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Primary care patients with musculoskeletal pain. Value of health-status and sense-of-coherence measures in predicting long-term work disability.

Scandinavian Journal of Rheumatology

Social Class, Adolescent, Adult, Disability Evaluation, Female, Health Status, Humans, Male, Middle Aged, Musculoskeletal Diseases, physiopathology, therapy, Predictive Value of Tests, Primary Health Care, Questionnaires, Sick Leave, statistics & numerical data

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      To investigate long-term sick leave among primary care patients with musculoskeletal disorders and the predictive value of health-status and sense-of-coherence measures. Patients aged 17 to 64 years who, during seven weeks, attended one of six primary care centers because of non-traumatic musculoskeletal pain and who completed the SF-36 health questionnaire and the sense of coherence (SOC) scale at baseline and after one year. Of 189 patients, 36 (19%) were sicklisted for at least three months before and/or after their visit; the most common diagnoses were non-specific soft-tissue or multiple joint, low back, and shoulder pain. The long-term sicklisted patients had significantly worse baseline SF-36 and SOC scores than the non-sicklisted patients; moderate improvement in the SF-36 bodily pain but no improvement in the physical functioning scores occurred. The duration of sick leave at baseline and the SF-36 bodily pain score were significant predictors of continuos one-year work disability. Long-term sick leave was common among primary care patients with musculoskeletal pain. The physical functioning and return-to-work outcomes after one year were poor. The SF-36 bodily pain scale might be helpful in identifying at risk patients.

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