Purpose The aim of this study was to synthesize the findings of
qualitative meta-syntheses (QMS) on return to work (RTW) of people with
different chronic illnesses and to develop a generic RTW model that can provide
advice on how to improve RTW interventions and strategies.
Methods We conducted a systematic literature search in PubMed,
Epistemonikos, CENTRAL, and PsycARTICLES to find relevant QMS, published in
English or German between 2000 and 2021, and adapted the meta-ethnographic
approach of Noblit and Hare to synthesize their findings.
Results Nineteen QMS (five focusing on musculoskeletal disorders or
chronic pain, four on acquired or traumatic brain injuries, four on cancer, two
on mental disorders, one on spinal cord injury, and three on mixed samples) met
our inclusion criteria for the meta-ethnographic synthesis. Through systematic
comparison and reciprocal translation of the single QMS findings, we could
identify a set of key cross-cutting themes/concepts, which formed the
basis for four RTW principles and a generic RTW model.
Conclusions RTW is a multifactorial and highly interactive
multistakeholder process, embedded in an individual‘s life and working
history, as well as in a determined social and societal context. It runs
parallel and interdependently to the process of coping with the disease and
realigning one’s own identity, thus emphasizing the significance of RTW
for the person. Besides symptoms and consequences of the disease, individual
coping strategies, and RTW motivation, the course and success of RTW are
strongly affected by the adaptability of the person’s working
environment and the social support in their private and working life. Thus, RTW
is not only a problem of the individual, but also a matter of the social
environment, especially the workplace, requiring a holistic, person-centered,
and systemic approach, coordinated by a designated body, which considers the
interests of all actors involved in the RTW process.