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A cognitive-behavioral return-to-work program: Effects on pain patients with a history of long-term versus short-term sick leave
Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Psychology.
2001 In: Pain, Vol. 91, 155-163 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2001. Vol. 91, 155-163 p.
URN: urn:nbn:se:uu:diva-89651OAI: oai:DiVA.org:uu-89651DiVA: diva2:161315
Available from: 2002-02-20 Created: 2002-02-20Bibliographically approved
In thesis
1. Musculoskeletal Pain and Return to Work: A Cognitive-Behavioral Perspective
Open this publication in new window or tab >>Musculoskeletal Pain and Return to Work: A Cognitive-Behavioral Perspective
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Musculoskeltal pain is the most common diagnosis for being on sick leave two months or longer in Sweden. The societal costs have been estimated at almost 30 billion Swedish kronor per year. Research aimed at improving occupational rehabilitation is therefore crucial.

In Study I a multidisciplinary cognitive-behavioral in-patient program conducted at a rehabilitation clinic was empirically evaluated. A randomized controlled trial with 36 chronic pain patients showed a difference in favor of the treated patients compared to their controls on measures of occupational training and activity level at a 1-month follow-up. A consecutive trial with 85 chronic patients showed a decrease in sick leave, pain intensity, depression, and use of analgesics, and an increase in life control and physical fitness from pre-treatment to a 2-month and a 1-year follow-up. Study II was a randomized controlled evaluation of a return-to-work focused cognitive-behavioral out-patient program with a 6-month follow-up conducted by a psychologist. Effects were compared over 36 pain patients on short-term sick leave (2-6 months) and 36 patients on long-term sick leave (>12 months). The treated patients on short-tem sick leave reduced their sick leave and returned to work more than their controls. They also improved their abilities to control and decrease the pain more. However, the patients on long-term sick leave did not improve on any outcome variables compared to their controls. In Study III a questionnaire aimed at identifying obstacles to return to work was developed and evaluated. The questionnaire was administrated to 154 chronic pain patients and was found to predict sick leave nine months after assessment. Important obstacles were perceived prognosis of a work return, social support at work, physical workload and harmfulness of work, pain intensity, and depression.

In conclusion, this thesis shows that cognitive-behavioral treatment focused on return to work is effective in helping chronic musculoskeletal pain patients back to work. A questionnaire developed to identify obstacles to return to work was shown to predict sick leave.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2002. 78 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 113
Psychology, Back pain, cognitive-behavioral, multidisciplinary, musculoskeletal, neck pain, prediction, prevention, rehabilitation, return to work, shoulder pain, sick leave, treatment, Psykologi
National Category
Research subject
Clinical Psychology
urn:nbn:se:uu:diva-1751 (URN)91-554-5234-5 (ISBN)
Public defence
2002-03-15, universitetshusets lärosal IX, Uppsala, 13:15
Available from: 2002-02-20 Created: 2002-02-20Bibliographically approved

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