Changes to body mass index, work self-efficacy, health-related quality of life, and work participation in people with obesity after vocational rehabilitation: a prospective observational study

Abstract

Background People on or at risk of sick leave from work due to obesity or obesity-related problems participated in a new vocational rehabilitation (VR). The study aimed to examine the outcome changes in the participants’ health-related quality of life (HRQoL), body mass index (BMI), return to work self-efficacy (RTWSE), work ability scale (WAS) and degree of work participation (DWP) after their participation in the 12-month VR programme. The secondary aim was to examine associations between the outcome changes and HRQoL at 12-month follow-up, measured with the HRQoL 15D instrument (15D). Methods This prospective observational study included 95 participants. The one-year multidisciplinary VR programme with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by 5 meetings. A paired sample t-test was used to examine changes in HRQoL, BMI, RTWSE, WAS, and DWP between baseline and the 12-month follow-up. Multiple linear regression analyses explored associations between changes in HRQoL and the outcome variables. Results The participants achieved statistically significant changes in HRQoL (2.57, 95% CI: 1.35 to 3.79), BMI (− 2.33, 95% CI: − 3.10 to − 1.56), RTWSE (15.89, 95% CI: 4.07 to 27.71), WAS (1.51, 95% CI: 0.83 to 2.20) and DWP (18.69, 95% CI: 8.35 to 29.02). At 12 months, a significant association was found between HRQoL and BMI (B = − 0.34, 95% CI: − 0.65 to − 0.04), RTWSE (B = 0.02, 95% CI: 0.004 to 0.04), WAS (B = 0.91, 95% CI: 0.55 to 1.28), DWP (B = − 0.02, 95% CI: − 0.04 to 0.001) and work absence (B = − 0.01, 95% CI: − 0.02 to − 0.002). The regression model explained 71.8% of the HRQoL variance. Conclusion The results indicated positive changes in HRQoL, BMI, RTWSE, WAS and DWP from baseline to the 12-month follow-up. Factors associated with HRQoL at the 12-month follow-up were decreased BMI, increased RTWSE, improved WAS and reduced work absence. Future studies examining VR programmes with lifestyle interventions for people with obesity are recommended. Trial registration Norwegian Regional Committee for Medical and Health Research Ethics (REC) 2017/573, Clinical Trials NCT03286374, registered 18. September 2017. https://clinicaltrials.gov/ct2/results?cond=Obesity&term=Anita+Dyb+Linge&cntry=NO&state=&city=&dist=

Promising results from a residential rehabilitation intervention focused on fatigue and the secondary psychological and physical consequences of cardiac arrest: The SCARF feasibility study

“…Screening CA survivors for fatigue or related secondary problems at outpatient cardiology follow-up may identify those with rehabilitation needs and therefore potential future study participants. A multi-center trial including similar residential facilities in European countries 62,63 may increase pace of recruitment. The residential delivery method used by SCARF meant survivors need only attend twice, improving retention, but possibly reducing recruitment for survivors with work or caring commitments.…”

What works? A qualitative study of participants experiences of a traditional lifestyle intervention with a work focus

“…However, changes in work participation can also depend on factors not directly affected by health or lifestyle changes, such as relations with managers and co-workers and other workplace factors. Workplace modifications can contribute to increased work ability as well as prevent sick leave (Franche & Krause, 2002 ; Kristman et al, 2020 ; Linge et al, 2021a , 2021b ; Schultz et al, 2007 ; Young et al, 2005 ), and job satisfaction has been shown to be an important factor for well-being at work (Ekberg & Ståhl, 2020 ; Figueredo et al, 2020 ; Hees et al, 2012 ; Linge et al, 2021b ; De Vries et al, 2011 ).…”

“…Until now, work focus has not been a part of lifestyle interventions for persons with obesity in Norway, although there is an increasing awareness of the problem of reduced work ability for this group (Linge et al, 2021a , 2021b ). In order to meet the challenges that persons living with obesity face regarding their working life, a newly developed work intervention was introduced as an additional element to a lifestyle intervention programme for persons with morbid obesity.…”

Bandura’s Self-Efficacy Model Used to Explore Participants’ Experiences of Health, Lifestyle, and Work After Attending a Vocational Rehabilitation Program with Lifestyle Intervention – A Focus Group Study

“…Return to work (RTW) (ie return, maintain or stay at work) is often the outcome measure and the final goal; however, it explains only a small part of rehabilitation’s complex picture. 14 , 20 For employees, job satisfaction, mental function and work-home balance are important outcomes of the RTW process. 21 Previous research has indicated that people attending VR programmes may enhance work ability and reduce sick leave.…”

“…VR with a lifestyle intervention is new and unexplored. Only a few studies have focused on the association between multifactorial lifestyle risk and work ability 20 , 28 and factors that generate work participation for people with obesity. 29 By examining the work dimension’s interpretation, we can explore a more holistic picture of the complexity of obesity and work participation.…”