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Encouraging Encounters: Experiences of People on Sick Leave in Their Meetings with Professionals
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0001-5173-5419
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The recent increase in long-term sickness absence both in Sweden and many other countries has been met with various attempts to intensify the use of rehabilitation measures in order to prevent people from remaining long-term sickness absent. Several actors, among them professionals in healthcare, occupational health services, and social insurance are involved in handling issues related to the sick leave of an individual, and in providing measures to promote return to work (RTW). Identification of the factors that are related to RTW of the individual is a multifaceted task; therefore to meet the individual in this process is an essential challenge for many actors involved. Knowledge is needed about factors that might promote RTW in order to facilitate future research aimed at designing effective rehabilitation programs. Such information is of great importance to improve the work situations of the professionals, to decrease the cost for society, and to improve the situations for people on sick leave by facilitating RTW.

Objectives: The overall aim of the work underlying this thesis was to ascertain whether contacts between professionals and sickness absentees might a factor that can promote RTW, and also to identify different aspects of how such positive encounters are experienced by those who are sick listed.

Material and methods: Five investigations were conducted using different study designs, data, and methods of data analyses. The first two (papers I and II) concerned interviews with people on sick leave about positive experiences of their encounters with professionals. The third study (paper III) was based on four questions about encounters, which were included in a questionnaire that was administrated to people who were on sick leave. The fourth study (paper IV) used a broad questionnaire to examine experiences of positive encounters, and the final study (paper V) proposed a model of possible effects of the encounters on RTW.

Results: In paper I and II different aspects of sick-listed person’s experiences of positive encounters were identified. For example, it seemed that important qualities included being treated with respect, feeling supported, establishing a personal relationship, and participating in decisions regarding RTW measures. Several of the interviewees stated that RTW might be promoted by positive encounters. Paper III showed that perceptions of interactions varied with the type of professionals, as well as with demographics. The respondents perceived their encounters with professionals within healthcare as most positive, followed by social insurance, and lastly occupational health services. In general, females, people born in Sweden, and those who were older, or had a higher education rated their encounters with professionals as more positive. The main finding reported in paper IV was that the majority of the participants had experienced being positive encountered by professionals. Three aspects of such encounters were stressed, namely being treated with ”competence”, ”personal attention”, and ”competence and trust”. The results related in paper V indicated that theories about empowerment and on social emotions could be successfully applied in this area, after they were specifically adapted to some unique features of the contacts between sickness absentees and rehabilitation professionals.

Conclusions: This thesis emphasizes that being positively encountered by professionals can have a beneficial impact on RTW after a period of sickness absence. More research is required to elucidate the interaction between sick-listed persons and professionals who are involved in their cases. Further studies should focus on how methods for professionals can be provided to increase sick-listed persons’ own ability to mobilize and develop their resources. Moreover, additional knowledge is needed to extend professional treatment strategies that enhance self-confidence and empowerment of individuals during sickness absence.

Place, publisher, year, edition, pages
Institutionen för hälsa och samhälle , 2007. , 61 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 981
Keyword [en]
Encounters, Sickness absence, Sick leave, Return to work, Client perspective, Health promotion, Work
Keyword [sv]
Sjukfrånvaro, Bemötande, Sociala emotioner, Återgång till arbete, Empowerment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-8262ISBN: 978-91-85715-94-7 (print)OAI: oai:DiVA.org:liu-8262DiVA: diva2:23111
Public defence
2007-03-02, Aulan, Hälsans hus, Campus US, Linköpings Universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02
List of papers
1. Positive encounters with rehabilitation professionals reported by persons with experience of sickness absence
Open this publication in new window or tab >>Positive encounters with rehabilitation professionals reported by persons with experience of sickness absence
2004 (English)In: Work: A Journal of Prevention, Assessment & Rehabilitation, ISSN 1051-9815, Vol. 22, no 3, 247-254 p.Article in journal (Refereed) Published
Abstract [en]

More knowledge is needed on different factors that can promote return to work among sick-listed persons. One such factor might be by their interactions with the rehabilitation professionals they encounter. The aim of the present study was to identify and analyze statements about positive encounters with rehabilitation staff, reported by persons who had been absent from work with back, neck, or shoulder diagnoses. A descriptive and explorative qualitative approach was used to analyze data from five focus-group interviews. There were few statements on positive encounters, and they were frequently attributed to sheer luck. Experiences of positive encounters were assigned to two major categories: respectful treatment and supportive treatment. Receiving adequate medical examination or treatment was also mentioned as being positive. Further efforts are needed to study and develop methods for investigating interactions with rehabilitation professionals that laypersons experience as positive and that may contribute to empowerment and influence return to work when sickness absent.

Keyword
sickness absence, sick leave, rehabilitation, encounter, return to work
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14286 (URN)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02
2. Encouraging encounters: sick-listed persons’ experiences of interactions with rehabilitation professionals
Open this publication in new window or tab >>Encouraging encounters: sick-listed persons’ experiences of interactions with rehabilitation professionals
2007 (English)In: Social work in health care, ISSN 0098-1389, Vol. 46, no 2, 71-87 p.Article in journal (Refereed) Published
Abstract [en]

Long-term sickness-absence has increased in many countries and more knowledge is warranted on factors that can promote return-to-work (RTW). Interactions with professionals might be one such factor and especially experiences of positive encounters. The purpose of the study was to identify and analyze sick-listed persons' experiences of positive encounters with professionals within social insurance and healthcare. An inductive and descriptive qualitative approach was used to analyze ttanscripts from 11 semi-structured interviews with persons with experience of long-term sickness absence.

The following five categories of qualities of encounters were found to be of importance: being treated with respect, feeling supported, establishing a personal relationship, perceiving demands as well-balanced, and participating in decisions regarding rehabilitation measures. Several interviewees expressed the opinion that positive encounters with professionals can promote RTW.

Further research is needed to elucidate the aspects of interactions that enhance empowerment and self-confidence in persons on sick leave, in order to develop professional treatment strategies that facilitate RTW.

Keyword
Sickness-absence, sick leave, encounter, return-to-work, professionals
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14287 (URN)10.1300/J010v46n02_05 (DOI)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02
3. A population-based questionnaire study of how people on sick leave perceive contacts with professionals in healthcare, occupational health services, and social insurance
Open this publication in new window or tab >>A population-based questionnaire study of how people on sick leave perceive contacts with professionals in healthcare, occupational health services, and social insurance
2007 (English)In: Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14288 (URN)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02
4. Positive experiences of encounters with professionals among people on long-term sick leave
Open this publication in new window or tab >>Positive experiences of encounters with professionals among people on long-term sick leave
2007 (English)In: Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14289 (URN)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02
5. Pride, empowerment and return to work: On the significance of positive social emotions in the rehabilitation of sickness absentees
Open this publication in new window or tab >>Pride, empowerment and return to work: On the significance of positive social emotions in the rehabilitation of sickness absentees
2006 (English)In: Work: A Journal of Prevention, Assessment & Rehabilitation, ISSN 1051-9815, Vol. 27, no 1, 57-65 p.Article in journal (Refereed) Published
Abstract [en]

Sickness absence is a great public health problem and there is a lack of knowledge concerning the hows and whys of success or failure in promoting return to work of sick-listed persons. Discussions of and research into social and psychological aspects of this problem area are in need of theoretical contextualisation. In this paper it is suggested that theories of social emotions may be useful, and that the concept of empowerment can be applied provided that it is reasonably well defined. The notions of pride/shame and empowerment are elucidated and discussed, and it is shown that they can be related in the context of research into emotional dimensions of sickness absentees' experiences of the rehabilitation process in a way that may help to guide empirical studies. A simple model of hypothetical relations between pride/shame, empowerment/disempowerment, work ability, health, and return to work is sketched.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-14290 (URN)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2015-06-02

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