Positive recovery expectations (Health factor for workers with an MSD)

Interpretation of the “Positive recovery expectations” factor

Positive recovery expectations positively influence RTW or sickness absence duration.

Definition of the “Positive recovery expectations” factor

Short definition: Recovery expectations relate to the person’s own assessment of when he or she will feel better in terms of health status.

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Positive recovery expectations positively influence RTW in workers with an MSD (Cole, Mondloch et Hogg-Johnson, 2002; Hagen, Svensen et Eriksen, 2005; Hogg-Johnson et Cole, 2003; Nicholas et al., 2019; Schultz et al., 2004). Recovery expectations, referring to a health/healing concept, should be differentiated from RTW expectations, referring to a work-participation (or social functioning) concept (Laferton, Kube, Salzmann, Auer et Shedden-Mora, 2017). Note that these two concepts seem to influence each other (Ozegovic, Carroll et David Cassidy, 2009). Recovery expectations can appear as future-directed thoughts or may exist unconsciously, and are expected helping to resume usual activities such as those related to work (Schultz et al., 2004).

According to the model of expectations by Laferton et al. (2017), recovery expectations regarding health outcomes (e.g., MSD or CMD symptoms) can be influenced by generalized expectations (generalized self-efficacy, optimism), behavior expectations (task and coping self-efficacy) and treatment-related expectations (treatment outcome). Consequently, negative recovery expectations need to be examined in more detail to identify their sources and thus intervene more effectively.

Recovery expectations appear to influence the clinical course of many physical and mental conditions (Mondloch, Cole et Frank, 2001). They play a crucial role in shaping placebo (positive) and nocebo (negative) effects as they can involve a wide range of physiological and social-psychological mechanisms that influence patients’ perceptions of their symptoms (Laferton et al., 2017). Researchers have identified five fundamental mechanisms by which recovery expectations can affect outcomes: (1) triggering a physiological response, (2) motivating patients to achieve better outcomes, (3) conditioning patients to observe certain types of symptoms and ignore others, (4) changing the understanding of the disease, and (5) acting in concert with anxiety to heighten or reduce symptoms (Flood, Lorence, Ding, McPherson et Black, 1993).

Cole, D. C., Mondloch, M. V. et Hogg-Johnson, S. (2002). Listening to injured workers: how recovery expectations predict outcomes–a prospective study. CMAJ., 166(6), 749-754. Tiré de

Flood, A. B., Lorence, D. P., Ding, J., McPherson, K. et Black, N. A. (1993). The role of expectations in patients’ reports of post-operative outcomes and improvement following therapy. Med Care, 31(11), 1043-1056. doi: 10.1097/00005650-199311000-00006

Hagen, E. M., Svensen, E. et Eriksen, H. R. (2005). Predictors and modifiers of treatment effect influencing sick leave in subacute low back pain patients. Spine (Phila Pa 1976), 30(24), 2717-2723. Tiré de

Hogg-Johnson, S. et Cole, D. (2003). Early prognostic factors for duration on temporary total benefits in the first year among workers with compensated occupational soft tissue injuries. Occupational and Environmental Medicine, 60(4), 244-253. Tiré de

Laferton, J. A., Kube, T., Salzmann, S., Auer, C. J. et Shedden-Mora, M. C. (2017). Patients’ Expectations Regarding Medical Treatment: A Critical Review of Concepts and Their Assessment. Front Psychol, 8 233. doi: 10.3389/fpsyg.2017.00233

Mondloch, M. V., Cole, D. C. et Frank, J. W. (2001). Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes. Canadian Medical Association Journal, 165(2), 174-179. Tiré de

Nicholas, M. K., Costa, D. S. J., Linton, S. J., Main, C. J., Shaw, W. S., Pearce, R., . . . McGarity, A. (2019). Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief OMPSQ-SF. J Occup Rehabil, 29(2), 295-302. doi: 10.1007/s10926-018-9784-8

Ozegovic, D., Carroll, L. J. et David Cassidy, J. (2009). Does expecting mean achieving? The association between expecting to return to work and recovery in whiplash associated disorders: a population-based prospective cohort study. Eur Spine J, 18(6), 893-899. doi: 10.1007/s00586-009-0954-4

Schultz, I., Crook, J., Meloche, G., Berkowitz, J., Milner, R., Zuberbier, O. et Meloche, W. (2004). Psychosocial factors predictive of occupational low back disability: towards development of a return-to-work model. Pain, 107(1-2), 77-85.

Tools for measuring the “Positive recovery expectations” factor