Work outcome in musculoskeletal diseases: the context of cross-cultural research, intervention and multimorbidity

This dissertation focusses on the impact of contextual factors on work outcome in people with locomotor and/or musculoskeletal diseases (MSDs). MSD is a common problem and a leading cause of sickness absence and work disability. It is shown that multimorbidity (the coexistence of two or more chronic diseases in the same individual) is associated with an increased risk of work disability, dependency on welfare benefits, unemployment and sickness absence, particularly if the chronic diseases involved include MSD. The results also indicate that a multidisciplinary treatment approach is associated with resuming work earlier compared to current care regimes. In people with rheumatoid arthritis, the country of residence and gross national product are shown to play a key role in having a job and being at risk for sickness absence and loss of work productivity.