Year: 2017
Type: dissertation
Study design: Observational Study
Abstract: Background Vocational rehabilitation is increasingly used to facilitate a successful\nreturn to work (RTW) after long-term sick leave. Some vocational rehabilitation\nprograms incorporate mindfulness training, suggesting that mindfulness is an\neffective tool for successful RTW. However, whether mindfulness enhances work\nability (WA) and RTW rates has not yet been investigated.\nMain aims To investigate whether mindfulness is a predictor of increased WA and\nsuccessful RTW after a multidisciplinary vocational rehabilitation program (MVRP),\nand to explore the mediating influences of mindfulness in the relationship between\npersonal health factors and WA.\nMethods The project featured one retrospective cohort study and one prospective\ncohort study. The retrospective cohort study included 80 former participants (from\n2008 to spring 2011) in the MVRP. Self-report measures were used to measure work\nstatus, WA, quality of life (QOL), and mindfulness. The prospective cohort study was\nconducted with 74 active participants in an MVRP in the period autumn 2011–\nautumn 2012. Self-report measures of functional health and psychological\nfunctioning were collected. In addition to a standard logistic regression analysis\nprocedure, a bias-corrected bootstrapping technique was used to test the\nhypothesized indirect effects.\nMain results Results from the retrospective cohort study suggested that mindfulness\nwas indirectly related to RTW through QoL. The covariates WA and education level\nsignificantly predicted RTW. Furthermore, mindfulness significantly predicted\nsuccessful RTW but only for the “high-educated” participants. Results from the\nprospective study suggest that the outcome of an MVRP is affected by pain intensity\nand sense of mastery at baseline. High pain intensity and low sense of mastery\nsignificantly predicted an unsuccessful WA response to the MVRP. Furthermore, the\nresults revealed that enhancement of mindfulness during the course of the program\nsignificantly predicted a successful WA response. In addition, decreased personal\nburnout and enhanced self-esteem were both unique predictors of a positive WA\nresponse. Mediation analysis showed that mindfulness mediated the effects of\npersonal burnout and self-esteem on the participants’ WA response.\nConclusion The data in the retrospective cohort study demonstrate that mindfulness\nmay be a usefull tool applied in the context of vocational rehabilitation, suggesting that mindfulness may enhance RTW and WA via QOL. Furthermore, for “higheducated”\nparticipants, mindfulness independently predicts RTW. We conclude that\nenhancement of education and qualifications for the labor market should be the\nhighest priority for “low-educated” people on long-term sick leave. Data from the\nprospective cohort study indicate that enhancing the skills of mindfulness may be\nuseful when aiming to increase WA. However, not all individuals respond positively to\nthe MVRP in terms of improved WA. In particular, unfavorable WA responses were\ndetected in participants who reported high pain intensity and a low sense of mastery\nat baseline. We conclude that it still is a challenge to understand the factors that\ndistinguish responders to MVRPs from nonresponders, and thus, further research is\nrequired.
Source: BIBSYS Brage (BIBSYS (Norway))
Author: Solveig Vindholmen
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funder: Universitetet i Agder
OpenAlex ID: W2766520078