Introduction 2001 2005 2006 2007 2001 2001 2003 2004 2006 2006 2006 2006 2006 1998 1998 2004 2006 Methods Population Patients with RSI were identified by approaching all 3,250 members of the Dutch RSI patients’ association. The Dutch RSI patient association was started 11 years ago. In the Netherlands, patients with the same disease are allowed and administratively helped by Governmental Services to join and start an association. Their goal is to gather and spread relevant information to all patients with the same disease in The Netherlands. In addition, their input in sickness-related policy matters is increasingly asked for. Members that were registered in March 2005 were eligible for inclusion. This group defined the study population in this cross-sectional study. Data collection In April 2005 questionnaires were sent by the secretariat of the RSI patients’ association to the home addresses of all their current members. An accompanying letter was included from the patients’ association. Patients were requested to complete a set of self-report measures. Return envelopes that were addressed directly to the research institute were included as well. One week later, a reminder letter was sent to all members. Data collection was stopped four weeks after sending the reminder. A total of 1,185 (36%) questionnaires were returned by mail. Outcome measurements 1992 1998 2003 2005 2006 2006 2003 2001 1994 2003 In order to compare the two groups of RSI patients, we classified the “working” group as those patients that had been present at their work for a minimum of 8 h during the previous week, and the “sick-listed” group were RSI patients with a sickness absence certificate following the Dutch social system (i.e. longer than 1 year sick-listed, or those that stated that they did not work according to their contract hours during the previous week before they filled in the questionnaire). Statistical analysis P 2003 Results 1 Table 1 Total study population and working vs. sick-listed groups: gender, education, age, pain intensity, pain duration, work status, and work-ability  n n n P Gender (% females) 67 62 78 a Education (% high ) 67 71  60 a Age in years (mean (SD)) 40.8 (8.7) 40.0 (8.3) 42.3 (9.4) a Pain intensity (0–100) (mean (SD)) 41.3 (25.4) 36.2 (24.7) 51.6 (23.9) a Stiffness/tingling intensity (0–100) (mean (SD)) 37.8 (26.8) 33.7 (25.8) 45.7 (27.0) a Pain duration in years (mean (SD)) 5.8 (3.2) 5.6 (3.1) 6.2 (3.3) 0.01 Pain extent (mean (SD) number of body regions) 6.4 (3.9) 5.7 (3.6) 7.7 (4.1) a b 48.4 (21.1) 48.7 (20.8) 45.9 (23.6) 0.885 b 27.8 (20.1) 27.4 (20.0) 31.5 (20.4) 0.157 b 35.1 (26.2) 34.4 (26.1) 42.0 (26.1) 0.138 a P b n RSI patients in the sick-listed group were two years older on average, and this group contained a relatively higher proportion of women and lower proportion of highly educated persons. In the sick-listed group, 76% was sick-listed longer than one year. In both groups, complaints were present for several years and extended over several upper body regions. In both groups, over 85% received a diagnostic label, provided by a medical professional, that belong to the umbrella term RSI. With respect to complaint-related variables, the patients in the sick-listed group reported significantly more pain in more regions, and they reported more stiffness/tingling complaints. The sick-listed group reported significantly lower ability to work, and no differences between groups were found in the psychosocial work characteristics experienced. With respect to co-morbidity, no other diseases were reported by 46% in the sick-listed group compared to 64% in the working group; depression and burnout were reported by 12 and 11% in the sick-listed group versus 6 and 5% in the working group. In the working patient group, 35% filled some kind of administrative function, 11% worked in IT, 10% worked in a physical job, and 10% in a management function. In both groups, almost 80% reported long- or short-term overexertion during work as the only main cause of the onset of their illness. 2 3 2 r r Table 2 n  1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 1 work-ability –                  2 pain intensiy −0.48 –                 3 pain duration −0.08 0.12 –                4 sf physical role 0.54 −0.45 −0.02 –               5 sf mental health 0.34 −0.25 0.03 0.32 –              6 sf emotional role 0.26 −0.18 0.05 0.31  –             7 sf social functioning −0.01 0.05 −0.01 −0.07 −0.01 0.09 –            8 sf pain 0.61 −0.72 −0.05 0.59 0.31 0.24 −0.03 –           9 sf vitality 0.40 −0.30 0.01 0.40 0.75 0.47 −0.08 0.39 –          10 sf physical functioning 0.60 −0.52 −0.18 0.48 0.27 0.22 −0.02 0.61 0.38 –         11 consequences −0.61 0.51 0.08 −0.58 −0.35 −0.27 −0.001 −0.62 −0.41 −0.49 –        12 timeline −0.13 0.18 0.32 −0.10 −0.03 0.01 0.01 −0.15 −0.07 −0.16 0.19 –       13 personal control 0.44 −0.36 −0.004 0.35 0.33 0.18 −0.001 0.42 0.35 0.34 −0.36 −0.06 –      14 treatment control 0.29 −0.19 −0.09 0.16 0.10 0.05 0.04 0.21 0.15 0.15 −0.16 −0.16 0.33 –     15 identity −0.51 0.64 0.07 −0.54 −0.29 −0.23 0.04 −0.67 −0.35 −0.49 0.68 0.23 −0.33 −0.10 –    16 concern −0.38 0.46 −0.03 −0.46 −0.35 −0.27 0.01 −0.49 −0.37 −0.30 0.57 0.16 −0.36 −0.10 0.58 –   17 comprehensibility 0.20 −0.16 0.04 0.22 0.20 0.14 −0.03 0.19 0.21 0.12 −0.21 0.00 0.31 0.22 −0.16 −0.29 –  18 emotional response −0.38 0.35 −0.07 −0.46 −0.51 −0.39 0.01 −0.41 −0.47 −0.25 0.59 0.08 −0.35 −0.08 0.48 0.64 −0.27 – Table 3 Mean (SD) scores by groups on SF-36 subscales physical role functioning, mental health, emotional role functioning, social functioning, pain, vitality, physical functioning, and work-ability  n n n P SF-36 scales (0–100) (mean (SD))  Physical role functioning 34.7 (38.2) 43.4 (39.2) 17.0 (29.0) a  Mental health 68.5 (16.7) 70.6 (15.6) 64.3 (18.0) a  Emotional role functioning 73.9 (38.3) 78.7 (34.8) 64.1 (43.1) a  Social functioning 54.5 (9.4) 54.6 (8.9) 54.2 (10.4) 0.208  Pain 54.7 (21.6) 60.7 (19.2) 42.7 (22.0) a  Vitality 53.6 (17.9) 55.7 (17.1) 49.3 (18.6) a  Physical functioning 76.5 (18.0) 81.7 (14.6) 65.9 (19.6) a  Work-ability (0–10) (mean (SD)) 5.4 (2.7) 6.6 (1.8) 3.1 (2.6) a a P 3 P P P 4 Table 4 Mean (SD) illness perception scores (B-IPQ) by groups Illness perception dimensions n n n P Consequences 6.3 (2.6) 5.6 (2.5) 7.6 (2.1) a Timeline 8.3 (2.0) 8.2 (2.1) 8.5 (1.7) 0.557 Personal control  6.3 (2.0) 6.7 (1.8) 5.6 (2.1) a Treatment control  5.2 (2.6) 5.7 (2.5) 4.4 (2.6) a Identity 6.2 (2.4) 5.8 (2.4) 7.1 (2.1) a Concern 5.5 (2.6) 5.2 (2.6) 6.1 (2.6) a Comprehensibility 6.9 (2.1) 7.1 (2.0) 6.6 (2.3) 0.014 Emotional response 5.4 (2.6) 5.1 (2.6) 6.0 (2.5) a a P With the exception of the dimension timeline and comprehensibility, there was a significant difference in the six other illness perception dimensions between the two groups. Clinically relevant differences between the two groups to the detriment of the sick-listed RSI patients were found for the illness perception dimensions of “consequences”, “personal-” and “treatment-control”, and “identity”. Discussion The aim of the present study was to describe working vs. sick-listed RSI patients’ perspectives in the Netherlands in 2005 with respect to their complaints, quality of life, and illness perception. The sick-listed RSI patients reported more severe and extensive complaints in the upper extremity, but the long duration (6 years) of their complaints was comparable to the working RSI patients. The sick-listed patients, however, experienced a considerably more decreased quality of life because of their complaints, as well as more distorted illness perceptions. 2000 2004 2006 2005 2006 2002 2001 2006