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Strengthened general self-efficacy with multidisciplinary vocational rehabilitation in women on long-term sick leave: A randomised controlled trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sociomedical Epidemiological Research unit)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sociomedical Epidemiological Research unit)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Sociomedical Epidemiological Research unit)
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(English)In: Article in journal (Refereed) Submitted
Abstract [en]

Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy for women on long-term sick leave ≥1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either 1) assessment of a multidisciplinary team and a multimodal intervention (TEAM), 2) Acceptance and commitment therapy (ACT), or 3) a control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the time for the intervention, the women in the TEAM group increased their self-efficacy mean value from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed that TEAM intervention increased self-efficacy at 12 months (B=0.25, 95% CI, 0.10 to 0.41). ACT intervention had no effect on self-efficacy at 12 months (B=0.02, 95% CI, -0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B=0.68, 95% CI, 0.54 to 0.81). Conclusion This study implies that an assessment of a multidisciplinary team with a multimodal intervention almost normalised the level of self-efficacy in women on long-term sick leave. Self-efficacy needs to be taken into consideration in vocational rehabilitation.

Keyword [en]
Sick leave • Vocational rehabilitation •Self-efficacy • Women • Multidisciplinary rehabilitation Chronic pain • Mental illness
National Category
Medical and Health Sciences
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-328789OAI: oai:DiVA.org:uu-328789DiVA: diva2:1137643
Available from: 2017-08-31 Created: 2017-08-31 Last updated: 2017-08-31
In thesis
1. Self-efficacy, Vocational Rehabilitation and Transition to Work
Open this publication in new window or tab >>Self-efficacy, Vocational Rehabilitation and Transition to Work
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine the relationship between self-efficacy, individually tailored vocational rehabilitation and transition to work or studies.

Study I was a cross-sectional study based on questionnaire- and registry data, investigating whether factors related to sick leave predict self-efficacy in women on long-term sick leave (n= 337) due to pain and/or mental illness. General self-efficacy was low. Anxiety and depression were the strongest predictors for low self-efficacy.

Study II used longitudinal data from a randomised controlled trial, comprising partly the same women (n=401) as in Study I. Participants were allocated to either 1) assessment of multidisciplinary team and multimodal intervention (TEAM), 2) acceptance and commitment therapy (ACT), or 3) control group. Self-efficacy increased in the TEAM group in comparison with the control group.

Study III had a descriptive qualitative design with individual interviews, studying participants’ (n=14) experiences with an individually tailored vocational rehabilitation project, and encounters with professionals working in it. The participants, who were on long-term sick leave due to mental illness or pain reported overall positive experiences with the project. The project was based on collaboration between authorities and motivational interviewing. The positive experiences were based on four categories: Opportunities for receiving various dimensions of support, Good overall treatment by the professionals, Satisfaction with the working methods of the project, and Opportunities for personal development.

Study IV was a prospective cohort study investigating perceived self-efficacy in unemployed young adults (n= 249) aged 19-29 year with disabilities, and the association between self-efficacy and transition to work or studies. The study used questionnaire- and registry data from a vocational rehabilitation project. Higher levels of self-efficacy were associated with increased odds for ‘transition to work’. General self-efficacy was low, and young adults with lower self-efficacy reported worse self-rated health compared with those with higher self-efficacy.

This thesis showed that multidisciplinary assessment with a multimodal intervention had positive effects on self-efficacy. Individually tailored vocational rehabilitation, based on cooperation and motivational interviewing, may be beneficial for individuals on long-term sick leave and the interactions between participants and the professionals may affect participants’ self-efficacy positively. Mental health needs to be considered when targeting self-efficacy in vocational rehabilitation. Furthermore, research is needed to a) clarify which components in the multidisciplinary team intervention can increase self-efficacy, b) study the effects of vocational rehabilitation based on an individual design, cooperation and motivational interviewing on self-efficacy, health and transition to work, and c) develop interventions that can increase self-efficacy and support transition to work/ studies in young adults with disabilities.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 86 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1366
Keyword
Self-efficacy, Vocational Rehabilitation, Sick leave, Women, Multidisciplinary rehabilitation, Chronic pain, Mental illness, Motivational interviewing, Young adults, Disability, Unemployment
National Category
Medical and Health Sciences
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-328796 (URN)978-91-513-0059-7 (ISBN)
Public defence
2017-10-20, B/A1:111a, Biomedicinskt centrum, Uppsala Universitet, Husargatan 3, Uppsala, 12:15 (Swedish)
Opponent
Supervisors
Available from: 2017-09-28 Created: 2017-08-31 Last updated: 2017-10-17

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