Changes to body mass index, work self-efficacy, health-related quality of life, and work participation in people with obesity after vocational rehabilitation: a prospective observational study

Anita Dyb Linge, Chris Jensen, Petter Laake, Stål Kapstø Bjørkly, Anita Dyb Linge, Chris Jensen, Petter Laake, Stål Kapstø Bjørkly

Abstract

Background: People on or at risk of sick leave from work due to obesity or obesity-related problems participated in a new vocational rehabilitation (VR). The study aimed to examine the outcome changes in the participants' health-related quality of life (HRQoL), body mass index (BMI), return to work self-efficacy (RTWSE), work ability scale (WAS) and degree of work participation (DWP) after their participation in the 12-month VR programme. The secondary aim was to examine associations between the outcome changes and HRQoL at 12-month follow-up, measured with the HRQoL 15D instrument (15D).

Methods: This prospective observational study included 95 participants. The one-year multidisciplinary VR programme with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by 5 meetings. A paired sample t-test was used to examine changes in HRQoL, BMI, RTWSE, WAS, and DWP between baseline and the 12-month follow-up. Multiple linear regression analyses explored associations between changes in HRQoL and the outcome variables.

Results: The participants achieved statistically significant changes in HRQoL (2.57, 95% CI: 1.35 to 3.79), BMI (- 2.33, 95% CI: - 3.10 to - 1.56), RTWSE (15.89, 95% CI: 4.07 to 27.71), WAS (1.51, 95% CI: 0.83 to 2.20) and DWP (18.69, 95% CI: 8.35 to 29.02). At 12 months, a significant association was found between HRQoL and BMI (B = - 0.34, 95% CI: - 0.65 to - 0.04), RTWSE (B = 0.02, 95% CI: 0.004 to 0.04), WAS (B = 0.91, 95% CI: 0.55 to 1.28), DWP (B = - 0.02, 95% CI: - 0.04 to 0.001) and work absence (B = - 0.01, 95% CI: - 0.02 to - 0.002). The regression model explained 71.8% of the HRQoL variance.

Conclusion: The results indicated positive changes in HRQoL, BMI, RTWSE, WAS and DWP from baseline to the 12-month follow-up. Factors associated with HRQoL at the 12-month follow-up were decreased BMI, increased RTWSE, improved WAS and reduced work absence. Future studies examining VR programmes with lifestyle interventions for people with obesity are recommended.

Trial registration: Norwegian Regional Committee for Medical and Health Research Ethics (REC) 2017/573, Clinical Trials NCT03286374 , registered 18. September 2017. https://clinicaltrials.gov/ct2/results?cond=Obesity&term=Anita+Dyb+Linge&cntry=NO&state=&city=&dist=.

Keywords: Health-related quality of life; Obesity; Return to work self-efficacy; Vocational rehabilitation; Work ability; Work absence.

Conflict of interest statement

The authors declare that they have no competing interests in this study.

Figures

Fig. 1
Fig. 1
A schematic overview above in-and outpatient stay of the vocational rehabilitation programme

References

    1. Colditz GA, Dart H. Epidemiology and health and economic consequences. In: Wadden TA, Bray G, editors. Handbook of obesity treatment. 2. New York: Guildford Press; 2018. pp. 3–24.
    1. Nossum R, Johansen A-E, Kjeken I. Occupational problems and barriers reported by individuals with obesity. Scand J Occup Ther. 2018;25(2):136–144. doi: 10.1080/11038128.2017.1279211.
    1. Stunkard AJ, Wadden TA. Psychological aspects of severe obesity. Am J Clin Nutr. 1992;55(2):524S–532S. doi: 10.1093/ajcn/55.2.524s.
    1. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring, Md) 2009;17(5):941–964. doi: 10.1038/oby.2008.636.
    1. Narbro K, Ågren G, Jonsson E, Larsson B, Näslund I, Wedel H, Sjöström L. Sick leave and disability pension before and after treatment for obesity: a report from the Swedish obese subjects (SOS) study. Int J Obes. 1999;23(6):619–624. doi: 10.1038/sj.ijo.0800890.
    1. Van Duijvenbode DC, Hoozemans MJ, Van Poppel MN, Proper KI. The relationship between overweight and obesity, and sick leave: a systematic review. Int J Obes. 2009;33(8):807–816. doi: 10.1038/ijo.2009.121.
    1. Ekberg K, Ståhl C. Employment as a Key Rehabilitation Outcome. In: Bültmann U, Siegrist J, editors. Handbook of Disability, Work and Health. 1: Springer International Publishing; 2020. p. 364–84.
    1. Lehnert T, Stuhldreher N, Streltchenia P, Riedel-Heller SG, Konig HH. Sick leave days and costs associated with overweight and obesity in Germany. J Occup Environ Med. 2014;56(1):20–27. doi: 10.1097/JOM.0000000000000065.
    1. Park S. Pathways linking obesity to health-related quality of life. Qual Life Res. 2017;26(8):2209–2218. doi: 10.1007/s11136-017-1565-x.
    1. Rejeski WJ, Williamson D. Effects of lifestyle interventions on health related quality of life and physical functioning. In: Wadden TA, Bray G, editors. Handbook of obesity treatment. 2. New York: The Guildford Press; 2018. pp. 223–240.
    1. Bowling A. Appendix 1: "The definition and measurement of well-being and quality of life in mental health promotion and outcomes" Annual report of the Chief Medical Officer 2013 Public mental health priorities: Investing in the evidence London: Department of Health; 2013. p. 320.
    1. Norwegian Labour and Welfare Administration (NAV). Arbeidsrettet rehabilitering : NAV; 2019 [cited 2021 12.02].
    1. Sewdas R, de Wind A, Abma FI, Boot CRL, Brouwer S. Personal and environmental factors influencing work participation among individuals with chronic diseases. In: Bültmann U, Siegrist J, editors. Handbook of disability, work and health. Cham: Springer International Publishing; 2020. pp. 385–398.
    1. De Vries H, Fishta A, Weikert B, Rodriguez Sanchez A, Wegewitz U. Determinants of sickness absence and return to work among employees with common mental disorders: a scoping review. J Occup Rehabil. 2018;28(3):393–417. doi: 10.1007/s10926-017-9730-1.
    1. Martimo K-P, Takala E-P. Concepts of work ability in rehabilitation. In: Bültmann U, Siegrist J, editors. Handbook of disability, Work and Health: Springer International Publishing; 2020. p. 551–570, DOI: 10.1007/978-3-030-24334-0_30.
    1. Van den Berg TI, Elders LA, de Zwart BC, Burdorf A. The effects of work-related and individual factors on the work ability index: a systematic review. Occupational Environ Med. 2009;66(4):211–220. doi: 10.1136/oem.2008.039883.
    1. Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology. 2007;132(6):2226–2238. doi: 10.1053/j.gastro.2007.03.051.
    1. Kaleta D, Makowiec-Dabrowska T, Jegier A. Lifestyle index and work ability. Person-related factors associated with work participation in employees with health problems: a systematic review. 2006;19(3):170–177.
    1. Heerkens Y, Engels J, Kuiper C, Van Der Gulden J, Oostendorp R. The use of the ICF to describe work related factors influencing the health of employees. Disabil Rehabil. 2004;26(17):1060–1066. doi: 10.1080/09638280410001703530.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. doi: 10.1037/0033-295X.84.2.191.
    1. Gomez-Rubalcava S, Stabbert K, Phelan S. Behavioral treatment of obesity. In: Bültmann U, Siegrist J, editors. Handbook of obesity treatment. 2. New York: Guilford Press; 2018. pp. 336–348.
    1. de Wit M, Wind H, Hulshof CTJ, Frings-Dresen MHW. Person-related factors associated with work participation in employees with health problems: a systematic review. Int Arch Occup Environ Health. 2018;91(5):497–512. doi: 10.1007/s00420-018-1308-5.
    1. Bandura A, Adams N, Hardy A, Howells G. Tests of generality of self-efficacy theory. Cognit Ther Res. 1980;4(1):39–66. doi: 10.1007/BF01173354.
    1. Shaw WS, Reme SE, Linton SJ, Huang YH, Pransky G. 3rd place, PREMUS best paper competition: development of the return-to-work self-efficacy (RTWSE-19) questionnaire--psychometric properties and predictive validity. Scand J Work Environ Health. 2011;37(2):109–119. doi: 10.5271/sjweh.3139.
    1. Costa-Black KM, Feuerstein M, Loisel P. Work disability models: past and present. In: Loisel PaA, J. R, editor. Handbook of work disability. New York: Springer; 2013. p. 71–93, DOI: 10.1007/978-1-4614-6214-9_6.
    1. Knauf MT, Schultz IZ. Current conceptual models of return to work. In: Schultz I, Gatchel R, editors. Handbook of return to work. Boston: Springer; 2016. pp. 27–51.
    1. Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculoskeletal disorders. J Occup Rehabil. 2007;17(2):327–352. doi: 10.1007/s10926-007-9071-6.
    1. Kristman VL, Boot CRL, Sanderson K, Sinden KE, Williams-Whitt K. Implementing best practice models of return to work. In: Bültmann U, Siegrist J, editors. Handbook of disability, work and health. Cham: Springer International Publishing; 2020. pp. 589–613.
    1. Bültmann U, Siegrist J. Handbook of disability, work and health. Switzerland: Springer International Publishing; 2020.
    1. Oellingrath IM, De Bortoli MM, Svendsen MV, Fell AKM. Lifestyle and work ability in a general working population in Norway: a cross-sectional study. BMJ Open. 2019;9(4):e026215. doi: 10.1136/bmjopen-2018-026215.
    1. Andersen JR, Karlsen T-I, Kolotkin RL. Obesity and its impact upon quality of life. Mullin GE, Cheskin LJ, Matarese LE, editors. New York: Springer New York; 2014.
    1. Kolotkin RL, Andersen JR. A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life. Clin Obesity. 2017;7(5):273–289. doi: 10.1111/cob.12203.
    1. Warkentin LM, Das D, Majumdar SR, Johnson JA, Padwal RS. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials. Obesity Review. 2014;15(3):169–182. doi: 10.1111/obr.12113.
    1. Carson TL, Hidalgo B, Ard JD, Affuso O. Dietary interventions and quality of life: a systematic review of the literature. J Nutr Educ Behav. 2014;46(2):90–101. doi: 10.1016/j.jneb.2013.09.005.
    1. Kroes M, Osei-Assibey G, Baker-Searle R, Huang J. Impact of weight change on quality of life in adults with overweight/obesity in the United States: a systematic review. Curr Med Res Opin. 2016;32(3):485–508. doi: 10.1185/03007995.2015.1128403.
    1. Maciejewski ML, Patrick DL, Williamson DF. A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol. 2005;58(6):568–578. doi: 10.1016/j.jclinepi.2004.10.015.
    1. Miller WR, Rollnick S. Motivational interviewing: helping people change. New York: Guilford Press; 2012.
    1. Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann Med. 2001;33(5):328–336. doi: 10.3109/07853890109002086.
    1. Fontaine K, Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001;2(3):173–182. doi: 10.1046/j.1467-789x.2001.00032.x.
    1. Moock J, Kohlmann T. Comparing preference-based quality-of-life measures: results from rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders. Qual Life Res. 2008;17(3):485–495. doi: 10.1007/s11136-008-9317-6.
    1. Victorzon M, Tolonen P, Sintonen H. Health-related quality of life in severely and morbidly obese patients waiting for bariatric surgery in Finland. Scand J Surg. 2010;99(3):122–126. doi: 10.1177/145749691009900304.
    1. Alanne S, Roine RP, Räsänen P, Vainiola T, Sintonen H. Estimating the minimum important change in the 15D scores. Qual Life Res. 2014;24(3):599–606. doi: 10.1007/s11136-014-0787-4.
    1. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care. 2003;41(5):582–592. doi: 10.1097/01.MLR.0000062554.74615.4C.
    1. World Health Organization BMI classification. WHO Health Topics, : World Health Organization; 2020 (May 5th) [cited 2020 May 5].
    1. Nøttingnes C, Fersum KV, Reme SE, Moe-Nilssen R, Morken T. Job-related self-efficacy in musculoskeletal disorders - a questionnaire. Tidsskr Nor Laegeforen. 2019;139(11):9.
    1. Gould R, Ilmarinen J, Järvisalo J, Koskinen S. Dimensions of work ability: results of the Health 2000 Survey. Helsinki: Finnish Centre for Pensions (ETK), The Social Insurance Institution (Kela), National Public Health Institute (KTL), Finnish Institute of Occupational Health (FIOH); 2008.
    1. Ahlstrom L, Grimby-Ekman A, Hagberg M, Dellve L. The work ability index and single-item question: associations with sick leave, symptoms, and health-a prospective study of women on long-term sick leave. Scand J Work Environ Health. 2010;36(5):404–412. doi: 10.5271/sjweh.2917.
    1. El Fassi M, Bocquet V, Majery N, Lair ML, Couffignal S, Mairiaux P. Work ability assessment in a worker population: comparison and determinants of work ability index and work ability score. BMC Public Health. 2013;13(1):305. doi: 10.1186/1471-2458-13-305.
    1. Janssens H, Clays E, Kittel F, De Bacquer D, Casini A, Braeckman L. The association between body mass index class, sickness absence, and presenteeism. J Occup Environ Med. 2012;54(5):604–609. doi: 10.1097/JOM.0b013e31824b2133.
    1. Neovius K, Johansson K, Kark M, Neovius M. Obesity status and sick leave: a systematic review. Obes Rev. 2009;10(1):17–27. doi: 10.1111/j.1467-789X.2008.00521.x.
    1. George D, Mallery P. IBM SPSS statistics 26 step by step: a simple guide and reference. New York: Routledge; 2020.
    1. Laake P, Hjartåker A, Thelle DS, Veierød MB. Epidemiologiske og kliniske forskningsmetoder. Gyldendal Akademisk: Oslo; 2007.
    1. Andersen RJ, Aasprang A, Bergsholm P, Sletteskog N, Våge V, Natvig KG. Health-related quality of life and paid work participation after duodenal switch. Obes Surg. 2010;20(3):340–345. doi: 10.1007/s11695-009-9837-3.
    1. Van den Berg S, Burdorf A, Robroek SJW. Associations between common diseases and work ability and sick leave among health care workers. Int Arch Occup Environ Health. 2017;90(7):685–693. doi: 10.1007/s00420-017-1231-1.
    1. Andersen LL, Izquierdo M, Sundstrup E. Overweight and obesity are progressively associated with lower work ability in the general working population: cross-sectional study among 10,000 adults. Int Arch Occup Environ Health. 2017;90(8):779–787. doi: 10.1007/s00420-017-1240-0.
    1. Neovius K, Johansson K, Rossner S, Neovius M. Disability pension, employment and obesity status: a systematic review. Obesity Review. 2008;9(6):572–581. doi: 10.1111/j.1467-789X.2008.00502.x.
    1. Niedhammer I, Bugel I, Bonenfant S, Goldberg M, Leclerc A. Validity of self-reported weight and height in the French GAZEL cohort. Int J Obes Relat Metab Disord. 2000;24(9):1111–1118. doi: 10.1038/sj.ijo.0801375.
    1. Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, Oxman AD, Moher D, CONSORT group. Pragmatic Trials in Healthcare (Practihc) group Improving the reporting of pragmatic trials: an extension of the CONSORT statement. BMJ. 2008;337(nov11 2):a2390. doi: 10.1136/bmj.a2390.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere