OTCohortJournal of rehabilitation medicine2023

Effect of sense of coherence on long-term work participation among rehabilitation patients: a longitudinal study.

Anne Mette Berget, Vegard Pihl Moen, Merethe Hustoft and 4 others

PMID 37855386

WHAT IT FOUND

Rehabilitation patients with a stronger sense that life is comprehensible, manageable and meaningful were more likely to work three years later, especially those with musculoskeletal diagnoses.

Key findings

01Of the 192 included patients, 148 (77%) were working during 2018.

02Baseline sense of coherence was related to work participation in 2018 and to days working without social security benefits in the total cohort and in patients with musculoskeletal diagnoses.

03Mental functioning at one year was associated with baseline sense of coherence and acted as a mediator in some groups, while physical functioning at one year was not associated with baseline sense of coherence and was not qualified as a mediator.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The final analysis included 192 patients, and the authors state the sample size was relatively small. The sample was selected. Patients had to respond to the 1-year follow-up survey, be 60 years old or younger, be working in 2015 with a yearly income at least 45,034 NOK, and not receive disability allowance or pension in 2015. Patients with severe functional limitations often receive specialized rehabilitation in hospital and were not represented, so results may not apply to them. The rehabilitation programme included physical activity, cognitive approaches, coping strategies, and pain management, so the contribution of any single component cannot be separated. The study is observational. The authors cannot exclude possible intervening events or unknown variables explaining the mediation or outcome. The age cut-off of 50 years was based on data exploration, and other cut-offs were not analysed because of insufficient observations. The diagnostic groups were small and heterogeneous, especially the non-musculoskeletal group, which limits subgroup interpretation.

Declared interests

The authors declare no conflicts of interest.

The easy way to misread this

Do not conclude that improving sense of coherence will cause work participation. This was an observational cohort, not a treatment trial, and the authors state possible intervening events and unknown variables may explain the results.

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