Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2018; 28(02): 103-113
DOI: 10.1055/s-0043-124440
Review
© Georg Thieme Verlag KG Stuttgart · New York

Einflussfaktoren auf die Rückkehr zur Arbeit bei chronischen Rückenschmerzen

Factors Influencing Return to Work in Chronic Back Pain
Linda Allgeier
1   Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Freiburg
,
Jürgen Bengel
1   Rehabilitationspsychologie und Psychotherapie, Institut für Psychologie, Freiburg
› Institutsangaben
Weitere Informationen

Publikationsverlauf

eingereicht 12. Juli 2017

akzeptiert 07. Dezember 2017

Publikationsdatum:
15. Februar 2018 (online)

Zusammenfassung

Theorie Die Mehrzahl der Menschen erlebt mind. eine Rückenschmerzepisode in ihrem Leben. Patienten mit chronischen Schmerzen verursachen durch Arbeitsunfähigkeit und Inanspruchnahme von Gesundheitsdienstleistungen hohe Kosten. Die Rückkehr an den Arbeitsplatz stellt daher ein zentrales Rehabilitationsziel dar.

Methode Die Literaturrecherche erfolgte in den Datenbanken PSYNDEX, PsycINFO, MEDLINE und ScienceDirect und ergab 27 Artikel.

Ergebnisse Die untersuchten Einflussfaktoren ließen sich in 3 Gruppen einteilen: (1) psychische und psychosoziale, (2) arbeits- und arbeitsplatzbezogene und (3) (gesundheits-)systembezogene Einflussfaktoren. Geringe Genesungserwartungen, Rezidivangst, Fear-avoidance-beliefs und ein Mangel an sozialer Unterstützung am Arbeitsplatz stellen Hindernisse für Return to work dar. Hohe Selbstwirksamkeitserwartungen, Anpassungen des Arbeitsplatzes an die Bedürfnisse des Patienten, sowie Informationen durch Gesundheitsdienstleister wirken sich positiv aus.

Abstract

Background The majority of humans experience at least one episode of back pain in their lifetime. Patients with persistent, chronic pain cause high costs through incapacity for work and health services. Returning back pain patients to work is therefore a substantial aim of rehabilitation programs.

Method The literature search took place in the databases PSYNDEX, PsycINFO, MEDLINE and ScienceDirect and 27 articles were included.

Results The articles resulted in a variety of factors which could be allocated into 3 groups: (1) psychological and psychosocial, (2) work- and workplace-related and (3) (healthcare)system-related factors. Low recovery expectations, fear-avoidance-beliefs, fears of further injury and a lack of social support at the workplace were identified as obstacles to return to work, whereas perceived self-efficacy, workplace adaptations and information and advice by health care providers were identified as facilitators of return to work.

Ergänzendes Material

 
  • Literatur

  • 1 Schmidt CO, Raspe H, Pfingsten M. et al. Back pain in the German adult population. The Spine Journal 2007; 32: 2005-2011
  • 2 Pfingsten M, Hildebrandt J. Rückenschmerzen. In: Kröner-Herwig B, Frettlöh J, Klinger R, Nilges P. (Hrsg.) Schmerzpsychotherapie. Grundlagen – Diagnostik – Krankheitsbilder – Behandlung. 7. Aufl Berlin: Springer; 2011: 431-452
  • 3 Sendera M, Sendera A. Chronischer Schmerz. Schulmedizinische, komplementärmedizinische und psychotherapeutische Aspekte. Wien: Springer; 2015
  • 4 Schulz IZ, Stowell AW, Feuerstein M. et al. Models of return to work for musculoskeletal disorders. Journal of Occupational Rehabilitation 2007; 17: 327-352
  • 5 Pfingsten M, Korb J, Hasenbring M. Psychologische Mechanismen der Chronifizierung– Konsequenzen für die Prävention. In: Kröner-Herwig B, Frettlöh J, Klinger R, Nilges P. (Hrsg.) Schmerzpsychotherapie. Grundlagen – Diagnostik – Krankheitsbilder – Behandlung. 7. Aufl Berlin: Springer; 2011: 115-134
  • 6 Göbel H. Epidemiologie und Kosten chronischer Schmerzen. Spezifische und undspezifische Rückenschmerzen. Der Schmerz 2001; 15: 92-98
  • 7 Schaafsma FG, Anema JR, van der Beek AJ. Back pain. Prevention and management in the workplace. Best Practice & Research Clinical Rheumatology 2015; 29: 483-494
  • 8 Labriola M, Lund T. Self-reported sickness absence as a risk marker of future disability pension. Prospective findings from the DWECS/DREAM study 1990-2004. International Journal of Medical Sciences 2007; 4: 153-158
  • 9 Lund T, Kivimäki M, Labriola M. et al. Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees. Occupational & Environmental Medicine 2008; 65: 28-31
  • 10 Larsen EL, Nielsen CV, Jensen C. Getting the pain right. How low back pain patients manage and express their pain experiences. Disability and Rehabilitation 2012; 35: 819-827
  • 11 Kuijer W, Groothoff JW, Brouwer S. et al. Prediction of sickness absence in patients with chronic low back pain. A Systematic Review. Journal of Occupational Rehabilitation 2006; 16: 430-458
  • 12 Zampolini M, Bernardinello M, Tesio L. RTW in back conditions. Disability and Rehabilitation 2007; 29: 1377-1385
  • 13 Costa-Black KM, Loisel P, Anema JR. et al. Back pain and work. Back Pain and Non- Inflammatory Spinal Disorders 2010; 24: 227-240
  • 14 Besen E, Young AE, Shaw WS. Returning to work following low back pain. Towards a model of individual psychosocial factors. Journal of Occupational Rehabilitation 2015; 25: 25-37
  • 15 Campbell P, Wynne-Jones G, Muller S. et al. The influence of employment social support for risk and prognosis in nonspecific back pain. A systematic review and critical synthesis. International Archives of Occupational and Environmental Health 2013; 86: 119-137
  • 16 Dionne CE, Bourbonnais R, Frémont P. et al. Obstacles to and facilitators of return to work after work-disabling pack pain. The workers’ perspective. Journal of Occupational Rehabilitation 2013; 23: 280-289
  • 17 McCluskey S, Brooks J, King N. et al. Are the treatment expectations of ‘significant others’ psychosocial obstacles to work participation for those with persistent low back pain?. Work 2014; 48: 391-398
  • 18 McGuire C, Kristman VL, Shaw W. et al. Supervisor autonomy and considerate leadership style are associated with supervisors’ likelihood to accommodate back injured workers. Journal of Occupational Rehabilitation 2015; 25: 589-598
  • 19 Ryan CG, Lauchlan D, Rooney L. et al. Returning to work after long term sickness absence due to low back pain – The struggle within: A qualitative study of the patient`s experience. Work: Journal of Prevention. Assessment & Rehabilitation 2014; 49: 433-444
  • 20 Wertli MM, Eugster R, Held U. et al. Catastrophizing – a prognostic factor for outcome in patients with low back pain: a systematic review. The Spine Journal: Official Journal of the North American Spine Society 2014; 14: 2638-2657
  • 21 Hayden JA, Dunn KM, van der Windt DA. et al. What is the prognosis of back pain?. Back Pain and Non-Inflammatory Spinal Disorders 2010; 24: 167-179
  • 22 Wertli MM, Rasmussen-Barr E, Weiser S. et al. The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. The Spine Journal 2014; 14: 816-836
  • 23 Wertli MM, Rasmussen-Barr E, Held U. et al. Fear-avoidance beliefs - a moderator of treatment efficacy in patients with low back pain: a systematic review. The Spine Journal 2014; 14: 2658-2678
  • 24 Jensen O, Stengaard-Pedersen K, Jensen C. et al. Prediction model for unsuccessful return to work after hospital-based intervention in low back pain patients. BMC Musculoskeletal Disorders 2013; 14: 140
  • 25 Hoefsmit N, Houkes I. Nijhuis FJN. Intervention characteristics that facilitate return to work after sickness absence. A systematic literature review. Journal of Occupational Rehabilitation 2012; 22: 462-477
  • 26 Du Bois M, Donceel P. Guiding low back claimants to work. Spine 2012; 37: 1425-1431
  • 27 Tong A, Flemming K, McInnes E. et al. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Medical Research Methodology 2012; 12: 181
  • 28 Elliott R, Fischer CT, Rennie DL. Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology 1999; 38: 215-229
  • 29 Petit A, Rozenberg S, Fassier JB. et al. Pre-return-to-work medical consultation for low back pain workers. Good practice recommendations based on systematic review and expert consensus. Annals of Physical and Rehabilitation Medicine 2015; 58: 298-304
  • 30 Lindell O, Johansson SE, Strender LE. Predictors of stable return-to-work in non-acute, non-specific spinal pain: low total prior sick-listing, high self prediction and young age. A two-year prospective cohort study. BMC. Family Practice 2010; 11: 53
  • 31 Lydell M, Hildingh C, Månsson J. et al. Thoughts and feelings of future working life as a predictor of return to work. A combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders. Disability and Rehabilitation 2011; 33: 1262-1271
  • 32 Reme SE, Shaw WS, Steenstra IA. et al. Distressed, immobilized, of lacking employer support? A sub-classification of acute work-related low back pain. Journal of Occupational Rehabilitation 2012; 22: 541-552
  • 33 Shaw WS, Main CJ, Johnston V. Addressing occupational factors in the management of low back pain: implications for physical therapist practice. Physical Therapy 2011; 91: 777-789
  • 34 Stewart AM, Polak E, Young R. et al. Injured workers’ construction of expectations of return to work with aub-acute back pain. The role of perceived uncertainty. Journal of Occupational Rehabilitation 2012; 22: 1-14
  • 35 Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain?. Best Practice & Research Clinical Rheumatology 2010; 24: 205-217
  • 36 Richard S, Dionne CE, Nouwen A. Self-efficacy and health locus of conrol. Relationship to occupational disability among workers with back pain. Journal of Occupational Rehabilitation 2011; 21: 421-430
  • 37 Rainville J, Smeets RJ, Bendix T. et al. Fear-avoidance beliefs and pain avoidance in low back pain – translating research into clinical practice. The Spine Journal 2011; 11: 895-903
  • 38 McCluskey S, Brooks J, King N. et al. The influence of ‘significant others’ on persistent back pain and work participation. A qualitative exploration of illness perceptions. BMC Musculoskeletal Disorders 2011; 12: 236
  • 39 Martel MO, Wideman TH, Sullivan MJ. Patients who display protective pain behaviors are viewed as less likable, less dependable, and less likely to return to work. Pain 2012; 153: 843-849
  • 40 De Vries HJ, Brouwer S, Groothoff JW. et al. Staying at work with chronic nonspecific musculoskeletal pain. A qualitative study of workers’ experiences. BMC Musculoskeletal Disorders 2011; 12: 126
  • 41 Pincus T, Greenwood L, McHarg E. Advising people with back pain to take time off work. A survey examining the role of private musculoskeletal practitioners in the UK. Pain 2011; 152: 2813-2818
  • 42 Pincus T, Woodcock A, Vogel S. Returning back pain patients to work. How private musculoskeletal practitioners outside the national health service perceive their role (an Interview Study). Journal of Occupational Rehabilitation 2010; 20: 322-330
  • 43 Soklaridis S, Ammendolia C, Cassidy D. Looking upstream to understand low back pain and return to work: Psychosocial factors as the product of system issues. Social Science & Medicine 2010; 71: 1557-1566
  • 44 Carroll C, Rick J, Pilgrim H. et al. Workplace involvement improves return to work rates among employees with back pain on long-term sick leave. A systematic review of the effectiveness and cost-effectiveness of interventions. Disability and Rehabilitation 2010; 32: 607-621