Barriers, facilitators and needs for self-direction in return-to-work: a multi-perspective study

BACKGROUND: Long-term sickness absence is not only an organizational, but also a societal public health problem. Many sick-listed workers experience challenges in self-directing their return-to-work (RTW), where RTW is considered as a gradual process in which work hours and tasks are gradually increased. This view of RTW as a process is common in several European countries, such as The Netherlands, Sweden, Denmark, Norway, Austria, Germany and Switzerland. Self-direction in RTW can reduce long-term sickness absence. The aim of this study is to provide a multi-perspective view on the experiences and needs regarding workers’ self-direction in RTW. METHODS: We conducted semi-structured interviews with (previously) sick-listed workers (n = 7) and focus groups with occupational physicians and labour experts (n = 10), case managers and job coaches (n = 6) and organizational representatives (n = 8). The interviews and focus groups were recorded, transcribed and coded thematically by two independent researchers. PRELIMINARY RESULTS: All stakeholders considered (self-directing) RTW as a learning process. Barriers to self-direct RTW were lack of sufficient support from employers and involved RTW professionals, lack of knowledge about the RTW process and responsibilities among both workers and their supervisors, and employers complying with legal requirements rather than applying a person-centered approach. Workers and the involved professionals emphasized the need to gain insight into long-term employability perspectives and scenarios to maintain work. CONCLUSIONS: This qualitative study shows that there is a need for knowledge among workers and person centered support in RTW. The findings can be used in policy and practice to improve self-direction of sick-listed workers during RTW. KEY MESSAGES: • (Self-directing) RTW is a learning process for sick-listed workers. • Sick-listed workers need knowledge and person-centered support from employers and professionals to self-direct RTW.