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Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial.

ABSTRACT: Background:Metacognitions are associated with work status, but no research has examined to what extent metacognitions before treatment and change in metacognitions following treatment predict return to work (RTW) prospectively. The present study aims to address these two gaps in knowledge. Methods:212 patients on long-term sick leave (>8 weeks) with extensive fatigue, chronic pain conditions and/or mental distress received 3.5 weeks of intensive rehabilitation treatment, aimed at returning them to work. Only part of the population (n = 137) had complete follow-up data on metacognitions. Metacognitions were measured with the Metacognitions Questionnaire 30 (MCQ-30), while RTW was measured using official registry data from the Norwegian Labor and Welfare Service. A registry record of participation in competitive work ?2.5 days (50% work participation) per week, averaging over 14 weeks, was chosen as an outcome reflecting a successful RTW. The registry data spanned a total of 56 weeks per participant. Results:Our results indicated that baseline MCQ scores was not associated with RTW. This was analyzed for the total MCQ score as well as for all subscales. We observed substantial changes in metacognitions following treatment, and a 1-point change in the total sum of metacognitive beliefs was associated with 5% greater odds for successful RTW at all time points (p = 0.040), while a 1-point change on the subscale of beliefs about the need to control thoughts gave 20% greater odds for successful RTW (p = 0.016). Conclusion:Metacognitions concerning the need to control thoughts appear to have a significant influence on patients return to work. Here, we observed that a change in these beliefs following treatment substantially affected RTW over the course of 1 year.

SUBMITTER: Jacobsen HB

PROVIDER: S-EPMC7025452 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial.

Jacobsen Henrik B HB Glette Mari M Hara Karen W KW Stiles Tore C TC

Frontiers in psychology 20200206

<h4>Background</h4>Metacognitions are associated with work status, but no research has examined to what extent metacognitions before treatment and change in metacognitions following treatment predict return to work (RTW) prospectively. The present study aims to address these two gaps in knowledge.<h4>Methods</h4>212 patients on long-term sick leave (>8 weeks) with extensive fatigue, chronic pain conditions and/or mental distress received 3.5 weeks of intensive rehabilitation treatment, aimed at ...[more]

PMID: 32116900

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Project description:IntroductionReturn-to-work is a key rehabilitation goal for many working aged stroke survivors, promoting an overall improvement of quality of life, social integration, and emotional wellbeing. Conversely, the failure to return-to-work contributes to a loss of identity, lowered self-esteem, social isolation, poorer quality of life and health outcomes. Return-to-work programmes have largely focused on physical and vocational rehabilitation, while neglecting to include mood and fatigue management. This is despite the knowledge that stroke results in changes in physical, cognitive, and emotional functioning, which all impact one's ability to return to work. The purpose of this systematic review is to conduct a comprehensive and up-to-date search of randomised controlled trials (RCTs) of return-to-work programmes after stroke. The focus is especially on examining components of mood and fatigue if they were included, and to also report on the screening tools used to measure mood and fatigue.MethodSearches were performed using 7 electronic databases for RCTs published in English from inception to 4 January 2023. A narrative synthesis of intervention design and outcomes was provided.ResultsThe search yielded 5 RCTs that satisfied the selection criteria (n = 626). Three studies included components of mood and fatigue management in the intervention, of which 2 studies found a higher percentage of subjects in the intervention group returning to work compared to those in the control group. The remaining 2 studies which did not include components of mood and fatigue management did not find any significant differences in return-to-work rates between the intervention and control groups. Screening tools to assess mood or fatigue were included in 3 studies.ConclusionOverall, the findings demonstrated that mood and fatigue are poorly addressed in rehabilitation programmes aimed at improving return-to-work after stroke, despite being a significant predictor of return-to-work. There is limited and inconsistent use of mood and fatigue screening tools. The findings were generally able to provide guidance and recommendations in the development of a stroke rehabilitation programme for return-to-work, highlighting the need to include components addressing and measuring psychological support and fatigue management.

Project description:BackgroundThis study investigated the long-term effects (12?months post-rehabilitation) of a standard inpatient multidisciplinary rehabilitation program for patients with chronic low back pain (CLBP), in which a control group (CG) received pain competence training and an intervention group (IG) received combined pain competence and depression prevention training.MethodsIn this prospective control group study with cluster-block randomization, a total of n?=?583 patients were included into per protocol analyses. To examine the effects of rehabilitation on depressive symptoms, pain self-efficacy, and work ability, patients were stratified in repeated-measures analyses of variance by treatment condition (IG vs. CG), level of depressive symptoms (low vs. high), and time of assessment (pre, post, 6, and 12?months after rehabilitation). The impact of each treatment on pain-related days of sick leave (DSL; dichotomized into ? vs. >?2?weeks) was determined separately by conducting non-parametric analyses. Multiple imputations (n?=?1225) confirmed the results. Effects were interpreted if clinical significance was given.ResultsOnly patients with high levels of depressive symptoms showed long-term improvements in depressive symptoms and self-efficacy. Long-term improvements in work ability index and mental work ability item were restricted to the IG. Furthermore, long-term effects on pain-related DSL were ascertained by per protocol and multiple imputation analyses only for the IG.ConclusionsPatients with high levels of depressive symptoms showed improvements in depressive symptoms and self-efficacy, supporting the psychological effectiveness of both interventions. However, the beneficial long-term effects of rehabilitation on work ability and pain-related DSL among the IG support implementation of combined pain competence and depression prevention training.Trial registrationDRKS00015465 (German Clinical Trial Register DRKS); date of registration: 03.09.2018.

Project description:Background This study aims to analyze the changes of approximately 1 month in fatigue, sleep, and mood in athletes after returning to training following infection with the COVID-19 Omicron strain and provide recommendations for returning to training after infection. Methods Two hundred and thirty professional athletes who had returned to training after being infected with COVID-19 in December 2022 were recruited to participate in three tests conducted from early January 2023. The second test was completed approximately 1 week after the first, and the third was completed about 2 weeks after the second. Each test consisted of completing scales and the exercise-induced fatigue measure. The scales included a visual analog scale, the Athens Insomnia Scale for non-clinical application, and the Depression-Anxiety-Stress scale. The exercise task was a six-minute stair climb test, and athletes evaluated subjective fatigue levels before and after exercise using another Visual Analog Scale and the Karolinska Sleepiness Scale. Results After returning to training, athletes’ physical fatigue decreased initially but increased as training progressed. Cognitive fatigue did not change significantly. The exercise task led to elevated levels of physical fatigue after a longer duration of training. Sleep quality problems decreased rapidly after the start of training but remained stable with prolonged training. Depression levels continued to decline, while anxiety levels only reduced after a longer duration of training. Stress levels decreased rapidly after the start of training but did not change with prolonged training. Conclusion Athletes who return to training after recovering from COVID-19 experience positive effects on their fatigue, sleep, and mood. It is important to prioritize anxiety assessment and interventions during the short period after returning and to continue monitoring fatigue levels and implementing recovery interventions over a longer period of time.

Dataset Information

Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial.

Publications

Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial.

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