Work 29 (2007) 233–238 233 IOS Press Does self-efficacy predict return-to-work after sickness absence? A prospective study among 930 employees with sickness absence for three weeks or more Merete Labriola * , Thomas Lund, Karl B. Christensen, Karen Albertsen, Ute B ¨ ultmann, Jette N. Jensen and Ebbe Villadsen National Institute of Occupational Health, Copenhagen, Denmark Received 22 March 2006 Accepted 7 May 2006 Abstract. Aim: To compare levels of self-efficacy among the general working population and employees with sickness absence from work, and to examine if general self-efficacy measured before occurrence of sickness absence predicted subsequent onset of sickness absence and Return-to-Work. Methods: The study follows a cohort of 5357 working employees and 106 long-term sickness absent employees in Denmark. They were interviewed in 2000 regarding self-efficacy and various co-variates, and followed for 78 weeks in a national sickness absence register. Cox regression analysis was performed in order to assess the effect of self-efficacy on Return-to- Work after sickness absence. Results: General self-efficacy was significantly lower among those with sickness absence compared to the general working population. Self-efficacy showed no statistically significant association with later onset of sickness absence or with Return-to- Work. Conclusion: The results may suggest that lower self-efficacy among employees with sickness absence is a result of the sickness absence itself rather than a precursor of it. This indicates a need to investigate the potential change in self-efficacy in relation to the employee’s change in labor market status; this will help to focus Return-to-Work interventions where planning has to be attentive towards the change in self-efficacy that can occur after onset of disease and sickness absence. Keywords: Sickness absence, return to work, self-efficacy, register, Denmark 1. Introduction Absence from work due to sickness can have con- siderable negative effects for employees, employers and the society. Sickness absence constitutes a public * Address for correspondence: Merete Labriola, National Institute of Occupational Health, Lerso Parkall´ e 105, DK-2100 Copenhagen, Denmark. Tel.: +45 3916 5200; Fax: +45 3916 5201; E-mail: mla@ ami.dk. health problem with associated economic burdens [2,7, 14]. Especially long-term sickness absence contributes disproportionately to these economic burdens [7,37]. Also, longer sickness absence is associated with a re- duced probability of Return-to-Work (RTW) and sub- sequent economic and social deprivation [11,21,24,35, 37]. Sickness absence and RTW are not uniquely biomedical outcomes, but are processes in a variety of social, psychological, and economic factors not neces- sarily specific to the underlying or precipitating injury 1051-9815/07/$17.00  2007 – IOS Press and the authors. All rights reserved