"Unable and useless" or "able and useful"? A before and after study in the primary care of self-rated inability to work in young immigrants having long-standing pain
Affiliations: [a] Rinkeby Health Centre, Stockholm, Sweden | [b] Department of Clinical Sciences, Division of Family Medicine, Karolinska Institutet, Stockholm, Sweden
Correspondence:
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Address for correspondence: Monica Löfvander, MD, Rinkeby Health Centre, Skårbygränd 3, SE -163 72 Spånga, Sweden. Tel.: +46 8 687 61 00; Fax: +46 8 687 61 90; E-mail: monica.lofvander@klinvet.ki.se
Abstract: Background:Perceived inability to work predicts a negative outcome of rehabilitation. Objectives:To analyse self-rated inability to work, (SIW), before and after a rehabilitation programme in the primary care, and the risk factors for persistent SIW. Patients:Immigrant patients aged 20–45 years. Methods:Somatic status, ratings of psychosocial stressors and interviews about concepts of pain were performed. Anxiety about pain, depression, and SIW were evaluated before (SIW1) and after (SIW2) the programme consisting of conversations about pain, and daily exercise. Correlation statistics was done by non-parametric methods. The odds ratios (OR) with 95 Results:49 men and 100 women with service-jobs, on the average 38 years, participated. All had pain from muscular structures in the shoulder, back and/or hip regions, 62 Conclusion:The frequency of SIW remained high despite a significant decrease. Preceding long sick leave, anxiety about the pain and psychosocial stress increased the risk of persistent SIW, implying the necessity of further improving the methods of reducing anxiety and the use of only short periods of sick leave in this category of patients.
