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Self-Efficacy and Health Locus of Control: Relationship to Occupational Disability Among Workers with Back Pain

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Abstract

Objectives Although self-efficacy and health locus of control (HLC) have been extensively studied in health research, little is known about their contribution to occupational disability among workers with back pain. This 2 year prospective study examined the association between these control belief constructs and “return to work in good health” (RWGH), a four-category, composite index of back pain outcome. Methods The participants (n = 1,007, participation = 68.4%, follow-up = 86%) were workers with occupational disruptions who sought a medical consultation for non specific back pain in primary care and emergency settings in the Quebec City area, Canada. Information about self-efficacy for return to work (SERW) and HLC, as well as potential confounders, was collected during a telephone interview about 3 weeks after the baseline medical consultation. Polytomous logistic regression was used to assess the relationship between the baseline control variables and RWGH at 2 year. Odds ratios (OR) and their 95% confidence intervals were used to quantify the strength of associations. For all analyses, the “success” category was considered the reference group. Results Although bivariate analyses showed a significant association between external HLC and RWGH at 2 year, this relationship was not significant in multivariate analyses. Higher scores on the self-efficacy questionnaire were however protective of “failure to return to work after attempt(s)” (OR: 0.28; 95% CI: 0.14–0.57) and of “failure to return to work” (OR: 0.19; 95% CI: 0.07–0.48) in multivariate analyses. Conclusion Self-efficacy is an important determinant of the occupational outcome of back pain.

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Acknowledgments

The authors thank all the study participants, the staff of the Population Health Research Unit, and all the research assistants who worked on this study. Thanks also to the following physicians for their help with the recruitment of subjects: Dr. Stéphane Bergeron, Dr. Alexandra Dansereau, Dr. Georges Dufresne, Dr. Louis Larue, Dr. Natalie Le Sage, Dr. Jean Maziade, and Dr. Jean Ouellet. Special thanks to Isabelle Larocque, MSc and Julie Soucy, PhD, for the coordination of the study and Eric Demers, MSc, for statistical analyses. This study was supported by a grant (#97-061) from the Quebec Institute for Occupational Safety and Health (Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec – IRSST) to CE Dionne, R Bourbonnais, P Frémont, M Rossignol and S Stock. IRSST did not interfere in any way in the scientific and publication processes. CE Dionne is a Senior Quebec Health Research Fund (FRSQ) Scholar. This article reports part of the Master’s thesis in Community Health of S Richard conducted under the supervision of CE Dionne, and has benefited from a collaboration with A Nouwen. Both authors are guarantors for the paper.

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Authors and Affiliations

  1. URESP du Centre de recherche FRSQ du CHA universitaire de Québec, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Quebec, QC, G1S 4L8, Canada

    Sylvie Richard & Clermont E. Dionne

  2. Department of Social and Preventive Medicine, Laval University, Quebec, Canada

    Sylvie Richard

  3. Department of Rehabilitation, Laval University, Quebec, Canada

    Clermont E. Dionne

  4. School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK

    Arie Nouwen

Authors
  1. Sylvie Richard
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  2. Clermont E. Dionne
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  3. Arie Nouwen
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Corresponding author

Correspondence to Clermont E. Dionne.

Appendix: Self-Efficacy for Return to Work Questionnaire

Appendix: Self-Efficacy for Return to Work Questionnaire

Although most individuals on sick leave want to work, some situations make return to work difficult. In order to better understand what kind of context makes return to work difficult for individuals with back pain, I will read you a list of specific situations. For each statement, I will ask you to rate how confident you are that you can do your work at present when that specific situation is present. Please rate your confidence in percentage from 0 to 100 where 0% = not at all confident, 50% = moderately confident and 100% = completely confident.

  1. 1.

    How confident are you to do your job:

    When you have a lot of pain

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  2. 2.

    How confident are you to do your job:

    When your pain level is low

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  3. 3.

    How confident are you to do your job:

    Without the risk of aggravating your existing back pain

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  4. 4.

    How confident are you to do your job:

    When your employer shows no or minimal effort to adapt your working conditions to your back pain

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  5. 5.

    How confident are you to do your job:

    When your employer lacks understanding as to your back pain

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  6. 6.

    How confident are you to do your job:

    When tension is present at work

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  7. 7.

    How confident are you to do your job:

    When you must work under pressure

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

  8. 8.

    How confident are you to do your job:

    When you have difficulty commuting to work because of your pain

    0% = not at all confident, 50% = moderately confident and 100% = completely confident

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Richard, S., Dionne, C.E. & Nouwen, A. Self-Efficacy and Health Locus of Control: Relationship to Occupational Disability Among Workers with Back Pain. J Occup Rehabil 21, 421–430 (2011). https://doi.org/10.1007/s10926-011-9285-5

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