The Effect of Self-Efficacy on Return-to-Work Outcomes for Workers with Psychological or Upper-Body Musculoskeletal Injuries: A Review of the Literature

Abstract

Purpose Work absence can result in substantial losses to the economy and workers. As a result, identifying modifiable factors associated with return-to-work (RTW) following an injury or illness is the focus of many empirical investigations. Self-efficacy, the belief about one's ability to undertake behaviours to achieve desired goals, has been identified as an important factor in RTW for injured workers. This paper systematically reviewed the literature on the association between self-efficacy and RTW outcomes for workers with an upper-body musculoskeletal injury or psychological injury. Methods A systematic search was conducted across five databases using two main search concepts- 'self-efficacy' and 'RTW'. After removing duplicates, our search strategy identified 836 studies, which were screened for relevance using titles and abstracts. Results A two stage screening process reduced the study pool to six studies using psychological injury cohorts and three using upper-body musculoskeletal (UB-MSK) cohorts. Eight cohorts from seven prospective cohort studies and one sample from a randomised control trial (RCT) were subjected to a risk of bias assessment. Higher levels of self-efficacy appeared to have a consistent and positive association with RTW across return-to-work status and work absence outcomes, injury type and follow-up periods. Effect ratios ranged from 1.00 to 5.26 indicating a potentially large impact of self-efficacy on RTW outcomes. The relationship between self-efficacy and RTW strengthened as the domain of self-efficacy became more specific to RTW and job behaviours. Studies assessing workers with psychological injuries were of a lower quality compared to those assessing workers with UB-MSK injuries. Conclusions Higher self-efficacy had consistent positive associations with RTW outcomes. Further empirical research should identify the determinants of self-efficacy, and explore the processes by which higher self-efficacy improves RTW outcomes.

Measurement Properties of the Modified Spinal Function Sort (M-SFS): Is It Reliable and Valid in Workers with Chronic Musculoskeletal Pain?

“…Obviously, such variation results in increased LoA. Large LoA scores in patient-reported outcome measure are common in pain patients [ 7 , 30 , 31 ]. We are unaware of accepted guidelines for cutoff points of LoA [ 30 ].…”

“…Previous studies reported that the LoA values of the original SFS administered by injured workers from a French-speaking rehabilitation setting were ±11 (6% of the maximal score of 200) while in the German-speaking area the values were ±27 (14% of the maximal score). Another study reported LoA values of ±33 (16% of the maximal score) of the original SFS in workers with subacute whiplash injuries [ 7 ]. The authors argued that beside individual differences, the cultural and legal context may also influence test–retest values [ 6 , 7 ].…”

“…The SFS yields a single rating ranging from 0 to 200, with higher scores indicating higher PSE. Validity and reliability of the SFS has been established for various musculoskeletal disorders, languages and settings [ 6 , 7 , 11 , 12 ].…”

“…By applying this model to rehabilitation it is assumed that patients with low levels of PSE are less likely to perform well on the tasks presented, and patients with high levels of PSE are assumed to perform better. In addition, PSE appears to be closely related to health outcomes [ 6 ] and return to work (RTW) in persons with MSD and psychological disorders [ 7 , 8 ]. Therefore, measuring levels of PSE may be critical when tailoring interventions aimed to increase PSE and improve RTW outcomes.…”

Return to work a bumpy road: A qualitative study on experiences of work ability and work situation in individuals with chronic whiplash-associated disorders

“…The ndings underscore that individuals with chronic WAD need to feel understood and acknowledged by their managers, colleagues, family, health care providers and other stakeholders during this process. According to previous studies, this bumpy road may be explained by different strategies to cope with uctuations in symptoms, but also by poor self-e cacy [28], a mismatch between stakeholder expectations [29,30] and/or insu cient support from health care [17,19,31], the SIA [17,19] or employer [32,33]. Our ndings show how the support for return to work for individuals with chronic WAD can be strengthened.…”