Kenneth Jay, Sannie Vester Thorsen, Emil Sundstrup, Ramon Aiguadé, Jose Casaña, Joaquin Calatayud, Lars Louis Andersen
{"title":"Fear Avoidance Beliefs and Risk of Long-Term Sickness Absence: Prospective Cohort Study among Workers with Musculoskeletal Pain.","authors":"Kenneth Jay, Sannie Vester Thorsen, Emil Sundstrup, Ramon Aiguadé, Jose Casaña, Joaquin Calatayud, Lars Louis Andersen","doi":"10.1155/2018/8347120","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>Musculoskeletal pain is common in the population. Negative beliefs about musculoskeletal pain and physical activity may lead to avoidance behavior resulting in absence from work. The present study investigates the influence of fear avoidance beliefs on long-term sickness absence.</p><p><strong>Methods: </strong>Workers of the general working population with musculoskeletal pain (low back, neck/shoulder, and/or arm/hand pain; n = 8319) from the Danish Work Environment Cohort Study were included. Long-term sickness absence data were obtained from the Danish Register for Evaluation and Marginalization (DREAM). Time-to-event analyses (cox regression) controlled for various confounders estimated the association between fear avoidance beliefs (very low, low, moderate [reference category], high, and very high) at baseline and long-term sickness absence (LTSA; ≥6 consecutive weeks) during a 2-year follow-up.</p><p><strong>Results: </strong>During the 2-year follow-up, 10.2% of the workers experienced long-term sickness absence. In the fully adjusted model, very high-level fear avoidance increased the risk of LTSA with hazard ratio (HR) of 1.48 (95% CI 1.15-1.90). Similar results were seen analyses stratified for occupational physical activity, i.e., sedentary workers (HR 1.72 (95% CI 1.04-2.83)) and physically active workers (HR 1.48 (95% CI 1.10-2.01)).</p><p><strong>Conclusion: </strong>A very high level of fear avoidance is a risk factor for long-term sickness absence among workers with musculoskeletal pain regardless of the level of occupational physical activity. Future interventions should target fear avoidance beliefs through information and campaigns about the benefits of staying active when having musculoskeletal pain.</p>","PeriodicalId":19786,"journal":{"name":"Pain Research and Treatment","volume":"2018 ","pages":"8347120"},"PeriodicalIF":0.0000,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8347120","citationCount":"12","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Research and Treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2018/8347120","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 12
Abstract
Background and objective: Musculoskeletal pain is common in the population. Negative beliefs about musculoskeletal pain and physical activity may lead to avoidance behavior resulting in absence from work. The present study investigates the influence of fear avoidance beliefs on long-term sickness absence.
Methods: Workers of the general working population with musculoskeletal pain (low back, neck/shoulder, and/or arm/hand pain; n = 8319) from the Danish Work Environment Cohort Study were included. Long-term sickness absence data were obtained from the Danish Register for Evaluation and Marginalization (DREAM). Time-to-event analyses (cox regression) controlled for various confounders estimated the association between fear avoidance beliefs (very low, low, moderate [reference category], high, and very high) at baseline and long-term sickness absence (LTSA; ≥6 consecutive weeks) during a 2-year follow-up.
Results: During the 2-year follow-up, 10.2% of the workers experienced long-term sickness absence. In the fully adjusted model, very high-level fear avoidance increased the risk of LTSA with hazard ratio (HR) of 1.48 (95% CI 1.15-1.90). Similar results were seen analyses stratified for occupational physical activity, i.e., sedentary workers (HR 1.72 (95% CI 1.04-2.83)) and physically active workers (HR 1.48 (95% CI 1.10-2.01)).
Conclusion: A very high level of fear avoidance is a risk factor for long-term sickness absence among workers with musculoskeletal pain regardless of the level of occupational physical activity. Future interventions should target fear avoidance beliefs through information and campaigns about the benefits of staying active when having musculoskeletal pain.
背景与目的:肌肉骨骼疼痛在人群中很常见。对肌肉骨骼疼痛和体力活动的消极看法可能导致回避行为,从而导致缺勤。本研究探讨了恐惧回避信念对长期疾病缺勤的影响。方法:有肌肉骨骼疼痛(腰背、颈/肩和/或手臂/手疼痛)的普通工人;来自丹麦工作环境队列研究的n = 8319)。长期疾病缺勤数据来自丹麦评估和边缘化登记册(DREAM)。控制各种混杂因素的事件时间分析(cox回归)估计了基线时恐惧回避信念(非常低、低、中等[参考类别]、高和非常高)与长期疾病缺勤(LTSA;≥连续6周),随访2年。结果:在2年的随访中,10.2%的员工经历了长期病假。在完全调整的模型中,非常高的恐惧回避增加了LTSA的风险,风险比(HR)为1.48 (95% CI 1.15-1.90)。对职业体力活动的分层分析也看到了类似的结果,即久坐工人(HR 1.72 (95% CI 1.04-2.83))和体力活动工人(HR 1.48 (95% CI 1.10-2.01))。结论:无论职业体力活动水平如何,高水平的恐惧回避是肌肉骨骼疼痛工人长期缺勤的一个危险因素。未来的干预措施应该针对恐惧避免信念,通过信息和运动,当有肌肉骨骼疼痛时保持运动的好处。