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Experience of the Implementation of a Multi-Stakeholder Return-to-Work Programme
Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Behavioural Sciences and Learning, Centre for Teaching and Learning. Linköping University, Faculty of Educational Sciences.
Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8031-7651
2009 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 19, no 4, 409-418 p.Article in journal (Refereed) Published
Abstract [en]

Introduction Employers can use several strategies to facilitate return-to-work for workers on sick leave, but there seems to be limited knowledge of how workplace-based interventions are actually implemented in organisations. One public Swedish employer initiated a return-to-work programme which incorporated interventions suggested by earlier research, e.g. multi-professional health assessment, case management, educational peer-support groups and adapted workplace training. The overall purpose of the study is to analyse how the programme was implemented and experienced in the organisation, from the perspective of involved stakeholders, i.e. supervisors, occupational health consultants and a project coordinator. The objective of this paper is to identify and analyse how these stakeholders perceived that the programme had been implemented in relation to its intentions. Methods A qualitative method was used, consisting of individual interviews with eight supervisors and the project leader. Two group interviews with five occupational health service consultants were also conducted. Results The study revealed barriers to the implementation of return-to-work interventions. Not all of the intended interventions had been implemented as expected in policy. One explanation is that the key stakeholders expressed a more biomedical, individual view of work ability, while the programme was based on a more holistic, biopsychosocial view. Conclusion Implementation of a return-to-work programme is an ongoing, long-term multi-level strategy, requiring time for reflection, stakeholder participation, openness to change of intervention activities, and continuous communication.

Place, publisher, year, edition, pages
2009. Vol. 19, no 4, 409-418 p.
Keyword [en]
Implementation; Qualitative; Return-to-work programme; Sweden; Workplace
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-21801DOI: 10.1007/s10926-009-9195-yOAI: oai:DiVA.org:liu-21801DiVA: diva2:241740
Available from: 2009-10-05 Created: 2009-10-05 Last updated: 2017-12-13
In thesis
1. Workplace Social Relations in theReturn-to-Work process
Open this publication in new window or tab >>Workplace Social Relations in theReturn-to-Work process
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore the impact of workplace social relations on the implementation of return-to-work interventions. The thesis consists of four separate papers with specific aims. In Paper I, the overall purpose of the study was to analyse how a multi-stakeholder return-to-work programme was implemented and experienced from the perspective of the stakeholders involved, i.e. supervisors, occupational health consultants and a project coordinator. The objective was to identify and analyse how these stakeholders perceived that the programme had been implemented in relation to its intentions. In Paper II, the objective was to explore how workplace actors experience social relations, and how organisational dynamics in workplace-based return-to-work start before and extend beyond the initial return of the sick-listed worker to the workplace. In Paper III, the objective was to explore the meaning of early contact in return-to-work, and how social relational actions and conditions can facilitate or impede early contact among workplace actors. In Paper IV, the objective was to explore the role of co-workers in the return-to-work process, and their contribution to the process, starting from when a colleague falls ill, continuing when he/she subsequently becomes sick-listed and finally when he/she re-enters the workgroup.

The general methodological approach to the papers in this thesis has been explorative and interpretive; qualitative methods have been used, involving interviews, group interviews and collection of employer policies on return-to-work. The data material has been analysed through back-and-forth abductive (Paper I), and inductive (Papers II-IV) content analysis.

The main findings from Paper I show that discrepancies in the interpretations of policy intentions between key stakeholders (project coordinator, occupational health consultants and supervisors) created barriers for implementing the employer-based return-to-work programme, due to lack of communication, support, coaching and training activities of key stakeholders dedicated to the biopsychosocial intentions of the programme. In Papers II-IV, the workplace actors (re-entering workers, co-workers, supervisors and/or human resources manager) experienced the return-to-work process as phases (time before the sick leave, when on sick leave, when re-entering the workplace, and future sustainability). The findings highlight the importance and relevance of the varied roles of the different workplace actors during the identified phases of the return-to-work process. In particular, the positive contribution of co-workers, and their experience of shifting demands and expectations during each phase, is acknowledged. During the period of time before sick leave the main findings show how workplace actors experience the meaning of early contact within a social relational context, and how early contact is more than an activity that is merely carried out (or not carried out). The findings show how workplace actors experience uncertainties about how and when contact should take place, and the need to balance possible infringement that early contact might cause for the re-entering worker between pressure to return to work and their private health management.

The findings in this thesis show how the workplace is a socially complex dynamic setting, which challenges some static models of return-to-work. The biopsychosocial and ecological/case management models and policies for return-to-work have been criticised for neglecting social relations in a return-to-work process at the workplace. This thesis provides increased knowledge and explanations regarding important factors in workplace social relations that facilitate an understanding of what might “make or break” the return-to-work process.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 62 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1197
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-57658 (URN)978-91-7393-336-0 (ISBN)
Public defence
2010-11-19, Berzeliussalen, ingång 64, plan 9, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2010-10-28 Created: 2010-06-28 Last updated: 2013-09-03Bibliographically approved

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Tjulin, ÅsaEdvardsson Stiwne, ElinorEkberg, Kerstin

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