Return to work after vocational rehabilitation: does mindfulness matter?

Figures & data

Figure 1 The hypothesized simple mediation model (conceptual model number 4 in Hayes’⁴⁶ “Process”).

Abbreviations: FFMQ, Five Facet Mindfulness Questionnaire; M, the proposed mediator; X, the predictor variable; Y, the predicted variable; QOL, quality of life.

Table 1 Basic characteristics of present sample (N=80)

Characteristic	Total (N=80)	Working sample (N=38)	Nonworking sample (N=42)
	N (%)		Work-related activity (N=24)	No activity (N=18)
Age
Mean ± SD	47.0±9.3	48.3±8.6	46.0±8.0	45.7±12.1
Range	24–66	30–63	31–66	24–64
Sex	80
Males	7 (9)	2 (5)	2 (8)	3 (17)
Females	73 (91)	36 (95)	22 (92)	15 (83)
Work/activity
In work, partly or mainly	38 (48)	38	0	0
Present sick leave	5 (6)	2	2	1
Work preparatory training	13 (16)	0	13	0
Student/educating	10 (10)	4	6	0
Vocational rehabilitation	4 (5)	0	4	0
Job-seeker, active	8 (10)	0	8	0
Education
Low education (primary school/high school)	40 (52)	12 (32)	18 (75)	11 (61)
High education (university, bachelor or lower/master+)	38 (48)	26 (68)	5 (21)	7 (39)
Main income source
Ordinary salary	36 (45)	36 (95)
Work assessment allowance	35 (44)		23 (96)	12 (67)
Other (disability pension, apprentice)	8 (10)	2 (5)	1 (4)	5 (28)
Civil status
Single	5 (6)	2 (5)	1 (4)	2 (12)
Live with partner	58 (73)	30 (79)	15 (62)	13 (72)
Widow/widower	3 (4)	1 (3)	1 (4)	1 (6)
Divorced/separated	14 (18)	5 (13)	7 (29)	2 (11)
Currently employed
Yes	45 (56)	38 (100)	6 (25)	1 (6)
No	35 (44)	0	17 (71)	17 (94)

Abbreviation: SD, standard deviation.

Table 2 Correlations, means, standard deviations, and reliability of all study measures (N=80)

Variable	1	2	3	4	5	6	7	8	9
1. FFMQ observe	–	0.60a	0.09	−0.03	0.54a	0.65a	0.21	0.17	0.37a
2. FFMQ describe		–	0.41a	0.19	0.55a	0.83a	0.17	0.10	0.41a
3. FFMQ act aware			–	0.48a	0.18	0.64a	0.15	0.13	0.37a
4. FFMQ nonjudge				–	0.15	0.56a	0.14	0.14	0.31a
5. FFMQ nonreact					–	0.69a	0.11	0.08	0.38a
6. FFMQ global						–	0.23b	0.19	0.54a
7. Return to work							–	0.61a	0.39a
8. Work ability								–	0.45a
9. Quality of life									–
Mean	28.7	29.7	26.6	27.2	21.8	26.8		6.4	7.0
SD	5.6	6.2	4.9	6.1	4.4	3.7		2.7	1.7
α	0.84	0.87	0.82	0.87	0.74	0.90

Notes: Mindfulness (FFMQ) subscales: for the nonreact facet, possible range of scores is 7–35. For all other facets, possible range is 8–40. Return to work, work ability, and quality of life are all single-item measures.

a P<0.01

b P<0.05.

Abbreviations: FFMQ, Five Facet Mindfulness Questionnaire; SD, standard deviation.

Table 3 Logistic regression analysis for variables predicting work reentry (N=75)

Variable	Work reentry
	B	SE	OR	P	95% CI
Work ability	0.71	0.18	2.03	0.01a	1.41–2.90
Sick-leave length	0.54	0.91	1.71	0.55	0.29–10.12
Education	1.86	0.72	6.43	0.01a	1.56–26.47
Time	0.45	0.35	1.56	0.21	0.78–3.14
Observation	0.07	0.09	1.07	0.47	0.89–1.28
Describe	−0.04	0.08	0.96	0.63	0.83–1.12
Act aware	0.07	0.09	1.07	0.46	0.90–1.27

Notes: R²=0.47 (Cox & Snell), 0.63 (Nagelkerke); Model X²(7) =48.0, P<0.01; 1= in work; 0= not in work.

a P<0.01.

Abbreviations: B, unstandardized beta coefficient; CI, confidence interval; OR, odds ratio; SE, standard error of B.

Table 4 Logistic regression analysis for mindfulness variable predicting work reentry, with the data stratified on education (N=78)

Variable	High educationa (N=38)					Low educationb (N=40)
	B	SE	OR	P	CI	B	SE	OR	P	CI
Observation	0.25	0.11	1.28	0.03c	1.03–1.59	−0.06	0.09	0.94	0.53	0.78–1.34
Describe	−0.21	0.12	0.70	0.07	0.64–1.02	0.10	0.08	1.10	0.25	0.93–1.30
Act aware	0.24	0.13	1.27	0.07	0.98–1.64	−0.01	0.07	0.92	0.92	0.86–1.14

Notes: R² high education =0.19 (Cox & Snell), 0.27 (Nagelkerke); Model high education X²(3) =8.3, P<0.05; R² low education =0.04 (Cox & Snell), 0.05 (Nagelkerke); Model low education X²(3) =1.7, P>0.05; 1= in work; 0= not in work.

a High education = university level

b low education = high school or lower

c P<0.05.

Abbreviations: B, unstandardized beta coefficient; CI, confidence interval; OR, odds ratio; SE, standard error of B.

Table 5 Mediation analysis for mindfulness on RTW and work ability through QOL (N=75)

	RTW					Work ability
	Coeff	SE	NT P	BC 95% CI		Coeff	SE	NT P	BC 95% CI
				Lower	Upper				Lower	Upper
FFMQ global (IV)
IV to M (path a)	0.27	0.00	<0.01			0.27	0.05	<0.01
Total effect (path c)	0.04	0.08	0.61			0.05	0.09	0.55
Direct effect (path c′)	−0.11	0.10	0.29			−0.11	0.09	0.23
Quality of life (M)
Direct effect (path b)	0.70	0.25	<0.01			0.67	0.19	<0.01
Indirect effect (path ab)	0.18	0.13		0.03	0.45	0.18	0.08		0.04	0.37
Partial effect of CV
Education	1.94	0.62	<0.01			0.92	0.58	0.11
Sick-leave length	1.25	0.84	0.14			1.59	0.72	0.03
Time from intervention	0.24	0.28	0.40			−0.14	0.28	0.62
Model summary (R^2)			0.30 (<0.01)					0.30 (<0.01)

Note: Dependent variables are RTW and work ability.

Abbreviations: BC, bias-corrected; CI, confidence interval; Coeff, point estimate of effects; CV, covariates; FFMQ, Five Facet Mindfulness Questionnaire; IV, independent variable; M, mediator; NT P, normal theory P-value; QOL, quality of life; RTW, return to work; SE, standard error of the point estimate.

HayesAFIntroduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based ApproachNew YorkThe Guilford Press2013

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