title: A prospective study of return to work across health conditions: perceived work attitude, self-efficacy and perceived social support.
abstract: BACKGROUND
  The aim of the present study was to conduct subgroup-analyses in a prospective cohort of workers on long-term sickness absence to investigate whether associations between perceived work attitude, self-efficacy and perceived social support and time to RTW differ across different health conditions.
  
  
  METHODS
  The study was based on a sample of 926 workers on sickness absence (6-12 weeks). The participants filled out a baseline questionnaire and were subsequently followed until the tenth month after listing sick. Perceived work attitude was measured with a Dutch language version of the Work Involvement Scale. Perceived social support was measured with a self-constructed standardized scale reflecting a person's perception of social support regarding RTW. Self-efficacy was measured with the standardised Dutch version of the General self-efficacy scale, assessing the subjects' expectations of their general capacities. The sample was divided into three subgroups: musculoskeletal health conditions, other physical health conditions and mental health conditions. Anova analyses and Cox proportional hazards regression analyses were used to identify differences in association between the three factors and the time to RTW between different subgroups.
  
  
  RESULTS
  The associations between the perceived work attitude, self-efficacy and perceived social support and the time to RTW vary across different health condition subgroups, not only with regard to the strength of the association but also for the type of factor. In the multivariate model, hazard ratios (HRs) of 1.33 (95% CI 1.01-1.75) in the musculoskeletal subgroup, and 1.26 (95% CI 0.89-1.78) in the other physical subgroup were found in perceived work attitude. With regard to perceived social support HRs of 1.39 (95% CI 1.12-1.99) respectively 1.51 (1.05-2.17) in the same subgroups were found. Only self-efficacy remained in the multivariate model in all subgroups with HRs of 1.49 (95% CI 1.12-1.99) in the musculoskeletal subgroup, 1.53 (95% CI 1.07-2.18) in the other physical subgroup and 1.60 (1.07-2.40) in the mental subgroup.
  
  
  CONCLUSIONS
  The results of this study show that perceived work attitude, self-efficacy and perceived social support are relevant predictors with regard to the time to RTW in all types of health conditions, but that important differences are observed in type of factor and strengths of the relationships between physical and mental health conditions.
authors.affiliation: Department of Health Sciences, Section of Social Medicine, Work & Health, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Building 3217, Room 620, Groningen, The Netherlands. sandra.brouwer@med.umcg.nl
authors.forename: Sandra
authors.initials: S
authors.lastname: Brouwer
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Reneman
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
authors.forename: Jac J L
authors.initials: JJ
authors.lastname: van der Klink
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D009140:Musculoskeletal Diseases / Q000534:rehabilitation; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011594:Psychometrics; D020377:Self Efficacy; D018582:Sick Leave; D012938:Social Perception; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors; D014937:Work; D014938:Work Capacity Evaluation; D055815:Young Adult