EFFECT OF SENSE OF COHERENCE ON LONG-TERM WORK PARTICIPATION AMONG REHABILITATION PATIENTS: A LONGITUDINAL STUDY

OBJECTIVE: To investigate the causal effect of sense of coherence on long-term work participation after rehabilitation, including stratification by age and diagnoses. DESIGN: Longitudinal cohort study. PARTICIPANTS: Patients aged ≤ 60 years, employed and accepted for somatic interprofessional rehabilitation in 2015 (n = 192). METHODS: Patients reported sense of coherence before rehabilitation in 2015 and mental and physical functioning in 2016. Register data were used to measure work participation during 2018 and days working without social security benefits during 2016–18. Regression models were used to explore the total effect of sense of coherence and the possible mediation of functioning. Results are reported as odds ratios (95% confidence intervals). RESULTS: During 2018, 77% of the total study cohort participated in work activities. The subgroup with musculoskeletal diagnoses had the fewest days of working without social security benefits. A causal relationship was found between sense of coherence and long-term work participation. Some of the effect of sense of coherence was mediated by mental functioning. The total effect of sense of coherence was strongest for patients with musculoskeletal diagnoses (work participation: 1.11 (1.05, 1.17), days working without social security benefits: 1.05 (0.01, 109)). CONCLUSION: Improving coping resources may be beneficial to facilitate long-term work participation after injury or illness, especially for individuals with musculoskeletal diagnoses. LAY ABSTRACT Sense of coherence is an inherent coping resource. The aim of this study was to investigate the effect of sense of coherence on long-term work participation among 192 rehabilitation patients. Patients reported sense of coherence before rehabilitation in 2015, and reported functioning in 2016. Register data were used to measure work participation. The study found that 77% of the patients who worked in 2015 also worked in 2018. The subgroup with musculoskeletal diagnoses had the fewest days of working without social security benefits (e.g. sick leave) during 2016–18. A stronger sense of coherence had a positive effect on long-term work participation. Sense of coherence also had an impact on mental functioning, which again had a positive effect on long-term work participation. The results suggest that interventions to improve coping resources (sense of coherence) may be important to help patients participate in working life after injury or illness, especially for individuals with musculoskeletal diagnoses.