What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals

Abstract

Objectives The aim of this study was to (i) explore promoting factors for sustained return to work (RTW), according to vocational rehabilitation professionals (VRP) that are amenable to change for employees who have been on sick leave >18 months and (ii) gain insight into crucial aspects of interventions.Methods Semi-structured interviews were carried out with 23 VRP. All interviews were transcribed fullyverbatim. An inductive analysis of the transcripts was performed, using a process of identifying, coding, and categorizing the primary patterns in the data.Results Key influenceable promoting factors for sustained RTW by long-term sick-listed employees include:employee-based vocational guidance; integral, effective communication between the sick-listed employee and all RTW stakeholders; personal factors; a supportive work environment; and a stimulating social environment. Crucial aspects of interventions include: gathering information and setting priorities; improving qualifications; influencing cognitions; monitoring the sick-listed employee through the rehabilitation process; offering tailormade interventions at different stages within a personal time-bound action plan; and preparing the employee and the work environment for RTW.Conclusions Sustained RTW for long-term sick-listed employees can be achieved by focusing on the influenceable promoting factors for RTW. The use of combined interventions in a holistic approach involving the worker and his environment is considered the best way to address the multicausality of work disability and could help maximize RTW outcomes.Key terms long-term sickness absence; return-to-work facilitators; RTW; RTW coordinators; sickness absence; work disablement; work rehabilitation. [E-mail: p.m.dekkers@amc.uva.nl] Long-term sick leave is a major socioeconomic problem in Western countries due to the enormous financial costs for society (1). Several studies have shown the importance of the return-to-work (RTW) transition process for employees on long-term sick leave (2-4). Early research has shown that the probability of RTW decreases as the duration of sick leave lengthens (5). Achieving early job reintegration of chronic work-disabled employees is a difficult goal to accomplish due to the complexity of factors involved, and the issue needs ongoing attention.An employee on long-term sick leave is an individual who functions in a complex context in which different factors can play a role, such as medical, personal, environmental, or work-related factors (6). These factors can either perpetuate sick leave or promote RTW (7) among employees who have been sick-listed for >1.5 years; the factors that stimulate RTW may be different from those that facilitate a sustained RTW. Some promoting factors for RTW are potentially influenceable and could offer opportunities for health professionals to improve work participation. Therefore, stimulation of these positive factors is important to facilitate work resumption of employees on long-term sick leave.There are several important actors...

Return to work after coronary revascularization procedures and a patient’s job satisfaction: A prospective study

“…Specifically, the results showed that the best predictors of a satisfying RTW after cardiac invasive procedures were: job satisfaction for the pre-illness work environment, depression and ambition, independently of sociodemographic factors, medical factors and a type of RTW (full or partial). The key role in the RTW process after an acute cardiac event played by non-medical factors has been also explored by earlier research [3][4][5]9,[15][16][17][18][19][20][21][22][23]. Recent studies have shown that the perception of work environment, which can be reflected in work stress and job satisfaction, has a strong effect on both people's decision to RTW [16,21,22] and duration of sickness absence [15,16].…”

“…Recent studies suggested an important role of psychosocial work environment in the RTW process, with particular emphasis on work stress and job satisfaction [15,16,18,19,21,22]. Dekkers-Sànchez et al [23] have recently explored factors promoting sustained RTW of employees on long-term sick leaves and underlined the key role played by the work environment and subjective attitude towards work (e.g., work motivation, positive meaning of work, cognitions and RTW expectations). However, what promotes satisfaction with RTW after a cardiac event is still an unexplored issue.…”

Sustained Return to Work after Long-term Sick Leave Improves Work Ability and Quality of Life

“…This could suggest a relation between already having high values of social domain and being able to remain at work after long sick leave. According to Dekkers-Sánchez et al [10], a sustainable process of returning to work after long sick leave can help solve social, financial or family problems for most workers. In this study, contradictory results were identified, however they do not allow us to understand if having already high social domain scores was crucial to help these workers to keep working.…”

“…According to Dekkers-Sánchez et al [10] sustained return to work requires an in-depth understanding of work disability and a multidimensional approach to optimize the return to work. Five promoting factors are identified by authors as follows: employed-based vocational guidance, effective communication between employee and employer, active participation of the sick-listed employee, a supportive work environment and a stimulating social environment.…”

“…The results showed that, even after a first sustained return to work, workers had still not completely recovered from the injury that led to the sick leave. The complexity of the process suggests that the success of returning to work depends on a comprehensive approach involving the worker and his occupational environment making the worker´s reintegration a challenge for occupational health service [10]. Considering this, following up a worker who returned to work for longer periods of time might contribute to the understanding of the effects of work on the workers' health and, consequently, the improvement of interventions aiming to encourage sustained return to work.…”