L. Aasdahl et al.
and depression disorders (3). There is also considerable
overlap in symptoms between different diagnoses, such
as back pain, anxiety and depression (10, 11). Øyeflaten
et al. (6) found that FABQ was a prognostic factor for
RTW in a group of participants with mixed diagnoses.
However, we are not aware of studies that used the
FABQ specifically for psychological disorders.
In Norway, there is a long tradition of offering
inpatient occupational rehabilitation to patients with
different diagnoses, mainly musculoskeletal com-
plaints, anxiety, depression and unspecific diagnoses.
We recently evaluated the effects of 2 inpatient oc-
cupational rehabilitation programmes. Both were
compared with an outpatient programme consisting
of group-based cognitive behavioural therapy (12, 13).
One of the inpatient programmes (3.5 weeks) enhanced
RTW compared with the outpatient programme [14]
(personal communication), while the other (4+4 days)
had no effect on RTW (13).
The present study evaluated whether inpatient occu-
pational rehabilitation reduced fear-avoidance beliefs
more than outpatient cognitive behavioural therapy. As
the inpatient programmes were more comprehensive
and included several work elements intended to reduce
fear-avoidance beliefs about work (e.g. work-related
problem solving) and physical activity (e.g. supervised
exercise sessions), it was hypothesized that the inpa-
tient programmes would reduce fear-avoidance beliefs
more than the outpatient programme. Furthermore, we
assessed whether baseline scores and changes (pre- to
post-intervention) in FABQ were associated with future
work-participation.
METHODS
Study design and participants
This study is based on data from 2 randomized clinical trials.
Both trials were designed with parallel groups (Fig. 1) (12). The
first trial compared a short inpatient multicomponent occupatio-
nal rehabilitation programme (4+4 days) to a less comprehensive
outpatient programme (6 sessions during 6 weeks) (hereafter
referred to as the short inpatient and outpatient programmes,
respectively) for individuals on sick-leave due to musculoskele-
tal, unspecific, or common mental health disorders. The second
trial compared a long inpatient programme (3.5 weeks) with the
176
Fig. 1. Flow of participants in the study. a Not eligible: serious somatic/psychiatric illness (n = 20), a specific disorder requiring specialized treatment
(n = 10), currently participating in another treatment programme (n = 15), insufficient Norwegian comprehension (n = 1), scheduled surgery next 6
months (n = 1). b Other reason: not met (n = 10), medical assessment not completed (n = 8), not motivated (n = 5), no longer on sick-leave (n = 2).
c
Not eligible: participating in another treatment programme (n = 22), serious somatic/psychiatric illness (n = 11), specialized treatment needs (n = 4),
problems with functioning in groups (n = 3), surgery scheduled next 6 months (n = 2), insufficient language skills (n = 2), alcohol/drug abuse (n = 1).
d
Other reason: medical assessment not completed (n = 15), no longer on sick-leave (n = 10), not motivated (n = 6), inability to participate in an
inpatient intervention (n = 7), unknown (n = 4).
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