This cross-sectional study analyzed data from 243 primary healthcare patients involved in the LEARN-to-COPE trial across 40 centers in Region Västra Götaland, Sweden. The study aimed to identify characteristics of patients with long-term impaired work ability and explore the relationship between sense of coherence and various health-related factors. The average participant age was 47.4 years, with a majority being women from Nordic countries, most of whom had at least secondary education. A significant portion of the cohort was on full-time sick leave, with a mean of 1,215 sick days (SD 1,010). Participants reported severe anxiety, moderate depression, and high pain-related sick leave risk, alongside extremely low health-related quality of life. Approximately half of the participants had inadequate health literacy and low sense of coherence. Notably, sense of coherence was significantly correlated with health literacy, health-related quality of life, mental health symptoms, perceived work ability, and pain (p<0.001), but showed no correlation with the duration of sick leave or rehabilitation participation. The findings suggest that enhancing health-related quality of life should be a priority for these patients, highlighting the potential role of sense of coherence in managing long-term impaired work ability.
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This study involves patients who have trouble working due to health problems, often for a long time. Researchers gathered information from over 240 patients in Sweden who were on sick leave or unable to work because of health issues. They discovered that many of these patients were dealing with high levels of anxiety, exhaustion, and depression, and reported a very low quality of life. Many also struggled to understand health information, which can make managing their health harder. The findings suggest that improving the overall health and well-being of these patients should be a priority. However, the study also found that while some factors were linked to how patients felt about their health and work ability, they did not affect how long they had been on sick leave. This means that even with support, some patients may still face long-term challenges. Moving forward, it will be important to focus on ways to help these patients improve their health and work situation.
What this means for you: Many patients with long-term work issues face serious health challenges that need attention.
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OBJECTIVE: To examine characteristics of primary healthcare patients with long-term impaired work ability, and to assess the correlation between sense of coherence and factors related to health, function, and work ability.
DESIGN AND SETTING: Cross-sectional study including patients from the LEARN-to-COPE cluster-randomized controlled trial, conducted across 40 primary care centers in Region Västra Götaland, Sweden.
SUBJECTS: Primary healthcare patients with recurrent or long-term sick leave or health-related unemployment ( = 243).
DATA COLLECTION: Sick leave data were collected from the Swedish Social Insurance Agency. Demographics and contextual data were patient-reported or retrieved from personal identity numbers. Symptoms, health-related quality of life, health literacy, sense of coherence, perceived work ability, and lifestyle were assessed using validated questionnaires.
RESULTS: Mean age was 47.4 years. Most were women born in a Nordic country, had at least secondary education, and were gainfully employed. A third was unemployed. Mean number of sick days was 1,215 (SD 1,010), and 67.9% were on full-time sick leave. Perceived work ability was low. Participants reported severe anxiety and exhaustion, moderate depression, and a high risk of long-term sick leave due to pain. Health-related quality of life was extremely low. Half reported inadequate or problematic health literacy, and sense of coherence was low. Smoking and obesity were common, physical activity levels were average, and excessive alcohol consumption was below average. About half participated in any rehabilitation activities. Sense of coherence was significantly correlated with health literacy, health-related quality of life, symptoms of mental illness, perceived work ability, and pain (all < 0.001); but not with sick leave duration or participation in rehabilitation.
CONCLUSION: Given participants' pronounced suffering, improving health-related quality of life among primary healthcare patients with long-term impaired work ability should be prioritized. Sense of coherence was associated with several determinants of sick leave, but not with its previous duration.
TRIAL REGISTRATION NUMBER: clinicaltrials.gov NCT04254367.