Background: Perceived inability to work predicts a negative outcome of rehabilitation. Objectives: To analyse self-rated inability to work, (S IW), before and after a rehabilitation programme in the primary care, and the risk factors for persistent SIW. Patients: Immigrant patients aged 20-45 years. Methods: Somatic status, ratings of psychosocial stressors and interviews about concepts of pain were performed. Anxiety about pain, depression, and SIW were evaluated before (SIW1) and after (SIW2) the programme consisting of conversations about pain, and daily exercise. Correlation statistics was done by non-parametric methods. The odds ratios (OR) with 95% confidence intervals (95% CI) as having SIW2 were calculated by logistic regression. Results: 49 men and 100 women with service-jobs, on the average 38 years, participated. All had pain from muscular structures in the shoulder, back and/or hip regions, 62% had a previous sick leave > 3 months, 54% had much psychosocial stress and 21% remained depressed. The frequencies of anxiety about pain decreased from 76% to 50%, and SIW from 75% to 60% (p < 0.001). The risks as having SIW2 were increased for participants on sick leave ≥ 3 months: OR 5.4 (95% CI 2.4-12.3), with persistent anxiety about pain, OR 3.6 (1.7-8.0) or much psychosocial stress: OR 3.4 (1.5-7.8). Conclusion: The frequency of SIW remained high despite a significant decrease. Preceding long sick leave, anxiety about the pain and psychosocial stress increased the risk of persistent SIW, implying the necessity of further improving the methods of reducing anxiety and the use of only short periods of sick leave in this category of patients. © 2004 - IOS Press and the authors. All rights reserved.

Primary care immigrants Disability Psychosocial stress sick leave rehabilitation Chronic pain

anxiety immigrant depression social psychology primary medical care logistic regression analysis exercise backache correlation analysis human risk assessment controlled study mental stress priority journal health status shoulder pain interview health program myalgia male female prediction risk factor outcomes research self concept Article major clinical study absenteeism frequency analysis adult disability Chronic Pain