Positive RTW expectations (Personal factor for workers with an MSD or CMD)

Interpretation of the “Positive RTW expectations” factor

Positive RTW expectations positively influence RTW or sickness absence duration.

Definition of the “Positive RTW expectations” factor

Short definition: RTW expectations encompass several factors (Besen, Young et Shaw, 2015), including the person’s own assessment of when he or she will feel better (recovery expectations) and be able to resume his or her usual activities (social functioning), such as those related to work (Schultz et al., 2004).

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Positive RTW expectations represent the best-documented factor in terms of positive influence on RT in workers with an MSD or CMD, leading to reviews on this topic (Carrière et al., 2023; Ebrahim et al., 2015). These expectations, which refer to a concept of social functioning, should be differentiated from recovery expectations, which refer to a concept of health/healing (Laferton, Kube, Salzmann, Auer et Shedden-Mora, 2017). Note that these two concepts seem to influence each other (Ozegovic, Carroll et David Cassidy, 2009). Indeed, the nature of these expectations can be influenced by several contextual elements, in addition to the worker’s health. For example, his/her employer’s attitudes and barriers to employment are factors that could affect the person’s assessment of when he/she will be able to RTW (Stewart, Polak, Young et Schultz, 2012). As RTW expectations are a very complex concept, current assessment tools, which generally consist of a single question (e.g., When do you think you will be able to return to work?), do not identify what underlies these expectations (Carrière et al., 2023; Ebrahim et al., 2015).  Where appropriate, workers should therefore be trained to identify the underlying issues to intervene effectively.

Besen, E., Young, A. E. et Shaw, W. S. (2015). Returning to work following low back pain: towards a model of individual psychosocial factors. Journal of Occupational Rehabilitation, 25(1), 25-37.

Carrière, J. S., Donayre Pimentel, S., Bou Saba, S., Boehme, B., Berbiche, D., Coutu, M. F. et Durand, M. J. (2023). Recovery expectations can be assessed with single-item measures: findings of a systematic review and meta-analysis on the role of recovery expectations on return-to-work outcomes after musculoskeletal pain conditions. Pain, 164(4), e190-e206. doi: 10.1097/j.pain.0000000000002789

Ebrahim, S., Malachowski, C., Kamal El Din, M., Mulla, S. M., Montoya, L., Bance, S. et Busse, J. W. (2015). Measures of patients’ expectations about recovery: a systematic review. J Occup Rehabil, 25(1), 240-255. doi: 10.1007/s10926-014-9535-4

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

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.

Stewart, A. M., Polak, E., Young, R. et Schultz, I. Z. (2012). Injured workers’ construction of expectations of return to work with sub-acute back pain: the role of perceived uncertainty. Journal of Occupational Rehabilitation, 22(1), 1-14.

Tools for measuring the “Positive RTW expectations” factor