Inpatient multimodal rehabilitation and the role of pain intensity and mental distress on return-to-work: causal mediation analyses of a randomized controlled trial.
J Rehabil Med
; 56: jrm18385, 2024 Jan 12.
Article
em En
| MEDLINE
| ID: mdl-38214181
ABSTRACT
OBJECTIVE:
Studies suggest that symptom reduction is not necessary for improved return-to-work after occupational rehabilitation programmes. This secondary analysis of a randomized controlled trial examined whether pain intensity and mental distress mediate the effect of an inpatient programme on sustainable return-to-work.METHODS:
The randomized controlled trial compared inpatient multimodal occupational rehabilitation (n = 82) with outpatient acceptance and commitment therapy (n = 79) in patients sick-listed due to musculoskeletal and mental health complaints. Pain and mental distress were measured at the end of each programme, and patients were followed up on sick-leave for 12 months. Cox regression with an inverse odds weighted approach was used to assess causal mediation.RESULTS:
The total effect on return-to-work was in favour of the inpatient programme compared with the control (hazard ratio (HR) 1.96; 95% confidence interval (95% CI) 1.15-3.35). There was no evidence of mediation by pain intensity (indirect effect HR, 0.98; 95% CI, 0.61-1.57, direct effect HR, 2.00; 95% CI, 1.02-3.90), but mental distress had a weak suppression effect (indirect effect HR, 0.89; 95% CI, 0.59-1.36, direct effect HR, 2.19; 95% CI, 1.13-4.26).CONCLUSION:
These data suggest that symptom reduction is not necessary for sustainable return-to-work after an inpatient multimodal occupational rehabilitation intervention.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terapia de Aceitação e Compromisso
/
Transtornos Mentais
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Rehabil Med
Assunto da revista:
REABILITACAO
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Noruega