Objective: The objective of this systematic review was to investigate which factors are associated with continued sick-leave among workers on sick-leave for at least six weeks. Methods: A systematic literature search was performed in Medline, EMBASE and PsycInfo, based on combinations of MESH terms and free text words. Inclusion of studies in this review was restricted to cohort studies of workers on sick leave for more than six weeks at baseline. The outcome was measured in terms of factors related to long-term sick leave. The factors were first classified as predisposing factors, precipitating factors and perpetuating factors. Secondly, the factors were classified as individual factors and work-related factors. The methodological quality was assessed for all studies. In addition, the strength of the evidence for each factor was assessed using the levels of evidence rating system. Results: Five cohort studies fulfilled all inclusion criteria. In these studies 77 factors were investigated. Sixteen different significant factors associated with long-term sick leave were identified. All factors identified were classified as predisposing factors. Evidence was found for 14 individual factors and two work-related factors. The level of evidence was found to be insufficient for all factors, except for the factors older age and history of sick leave which were found to have a weak evidence. Conclusions: Based on this review, there is weak evidence for older age and history of sickness absence as factors associated with long-term sick leave in sick-listed employees. There is insufficient evidence for an effect of other individual factors and work-related factors on long-term sick leave. There are no published studies on perpetuating factors related with long-term sick leave.
- long-term sick leave
- perpetuating factors
- return to work
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