Psycho-social construct | Studies measuring construct | Quality score/17 | How construct measured | Tested and significant in prognosis | ||||
Uni-variate* | Multi-variate** | Part of pred-ictive model‡ | Outcome | |||||
Recovery | Turner et al44 | 16 (H) | Certainty will be working in 6 months (0–10) | – | Work disability at | |||
expectation | 6 months | |||||||
Dionne et al30 | 13 (H) | Do you think you will be back to normal work in | – | – | RTW success | |||
3 months? (yes/no) | Partial success (RTW with limitations) | |||||||
Failure | ||||||||
Hagen et al32 | 12 (H) | Don’t believe BP will disappear (yes/no) | – | RTW at 3 months | ||||
RTW at 12 months | ||||||||
Karjalainen et al36 | 12 (H) | Perceived risk of not recovering (0–10) | – | Pain interfering with daily life or work | ||||
X | X | – | Sick leave (0, 1–30, >30 days) | |||||
Steenstra et al23 | 11 (M) | Expected duration of sick leave (1–10 days, | Duration absent until RTW | |||||
>10 days) | ||||||||
Duration absent until RTW for 4 weeks | ||||||||
Total duration of sick leave | ||||||||
Hazard et al34 | 9 (L) | How certain are you that you will be working in 6 months? (0–10) | – | – | RTW at 3 months | |||
Schultz et al (2005)46 | 9 (L) | Expectation of recovery scale (7 items) | RTW at 3 months | |||||
Schultz et al (2004)40 | 9 (L) | Expectation of recovery scale (8 items) | RTW at 3 months | |||||
– | Number of days lost from work | |||||||
Shaw et al42 | 9 (L) | Will you be able to do your regular job without restrictions 4 weeks from now? (5-point scale) | – | RTW at 1 month | ||||
Physician estimated days until RTW | – | |||||||
Fear | Turner et al44 | 16 (H) | Average of two items from Fear Avoidance | – | Work disability at | |||
avoidance | Beliefs Questionnaire (FABQ) | 6 months | ||||||
beliefs/ | work subscales | |||||||
behaviours | ||||||||
Dionne et al30 | 13 (H) | FABQ activity subscale (4 items) | – | – | X | RTW success | ||
FABQ work subscale (7 items) | Partial success | |||||||
– | – | X | Failure | |||||
Hagen et al32 | 12 (H) | Believe work will aggravate condition (yes/no) | – | RTW at 3 months | ||||
– | RTW at 12 months | |||||||
Fritz et al26 27 | 10 (M) | FABQ activity subscale (4 items) | X | X | RTW with or without restrictions at 4 weeks | |||
FABQ work subscale (7 items) | ||||||||
Haldorsen et al33 | 9 (L) | If you continue working, what effect will that have on your complaints? (5-point scale) | X | X | X | RTW at 12 months | ||
Klenerman et al25 | 9 (L) | Combination of Holmes and Rahe stressful life events scale (43 items), Modified Somatic Perception Questionnaire (MSPQ) (13 items), previous pain history (3 items) and pain coping strategies (8 items) | X | RTW at 12 months | ||||
Shaw et al47 | 9 (L) | Worried physical activity will increase pain or cause re-injury? (5-point scale) | – | X | X | RTW at 1 month | ||
Boersma and Linton28 | 6 (L) | Average of two items from Orebro Musculoskeletal Pain Questionnaire | – | – | Long term sick leave (>15 days) | |||
Depression | Dionne et al30 | 13 (H) | Symptoms of depression (Symptom Checklist-90 Revised – 90 items) | – | – | X | RTW: success, partial success, failure | |
Fritz et al26 27 | 10 (M) | Centre for Epidemiological Studies Depression Scale (CES-D) (20 items) | X | X | RTW with or without restrictions at 4 weeks | |||
Gatchel et al31 | 10 (M) | Clinical DSM-III-R diagnosis of depression | X | X | X | Currently working at 1 year | ||
Minnesota Multiphasic Personality Inventory (MMPI) scale 2 (60 items) | X | X | X | |||||
Truchon and Cote43 | 10 (M) | Hospital Anxiety and Depression Scale (HADS) (14 items) | X | X | RTW at 6 months | |||
Haldorsen et al33 | 9 (L) | Ursin’s Health Inventory (29 items) | X | X | X | RTW at 12 months | ||
Klenerman et al25 | 9 (L) | Modified Zung depression inventory (20 items) | – | X | X | Work status at 12 months | ||
Lehmann et al24 | 9 (L) | Beck Depression Inventory (BDI) | X | – | – | Time to RTW | ||
Schultz et al (2004)40 | 9 (L) | Centre for Epidemiological Studies Depression | X | X | X | RTW at 3 months | ||
Scale (CES-D) (20 items) | Number of days lost from work | |||||||
Schultz et al (2005)46 | 9 (L) | Distress scale: gross screen for psychological distress, including depression (11 items) | X | X | RTW at 3 months | |||
Shaw et al42 | 9 (L) | How much of the time felt downhearted and blue in past week? (6-point scale) | – | X | X | RTW at 1 month | ||
Clinician assessed evidence of depression (yes/no) | X | – | – | |||||
Coste et al22 | 8 (L) | Clinical DSM-III-R diagnosis of depression | X | X | X | RTW at 3 months | ||
Lanier and Stockton37 | 8 (L) | Clinician assessment of history of depression | X | – | Number of lost working days | |||
Boersma and Linton28 | 6 (L) | How much have you been bothered by feeling depressed in the past week? (0–10) | – | – | Long term sick leave (>15 days) | |||
Stress/ | Dionne et al30 | 13 (H) | Exposure to stressful events in last 12 months (1 | – | – | X | RTW success | |
psycho- | item) | |||||||
logical | Psychological demands of work (1 item) | – | – | X | Partial success | |||
strain | Failure | |||||||
Hagen et al32 | 12 (H) | High psychological workload (yes/no) | X | X | – | RTW at 3 and 12 months | ||
Steenstra et al23 | 11 (M) | Complaints related to job stress (yes/no) | X | Duration absent until RTW for 4 weeks | ||||
Complaints related to stressful life events (yes/no) | X | X | X | |||||
Van der Weide et al45 | 10 (M) | Emotional effort (0–100) | X | X | – | RTW at 12 months | ||
Mentally demanding work (yes/no) | X | X | – | |||||
Deyo and Diehl29 | 9 (L) | Worried about serious illness (yes/no) | – | X | – | RTW at 3 months | ||
Haldorsen et al33 | 9 (L) | Eysenck Personality Inventory: neuroticism-stability (lability to breakdown under stress) (57 items) | X | X | X | RTW at 12 months | ||
Klenerman et al25 | 9 (L) | Holmes and Rahe scale of stressful life events (43 items) | – | X | X | Work status at 12 months | ||
Lehmann et al24 | 9 (L) | Job stress (0–9) | X | – | – | Time to RTW | ||
Severe emotional discomfort: Low Back Classification Scale (LCBS) (0–9) | X | – | – | |||||
Psychological disturbance: Low Back Classification Scale (LBCS) (0–9) | X | – | – | |||||
Schultz et al (2004)40 | 9 (L) | Karasek Job Content Questionnaire (27 items): | X | X | X | RTW at 3 months | ||
psychological demand subscale | Number of days lost from work | |||||||
Schultz et al (2005)46 | 9 (L) | Current psychological distress (11 items) | X | X | RTW at 3 months | |||
Shaw et al42 | 9 (L) | Feel under stress (1–5) | – | X | X | |||
Anxiety | Hagen et al32 | 12 (H) | State-Trait Anxiety Index (STAI) (20 items): | X | X | – | ||
State anxiety subscale | X | X | – | |||||
Trait anxiety subscale | X | – | RTW at 12 months | |||||
Fritz et al26 27 | 10 (M) | Beck Anxiety Index (BAI) (21 items) | X | X | RTW with or without restrictions at 4 weeks | |||
Gatchel et al31 | 10 (M) | Clinical DSM-III-R diagnosis of presence of depression, anxiety and substance abuse disorders | X | X | – | Currently working at 1 year | ||
Haldorsen et al33 | 9 (L) | State-Trait Anxiety Index (STAI) (20 items): | X | X | – | RTW at 12 months | ||
State anxiety subscale | X | X | – | |||||
Trait anxiety subscale | X | X | – | |||||
Ursin’s Health Inventory (scale included depression, anxiety, sleep problems, hot spells and chest pain) (29 items) | X | X | – | |||||
Schultz et al40 (2004) | 9 (L) | State-Trait Anxiety Index (STAI) (20 items): State anxiety subscale | X | X | RTW at 3 months | |||
Coste et al22 | 8 (L) | DSM-III-R diagnosis of generalised anxiety | X | X | X | RTW at 3 months | ||
Lanier and Stockton37 | 8 (L) | Clinician assessment of history of anxiety | X | – | Number of lost working days | |||
Job | Dionne et al30 | 13 (H) | Satisfaction concerning possibilities of work | – | – | X | RTW success | |
satisfaction | adaptation† | |||||||
Job satisfaction† | – | – | X | Partial success | ||||
Satisfaction with health services† | – | – | X | Failure | ||||
Karjalianen et al36 | 12 (H) | Satisfaction with work (0–10) | X | X | – | Sick leave (0, 1–30, >30 days) | ||
Satisfaction with medical care (0–10) | X | X | – | |||||
Nordin et al38 | 11 (M) | Quinn and Shepard: job satisfaction scale (7.2–27.8) | X | X | – | >28 days off work | ||
Quinn and Shepard: negative feelings about work (4–20) | X | X | – | |||||
Van der Weide et al45 | 10 (M) | Not enjoying work (0–100) | X | X | – | RTW at 12 months | ||
Lehmann et al24 | 9 (L) | Price and Meuller job satisfaction scale (6 items) | X | – | – | Time to RTW | ||
Shaw et al42 | 9 (L) | Job satisfaction (1–10) | – | X | X | RTW at 1 month | ||
Coste et al22 | 8 (L) | Poor job satisfaction† | X | – | Longer recovery | |||
Cats-Baril and Frymoyer21 | 5 (L) | Job satisfaction† | – | – | RTW at 6 months | |||
Satisfaction with retirement policies and benefits† | – | – | X | |||||
Compens- | Dionne et al30 | 13 (H) | Current financial problems due to BP (yes/no) | – | – | X | RTW success | |
ation | Current compensation for BP (yes/no) | – | – | X | Partial success | |||
Likelihood of losing job† | – | – | X | Failure | ||||
Previous compensation for BP† | – | – | X | |||||
Gatchel et al31 | 10 (M) | Workers compensation/personal injury insurance case (yes/no) | – | Currently working at 1 year | ||||
Infante-Rivard and Lortie35 | 10 (M) | Salary insurance (yes/no) | X | – | RTW | |||
Schultz et al (2004)40 | 9 (L) | WCB/Employer Response to Claim Scale (4 items) | X | X | RTW at 3 months | |||
Schultz et al (2005)46 | 9 (L) | WCB/Employer Response to Claim Scale (4 items) | X | RTW at 3 months | ||||
Shaw et al42 | 9 (L) | Supervisor questioned whether you were really hurt (yes/no) | – | X | RTW at 1 month | |||
Supervisor discouraged you from filing injury claim (yes/no) | – | X | X | |||||
Coste et al22 | 8 (L) | Compensation status (yes/no) | X | – | Longer recovery | |||
X | – | Lost work time | ||||||
Cats-Baril and Frymoyer21 | 5 (L) | Perception of injury was source of compensation (yes/no) | – | – | X | RTW at 6 months | ||
Lawyer had been contacted (yes/no) | – | – | X |
*Significant (p<0.05) in univariate test comparing groups, such as t test or χ2 analysis.
**Significant (p<0.05) in multivariate test comparing groups, such as multiple regression or Cox hazard ratios.
†No further information presented in study.
‡Prognostic model tested to determine sensitivity, specificity or accuracy of predicting outcomes.
, tested and found significant, or used as part of tested predictive model; –, not assessed in this category (univariate testing not carried out, multivariate testing not carried out, predictive model not tested); X, tested and not found significant in predicting outcome, or not included in tested prognostic model.
Studies are listed in each section with highest methodological quality first. H, high quality study with quality score of 12 or greater out of 17; L, low quality study with quality score of 9 or less out of 17; M, medium quality study with quality score of 10 or 11 out of 17.
BP, back pain; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; FABQ, Fear Avoidance Beliefs Questionnaire; RTW, return to work; WCB, Workers’ Compensation Board.