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Ethical aspects of the coordination of return-to-work among employees on sick leave due to common mental disorders: a qualitative study
Karolinska Inst, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. (National Centre for Priority Setting in Health Care)ORCID iD: 0000-0003-0987-7653
Karolinska Inst, Sweden; Uppsala Univ, Sweden.
Karolinska Inst, Sweden.
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2023 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 45, no 13, p. 2118-2127Article in journal (Refereed) Published
Abstract [en]

Purpose Identify ethical issues that arise in the coordination of return-to-work (RTW) among employees on sick leave due to common mental disorders (CMDs). Material and methods 41 semi-structured individual interviews and one focus group interview with stakeholders (n = 46) involved in RTW: employees on sick leave due to CMDs, coordinators and physicians at primary health care centres, managers, representatives of the Swedish social insurance agency and occupational health services. A six-step thematic analysis focused on the ethical values and norms related to autonomy, privacy, resources and organization, and professional values. Results Five themes were identified: (1) autonomous decision-making versus the risk of taking over, (2) employee rights versus restrictions to self-determination, (3) respect for employee privacy versus stakeholders interests, (4) risk of unequal inclusion due to insufficient organizational structure and resources, (5) risk of unequal support due to unclear professional roles and responsibilities. Conclusion The main ethical issues are the risks of unequal access to and unequal support for the coordination of RTW. For the fair and equal provision of coordination, it is necessary to be transparent on how to prioritize the coordination of RTW for different patient groups, provide clarity about the coordinators professional role, and facilitate ongoing boundary work between stakeholders.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2023. Vol. 45, no 13, p. 2118-2127
Keywords [en]
Adjustment disorder; anxiety disorders; autonomy; depression; fairness; mental health; privacy; sickness absence
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-186144DOI: 10.1080/09638288.2022.2084779ISI: 000808178700001PubMedID: 35676198OAI: oai:DiVA.org:liu-186144DiVA, id: diva2:1674001
Note

Funding Agencies|AFA Insurance [160183]

Available from: 2022-06-21 Created: 2022-06-21 Last updated: 2023-11-16Bibliographically approved

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Sandman, Lars

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