Table 2.
Summary evidence statements with GRADE and CERqual ratings
| Evidence statement (outcomes) | Rating | Reasoning |
|---|---|---|
| Support from leaders plays a role in facilitating sustainable RTW for employees with musculoskeletal disorders (MSDs) | Strong confidence (high level of evidence) | Seven randomized controlled trials were included, one of which was graded low quality as a result of a high risk of bias. Ten High-quality qualitative studies and one high-quality mixed study based on the CERqual criteria was included. Twenty-three observational studies initially rated low quality using the GRADE system were included. Nineteen of which were upgraded to high-quality studies using the GRADE upgrade criteria and four of which were graded low quality. As such, good quality studies were predominantly evaluated in this study |
| Support from co-workers plays a role in facilitating sustainable RTW for employees with musculoskeletal disorders (MSDs) | Strong confidence (high level of evidence) | Five high-quality qualitative studies and one high-quality mixed study based on the CERqual criteria were included. Eleven observational studies initially rated low quality using the GRADE system were included. Nine of which were upgraded to high-quality studies using the GRADE upgrade criteria and two of which were graded low quality. Although there were no randomized control trials, fifteen out of the seventeen included studies showed consistent positive effects on sustainable RTW |
| Job-crafting plays a role in facilitating sustainable RTW for employees with musculoskeletal disorders (MSDs) | Low confidence (low level of evidence) | Only three studies (one high quality randomized control trial, one high quality qualitative study and one observational study upgraded to high quality using the GRADE criteria) with consistent effects across all studies were included. Considering the small number of studies, more studies in the area will need to be conducted to produce strong conclusions on its effects |
| Personal characteristics play a role in facilitating sustainable RTW for employees with musculoskeletal disorders (MSDs) | ||
| Attitude | Strong confidence (high level of evidence) | One very high-quality RCT and Two high-quality qualitative/ mixed based on the CERqual criteria were included. Eleven observational studies initially rated low quality using the GRADE system were included. Nine of which were upgraded to high-quality studies using the GRADE upgrade criteria and Two of which were graded low quality. Although there was only one randomized control trial, all sixteen included studies showed consistent positive effects on sustainable RTW |
| Self-efficacy | Moderate confidence (moderate level of evidence) | Four observational studies upgraded to high quality studies using the GRADE criteria were included. All studies showed consistent positive effect on sustainable RTW. Regardless of the small number of studies, evidence is promising |
| Age | Strong confidence (high level of evidence) | One randomized controlled trials was included, one low-quality qualitative study and eleven observational studies initially rated low-quality and upgraded to high-quality using the GRADE system were included. All included studies showed a consistent positive effect on sustainable RTW |
| Gender | Very low confidence (very low level of evidence) | Despite some randomized control trials and large sample sizes, there were conflicting results regarding effects of gender on sustainable RTW for both men and women. Some studies suggest men RTW more sustainably than men, while a few studies suggest otherwise. It, therefore, suggest that it is possible that the effect of gender on sustainable RTW is influenced by an interaction of some factors for both sexes. However, it is unclear what specific factors are involved. Hence the need for further research in this area |
| Education | Moderate confidence (moderate level of evidence) | Five observational studies upgraded to high quality study based on the GRADE criteria. There were consistent positive effects across all five studies |
| Length of absence | Moderate confidence (moderate level of evidence) | Four studies with one randomized controlled trial and three observational studies upgraded to high quality study based on the GRADE criteria. There were consistent positive effects across all four studies |
| Job contract/security | Very Low confidence (very low level of evidence) | Only two observational studies upgraded to high quality based on the GRADE criteria. More studies would be necessary to draw strong conclusions on its effects on sustainable RTW |
| Support from leaders plays a role in facilitating sustainable RTW for employees with common mental disorders (CMDs) | Strong confidence (high level of evidence) | There were six randomized controlled trials, four and seven high quality mixed studies and qualitative studies according to the CERqual criteria respectively and 1 low quality qualitative studies. Thirteen out of sixteen low quality observational studies were upgraded to high quality studies based on the GRADE system, while three of the remaining observational studies maintained its low quality grade. Evidence presented is considered promising |
| Support from co-workers plays a role in facilitating sustainable RTW for employees with common mental disorders (CMDs) | Strong confidence (high level of evidence) | Five high-quality qualitative studies, three high-quality mixed study and one low-quality qualitative study based on the CERqual criteria were included. Six observational studies initially rated low quality using the GRADE system were included. Five of which were upgraded to high-quality studies using the GRADE upgrade criteria and one of which was graded low quality. Although there were no randomized control trials, twelve out of the fifteen included studies showed consistent positive effects on sustainable RTW |
| Job-crafting plays a role in facilitating sustainable RTW for employees with common mental disorders (CMDs) | Very low confidence (very low level of evidence) | Only two observational studies upgraded to high quality based on the GRADE criteria. More studies are required to build strong evidence base in this area |
| Personal characteristics play a role in facilitating sustainable RTW for employees with common mental disorders (CMDs) | ||
| Attitude | Strong confidence (high level of evidence) | Only one randomized control trial, one high-quality qualitative studies and two high-quality mixed methods studies based on the CERqual criteria were included. Ten observational studies initially rated low quality using the GRADE system were included. Seven of which were upgraded to high-quality studies using the GRADE upgrade criteria and three of which were graded low quality. Twelve studies produced promising evidence with consistent positive effects on sustainable RTW |
| Self-efficacy | Moderate confidence (moderate level of evidence) | Only one randomized control trial and six observational studies upgraded to high-quality studies using the GRADE upgrade criteria and three of which were graded low quality. Apart from one observational study, all six studies produced promising evidence regarding the effects of self-efficacy on sustainable RTW |
| Age | Strong confidence (high level of evidence) | Ten observational studies upgraded to high-quality studies using the GRADE upgrade criteria. One of which was ranked low quality. Studies produced promising evidence of the effects of age on worker’s ability to RTW sustainably after ill-health |
| Gender | Very low confidence (very low level of evidence) | There were conflicting results regarding the effects of gender on sustainable RTW for both men and women. Some studies suggest men RTW more sustainably than men, while a few studies suggest otherwise. It, therefore, suggest that it is possible that the effect of gender on sustainable RTW is influenced by an interaction of some unknown factors for both sexes. Hence the need for further research in this area |
| Education | Low confidence (low level of evidence) | Four observational studies. Three of which were upgraded to high quality and one maintained the initial low quality rating based on the GRADE criteria. Although all three studies showed a consistent positive effects on sustainable RTW, evidence is not considered strong |
| Economic status/income | Very low confidence (very low level of evidence) | Only two observational studies. One of which was upgraded to high quality based on the GRADE criteria and the other graded low. More studies would be necessary to draw strong conclusions on its effects on sustainable RTW |
| Length of absence | Very low confidence (very low level of evidence) | Only two observational studies upgraded to high quality based on the GRADE criteria. More studies would be necessary to draw strong conclusions on its effects on sustainable RTW |
| Job contract/security | Very low confidence (very low level of evidence) | Only two observational studies upgraded to high quality based on the GRADE criteria. More studies would be necessary to draw strong conclusions on its effects on sustainable RTW |
| Sustainable RTW for employees with musculoskeletal disorders (MSDs) is dependent on the interplay between multiple personal and social factors | Moderate confidence | Only one low quality randomized controlled trial was included. Two mixed studies and one qualitative study graded high quality using the CERqual criteria were also included. Out of thirteen observational studies included, ten were upgraded to high quality studies as a result of meeting GRADE criteria. However, the remaining three maintained the low quality grade assigned to it by the criteria as a result of the study design. Results suggest that sustainable RTW for employees with MSDs is dependent on an interplay of personal and social factors |
| Sustainable RTW for employees with common mental disorders (CMDs) is dependent on the interplay between multiple personal and social factors | Moderate confidence | Two randomized controlled trials were included in this evaluation. Four mixed studies graded high quality using the CERqual criteria were also included. Out of twelve observational studies included, eight were upgraded to high quality studies as a result of meeting the GRADE criteria. However, the remaining four maintained the low quality grade assigned to it by the criteria as a result of the study design. Generally, moderate quality studies were included in this study. Results suggest that sustainable RTW for employees with CMDs is dependent on an interplay of personal and social factors |