Perceptions of illness and their impact on sickness absence

A patient's perception of their illness can influence their coping ability, compliance with treatment and functional recovery. Psychological interventions to address negative beliefs may facilitate an earlier return to work.

To compare perceptions of illness, fitness to return to work and time to return to work among employees with those of their occupational physicians (OPs).

A cross-sectional study of employees off sick for >2 weeks, with the return to work date ascertained at 3 months. Employees and their OPs completed similar questionnaires that included the Brief Illness Perception Questionnaire.

Of total, 84 employees (76% response rate) and nine OPs participated. Employees reported a greater impact on their life (P < 0.01), a longer duration of illness (P < 0.01), more symptoms (P < 0.01), more concern about their illness (P < 0.01), more emotional impact of their illness (P < 0.01) and that their illness was more serious (P < 0.01) than did the OPs. They attributed their illness to work more often than their OPs (P < 0.05) and predicted more accurately when they would be fit to return to work (P < 0.01). Employees who returned to work believed that their illness was shorter lasting (P < 0.01), more treatable (P < 0.01), more controllable (P < 0.05), less serious (P < 0.01), had less emotional impact (P < 0.01), perceived fewer symptoms (P < 0.05) and had less concern (P < 0.05) than those who failed to return to work.

Employees had more negative perceptions about their illness than OPs. Positive perceptions were associated with an earlier return to work. Unhelpful negative beliefs about illness need to be addressed by OPs.