title: Long sick leave after orthopaedic inpatient rehabilitation: treatment failure or relapse?
abstract: We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission, discharge and 1-year follow-up. Outcome measures included disability, depression, self-efficacy, health status and attitudes towards work. Later short-term versus long-term sick leave was not significantly predicted by pretreatment and posttreatment scores. Surprisingly, both groups improved comparably during treatment. The long-term sick leave group deteriorated on most of the variables at follow-up, whereas the short-term sick leave group maintained the improvements. Rehabilitation interventions should not only focus on inpatient treatment but also on the follow-up interval to prevent relapses and maintain success reached during treatment.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Marburg, Germany. mangelsm@staff.uni-marburg.de
authors.forename: Marija
authors.initials: M
authors.lastname: Mangels
authors.forename: Susanne
authors.initials: S
authors.lastname: Schwarz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Worringen
authors.forename: Martin
authors.initials: M
authors.lastname: Holme
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
mesh_terms: D000328:Adult; D001290:Attitude; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D012008:Recurrence; D020377:Self Efficacy; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors; D017211:Treatment Failure