Perceived psychosocial work environment and effects of a work-focused intervention among patients with neck and back pain

Abstract

A growing number of studies have focused on the return to work (RTW) processes associated with patients with back pain. Many studies have combined a workplace focus with multidisciplinary treatments; however, this focus has not been evaluated in Norway among patients with neck and back pain thus far. Several factors, including psychosocial factors at work as well as fear–avoidance beliefs (FAB), may influence the sick leave in these patients. The main aim of this study was to evaluate the perceived psychosocial work environment among sick-listed patients with neck or back pain and the effect of interventions with respect to sickness absence. The present multicentre randomised trial demonstrated that a work-focused intervention in secondary care added no supplementary effects compared to a control intervention with regard to the RTW rate or the proportion of patients who had achieved RTW during the first 12 months. In addition, the perceived psychosocial work factors were strongly associated with FAB about work in the current patient sample. However, the average perceived demand, control and support were quite similar to that of reference worker populations, except for a significantly increased demand for physical endurance. Furthermore, the overall perception of demand, control and support was fairly stable over one year, despite marked improvements in pain and disability. The evaluation of the measurement properties of the applied questionnaire, the Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic), showed that the demand, control and support domains of the QPS Nordic comprised unidimensional constructs with good targeting to the present patients problems regarding work demands. The lower resolution of the scaling of the items may have implications for the responsiveness of the QPS Nordic.