The Work Ability Divide: Holistic and Reductionistic Approaches in Swedish Interdisciplinary Rehabilitation Teams
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Introduction Stakeholder cooperation in return to work has been increasingly emphasised in research, while studies on how such cooperation works in practise are scarce. This article investigates the relationship between professionals in Swedish interdisciplinary rehabilitation teams, and the aim of the article is to determine the participants’ definitions and uses of the concept of work ability. Methods The methods chosen were individual interviews with primary health care centre managers and focus groups with twelve interdisciplinary teams including social insurance officers, physicians, physiotherapists, occupational therapists, medical social workers and coordinators. Results The results show that the teams have had problems with reaching a common understanding of their task, due to an inherent tension between the stakeholders. This tension is primarily a result of two factors: divergent perspectives on work ability between the health professionals and the Social Insurance Agency, and different approaches to cooperative work among physicians. Health professionals share a holistic view on work ability, relating it to a variety of factors. Social insurance officers, on the other hand, represent a reductionistic stance, where work ability is reduced to medical status. Assessments of work ability therefore tend to become a negotiation between insurance officers and physicians. Conclusions A suggestion from the study is that the teams, with proper education, could be used as an arena for planning and coordinating return-to-work, which would strengthen their potential in managing the prevention of work disability.
KeywordsWork ability Return to work Cooperation Team Interdisciplinary
The authors wish to thank Linda Schultz for assisting with the data collection, Peter Johansson and Grace Hagberg for help with the selection of participants, Lars-Christer Hydén for comments on the design, and Åsa Tjulin for valuable support during the revision of the text.
The authors declare that they have no competing interests.
CS: study design, fieldwork, first draughts of the analysis and writing the text. KE: study design, examining and commenting on the analysis and the manuscript. TS and GP: examining and commenting on the analysis and the manuscript.
- 1.Brunarski D, Shaw L, Doupe L. Moving toward virtual interdisciplinary teams and a multi-stakeholder approach in community-based return-to-work care. Work (Reading, Mass). 2008;30(3):329–36.Google Scholar
- 5.Wilthagen T, Tros F. The concept of ‘flexicurity’: a new approach to regulating employment and labour markets. Transfer: European Review of labour and research. 2004;10(2):166–86.Google Scholar
- 8.World Health Organization. International classification of functioning, disability and health. Geneva: World Health Organization; 2001.Google Scholar
- 10.Sjukförsäkring.Kulturer och Attityder: Fyra aktörers perspektiv (Sickness Insurance, Cultures and Attitudes: Four Actors’ Perspectives) Stockholm: Försäkringskassan (SSIA); 2006.Google Scholar
- 11.Alexanderson K, Brommels M, Ekenvall L, Karlsryd E, Löfgren A, Sundberg L, et al. Problem inom hälso- och sjukvården kring handläggning av patienters sjukskrivning (Problems in health care in handling patients’ sicklisting). Stockholm: Karolinska Institutet; 2005.Google Scholar
- 13.Patton MQ. Qualitative research and evaluation methods. 3 ed. London: Sage; 2002.Google Scholar
- 14.Krueger RA. Focus groups: A Practical Guide for Applied Research. 2 ed. London: Sage; 1994.Google Scholar
- 15.Wibeck V. Fokusgrupper (Focus groups). Lund: Studentlitteratur; 2000.Google Scholar
- 19.Berwick DM. Ideas for medical education. Acad Med. 1996;71(9):972.Google Scholar
- 24.Lincoln Y, Guba E. Naturalistic inquiry. Newbury Park: Sage; 1985.Google Scholar