked with arrows.
See this image and copyright information in PMC

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