Occupational Rehabilitation Is Associated With Improvements in Cognitive Functioning

Abstract

IntroductionOccupational rehabilitation may be offered to workers on long-term sick leave who often report problems with cognitive functioning, anxiety, depression, pain, and reduced work ability. The empirical knowledge is sparce on how occupational rehabilitation may influence cognitive and emotional functioning and patients have not previously been subjected to comprehensive objective testing. The main aim of this study was to assess possible changes in cognitive and emotional functioning such as memory, attention, executive function, and emotion recognition among patients in occupational rehabilitation.MethodsA large sample of 280 sick-listed workers referred to inpatient and outpatient occupational rehabilitation was recruited. The rehabilitation programs had a mean duration of 28 days and comprised physical activity, cognitive behavior treatment components and collaboration with the workplace. A pre–post design was applied to investigate possible changes in cognitive and emotional functioning (primary outcomes) and work and health measures (secondary outcomes), comparing the rehabilitation group with a control group of 70 healthy workers. Individuals in the control group were tested at random time points with an approximately 28 day interval between pre- and post-test, thus coinciding with the duration of rehabilitation. Repeated measures analysis of variance was used for the main analyses.ResultsCompared to the control group, the rehabilitation group had greater gains from pre- to post-test in focused and sustained attention, as well as greater improvements in work ability and reduction in subjective health complaints (SHC), helplessness, pain, pain related to work, anxiety, and depression. In the rehabilitation group, exploratory correlational analysis indicated that improvements in focused and sustained attention were associated with improvements in return-to-work self-efficacy, work ability as well as a reduction in SHC.ConclusionThe sick-listed workers improved in focused and sustained attention and work and health measures after participating in occupational rehabilitation. This study is one of the first to systematically investigate changes in cognitive and emotional functioning during occupational rehabilitation. Clinical practice should benefit from increased knowledge about all cognitive functions and should be specifically aware of the improvements in focused and sustained attention, while memory, executive function and emotion recognition remained unchanged. The results can be used as a motivation to tailor specific interventions to gain further improvements in all cognitive and emotional functions.

Sustained Attention and Working Memory Predict the Number of Days on Health-Related Benefits in the Year Following Occupational Rehabilitation

“…More details about the cognitive and emotional tests and the work and health related questionnaires are available from Johansen et al [7].…”

“…Therefore, it can be assumed that cognitive and emotional abilities such as attention, memory, executive function and emotion regulation are essential for performing well in working life [1][2][3]. Cognitive impairments are prevalent in individuals on long-term sick leave [4][5][6][7] and improving cognitive and emotional functioning will enhance the ability to stay focused, process and remember information, and shift focus when required because individuals have increased mental resources and capacity [7]. Emotional functioning refers to our ability to regulate and label our emotions enabling us to influence and direct our attention away from negative emotions and biases resulting in better coping [10].…”

“…The benefits of improved cognitive and emotional functioning are better flexibility, better regulation of our emotions and experiences, and increased quality of life [8][9][10]. Efforts have been made to better understand cognitive as well as emotional functioning in long-term sick-listed individuals participating in occupational rehabilitation [4,7,[11][12][13]. In Norway, the occupational rehabilitation programmes are designed to facilitate return to work (RTW) through physical and psychological empowerment and communication with the employer.…”

“…We have recently reported that focused and sustained attention improved more than memory, executive function and emotion recognition during occupational rehabilitation [7]. The next step is to investigate whether baseline scores and change scores during rehabilitation in cognitive and emotional functioning, such as sustained attention and emotion recognition, are associated with a higher probability of RTW when the duration of sick leave before enrolment in the programme is taken into account.…”

“…The next step is to investigate whether baseline scores and change scores during rehabilitation in cognitive and emotional functioning, such as sustained attention and emotion recognition, are associated with a higher probability of RTW when the duration of sick leave before enrolment in the programme is taken into account. If such associations are present, the treatment success of occupational rehabilitation may depend, at least partly, on improving cognitive functioning [7] and cognitive beliefs related to work through cognitive therapy [14].…”