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Medicina y Seguridad del Trabajo

versión On-line ISSN 1989-7790versión impresa ISSN 0465-546X


VICENTE PARDO, José Manuel  y  LOPEZ-GUILLEN GARCIA, Araceli. Psychosocial Factors as Predictors for Difficult Labor Return after Incapacity. Med. segur. trab. [online]. 2018, vol.64, n.250, pp.50-74. ISSN 1989-7790.

One may be incapacitated for work for being ill and presenting functional limitations that affect the work capacity preventing him/her from work. Psychosocial factors are decisive in the health of the population and therefore decisive in both the disease itself and in the fact of working population getting sick. These psychosocial factors are precipitating factors at the onset of disability. They are factors that keep the incapacity active which linked to the chronification of the incapacity processes they condition the poor response and the therapeutic adherence. They imply barriers to return to work, and may cause presenteeism (being present at work in poor conditions for fear of losing employment). Psychosocial factors are predictors of returning to work. Since they are initial factors to the declaration of the incapacity it is necessary to know them well to prevent the appearance and maintenance that determine a non-return labor or its postponement, either in the temporary or permanent incapacity. Psychosocial factors do not cause disability but can precipitate it, maintain it or modify it, ending up by conditioning the capacity / incapacity for work. Psychosocial factors were present in a significant 23% in a follow-up study of medical leave processes that reached up to 365 days.

Material and method:

the following bibliographic databases were searched up to May 2017: SciELO, PUBMED, as well as the psychosocial factors study appeared in low processes up to 365 days.


The psychosocial factors are at the beginning of the sick leave as a preventive labor trigger of previous baseline situations. They are in the chronification process once the disability has occurred; they are in the patient’s perception of symptom persistence and poor response to treatment; they imply a perception of poor evolution of their incapacitation process, enhance the dysfunctional disabling and hinder the return to work. Unresolved and still returning to work will be cause of low work performance, being able to be determinant of “ineptitude overdue” and dismissed. For theses reasons it is important to early identify and prevent these psychosocial factors in order to reduce absenteeism due to disability.

The following measures will reduce the impact of psychological factors on temporary disability: acting on inadequate emotional responses through psychological care; taking an early attention to musculoskeletal and psychic processes; avoiding the waiting lists for the diagnostic tests and treatments; having a preventive consideration of return-to-work decisions; taking a partial incorporation to work (high partial fit note-certified sickness episodes) after incapacity; facilitating the work adaptation to the “overcoming attitude” of the returned worker; avoiding disputes reaching decisive agreements between medically discharged and unfit; providing flexible hours or reduced hours that favor family reconciliation; receiving social care benefits for the dependents or acutely ill family members’ attention; having a greater detection and protection of psychosocial factors at work and improving the organization, conditions and working climate promoting the satisfaction labor.

Palabras clave : psychosocial factors; return to work; work incapacity; predictive predictors; psychosocial risks.

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