Sense of Coherence Tied to Health Factors in Long-Term Impaired Work AbilityStruggling to Work? Your Mental Health Might Be the Key to Recovery

OBJECTIVE: To examine characteristics of primary healthcare patients with long-term impaired work ability, and to assess the correlation between sense of coherence and factors related to health, function, and work ability. DESIGN AND SETTING: Cross-sectional study including patients from the LEARN-to-COPE cluster-randomized controlled trial, conducted across 40 primary care centers in Region Västra Götaland, Sweden. SUBJECTS: Primary healthcare patients with recurrent or long-term sick leave or health-related unemployment ( = 243). DATA COLLECTION: Sick leave data were collected from the Swedish Social Insurance Agency. Demographics and contextual data were patient-reported or retrieved from personal identity numbers. Symptoms, health-related quality of life, health literacy, sense of coherence, perceived work ability, and lifestyle were assessed using validated questionnaires. RESULTS: Mean age was 47.4 years. Most were women born in a Nordic country, had at least secondary education, and were gainfully employed. A third was unemployed. Mean number of sick days was 1,215 (SD 1,010), and 67.9% were on full-time sick leave. Perceived work ability was low. Participants reported severe anxiety and exhaustion, moderate depression, and a high risk of long-term sick leave due to pain. Health-related quality of life was extremely low. Half reported inadequate or problematic health literacy, and sense of coherence was low. Smoking and obesity were common, physical activity levels were average, and excessive alcohol consumption was below average. About half participated in any rehabilitation activities. Sense of coherence was significantly correlated with health literacy, health-related quality of life, symptoms of mental illness, perceived work ability, and pain (all  < 0.001); but not with sick leave duration or participation in rehabilitation. CONCLUSION: Given participants' pronounced suffering, improving health-related quality of life among primary healthcare patients with long-term impaired work ability should be prioritized. Sense of coherence was associated with several determinants of sick leave, but not with its previous duration. TRIAL REGISTRATION NUMBER: clinicaltrials.gov NCT04254367.