Workers with musculoskeletal disorders undertaking Malaysia's return to work (RTW) programmes may experience challenges in occupational competence (OC) and negative emotional states (NES). This study aimed to measure and examines the OC and NES of the workers by comparing specific comparison groups and groups of different phases. A total of 76 participants were recruited from a national RTW programme and categorized into three groups based on different RTW phases: off-work (n = 22), re-entry (n = 31), and maintenance (n = 23). Self-report questionnaires consisted of the Occupational Self Assessment version 2.2 and the Depression, Anxiety and Stress Scale-21. Results showed that injured workers exhibited significantly lower OC in comparison with an international group with various disabilities. In contrast, there was significantly higher NES when compared with Malaysia's general population. Significant differences in OC and NES were also found between workers in the three RTW phases. In particular, OC and NES in the off-work and re-entry phases were significantly lower (OC) and higher (NES) than in the maintenance phase. Furthermore, there was a moderate, negative correlation between OC and NES in the off-work and re-entry phase groups. This indicated that low levels of perceived OC were associated with higher levels of NES.

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Return to work (RTW) for workers with musculoskeletal disorders (MSDs) due to work-related injury is often a long rehabilitation process, which Young et al (2005) divided into four main phases: off-work, work re-entry, maintenance and advancement. The end of each RTW phase marks the achievement of important milestones. These are, respectively, (1) the ability to attempt work re-entry, (2) the ability to perform satisfactorily in pre-injury or alternative duties, (3) the ability to maintain employment and (4) the ability to advance in one's career (Young et al 2005). There are several issues at the different phases that need to be addressed, specific to the level of functioning of the worker, such as personal factors of volition, habituation and skill /occupational performance (Baron and Littleton 1999, Kielhofner 2008). However, evaluation of the individual's abilities at each level requires the use of measurements that are valid and reliable, and also sensitive to change over time. While such instruments are available in countries such as North America, the United Kingdom and Australia, the Occupational Self Assessment (OSA), one of the Model of Human Occupation (Kielhofner 2008) assessments, has not been validated for use in Asian countries such as India and Malaysia.

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