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Journal of Occupational Rehabilitation

, Volume 22, Issue 4, pp 553–564 | Cite as

Policy and Practice of Work Ability: A Negotiation of Responsibility in Organizing Return to Work

  • Ida SeingEmail author
  • Christian Ståhl
  • Lennart Nordenfelt
  • Pia Bülow
  • Kerstin Ekberg
Article

Abstract

Purpose In welfare policy and practical work it is unclear what the concept of work ability involves and assessments may be different among involved actors, partly due to a lack of theoretical research in relation to regulations and practice. Based on theoretical and legal aspects of work ability the aim of the study is to analyze stakeholders’ perspectives on work ability in local practice by studying multi-stakeholder meetings. Methods The material comprises nine digitally recorded multi-stakeholder meetings. Apart from the sick-listed individual, representatives from the public Social Insurance Agency, health care, employers, public employment service and the union participated in the meeting. The material was analyzed using qualitative content analysis. Results Three perspectives on work ability were identified: a medical perspective, a workplace perspective and a regulatory perspective. The meetings developed into negotiations of responsibility concerning workplace adjustments, rehabilitation efforts and financial support. Medical assessments served as objective expert statements to legitimize stakeholders’ perspectives on work ability and return to work. Conclusions Although the formal goal of the status meeting was to facilitate stakeholder collaboration, the results demonstrates an unequal distribution of power among cooperating actors where the employers had the “trump card” due to their possibilities to offer workplace adjustments. The employer perspective often determined whether or not persons could return to work and if they had work ability.

Keywords

Work ability Return to work Employers Multi-stakeholder meeting 

Notes

Acknowledgments

The authors would like to thank Ellen MacEachen for valuable comments during the finalization of the manuscript.

References

  1. 1.
    MacEachen E, Kosny A, Ferrier S, Lippel K, Neilson C, Franche RL, Pugliese D. The ‘ability’ paradigm in vocational rehabilitation: challenges in an ontario injured worker retraining program. J Occup Rehabil. 2011; doi:  10.1007/s10926-011-9329-x.
  2. 2.
    Holmqvist M. The active welfare state and its consequences. Eur Soc. 2010;12(2):209–30.CrossRefGoogle Scholar
  3. 3.
    De Boer W. Quality of evaluation of work disability. Hoofddorp: TNO Quality of Life; 2010.Google Scholar
  4. 4.
    World Health Organization. Classification of functioning, disability and health (ICF). Geneva: WHO; 2001.Google Scholar
  5. 5.
    Ilmarinen JE. Aging workers. Occup Environ Med. 2001;58(8):546–52.PubMedCrossRefGoogle Scholar
  6. 6.
    Tengland P-A. The concept of work ability. J Occup Rehabil. 2011;21(2):275–85.PubMedCrossRefGoogle Scholar
  7. 7.
    Nordenfelt L. The concept of work ability. Bruxelles: P.I.E. Peter Lang; 2008.Google Scholar
  8. 8.
    Garsten C, Lindvert J, Thedvall R, editors. Arbetets marknad: Arbetsmarknadens nya organisering. Liber: Malmö; 2011.Google Scholar
  9. 9.
    Garsten C, Jacobsson K. Sorting people out: detecting and classifying employability, work capacity and disability at Swedish Public Employment Services. International Sociological Association-conference; Guthenburg 2011.Google Scholar
  10. 10.
    Garsten C, Jacobsson K, editors. Learning to be employable: new agendas on work, responsibility, and learning in a globalizing world. Palgrave Macmillan: Basingstoke; 2004.Google Scholar
  11. 11.
    Peralta Pierto J. Den sjuka arbetslösheten: Svensk arbetsmarknadspolitik och dess praxis 1978–2004. Uppsala: Uppsala University; 2006.Google Scholar
  12. 12.
    Lindqvist R. Funktionshinder, arbetsförmåga och socialpolitik. In: Westerhäll L, editor. Arbets(o)förmåga—ur ett mångdiciplinärt perspektiv. Stockholm: Santérus; 2008.Google Scholar
  13. 13.
    Esping-Andersen G. The three worlds of welfare capitalism. Cambridge: Polity Press; 1990.Google Scholar
  14. 14.
    Jacobsson K. A European politics of employability: the political discourse on employability of the EU and the OECD. In: Garsten C, Jacobsson K, editors. Learning to be employable: new agendas on work, responsibility, and learning in a globalizing world. Basingstoke: Palgrave Macmillan; 2004.Google Scholar
  15. 15.
    Vahlne Westerhäll L. Det sjukförsäkringsrättsliga arbetsförmågebegreppet i lagstiftning och rättstillämpning. In: Vahlne Westerhäll L, editor. Arbets(o)förmåga: ur ett mångdisciplinärt perspektiv. Stockholm Santérus; 2008.Google Scholar
  16. 16.
    Proposition. Förändringar inom sjukförsäkringen för ökad hälsa i arbetslivet. 2002.Google Scholar
  17. 17.
    Riksförsäkringsverket. Om avstämningsmöten. 2003.Google Scholar
  18. 18.
    Hammersley M, Atkinson P. Ethnography: principles in practice. London: Routledge; 1995.Google Scholar
  19. 19.
    Patton MQ. Qualitative research & evaluation methods. 3rd ed. London: SAGE; 2002.Google Scholar
  20. 20.
    Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):209–30.CrossRefGoogle Scholar
  21. 21.
    Johansson R. Vid byråkratins gränser: Om handlingsfrihetens organisatoriska begränsningar i klientrelaterat arbete. Lund: Studenteratur; 1992.Google Scholar
  22. 22.
    Stone D. The disabled state. Basingstoke: Macmillan; 1985.Google Scholar
  23. 23.
    de Swaan A. In care of the state. Health Care, Education and welfare in Europe and the USA in Modern Era. Cambridge: Cambridge Polity Press; 1990.Google Scholar
  24. 24.
    Löfgren A. Physicians’ sickness certification practices: frequency, problems, and learning. Stockholm: Karolinska Institutet; 2010.Google Scholar
  25. 25.
    Conrad P. Medicalization and social control. Annu Rev Sociol. 1992;18:209–32.CrossRefGoogle Scholar
  26. 26.
    Castells M. The information age: economy, society and culture. The rise of the network society. Malden, Mass: Blackwell; 2000.Google Scholar
  27. 27.
    Garsten C. Workplace vagabonds. Basingstoke: Palgrave Macmillan; 2008.CrossRefGoogle Scholar
  28. 28.
    Swedish Public Employment Service. Statistics on unemployed at the Swedish Public Employment Service. 2010.Google Scholar
  29. 29.
    MacEachen E, Kosny A, Scott-Dixon K, Facey M, Chambers L, Breslin C, Kyle N, Irvin E, Mahood Q and the Small Business Systematic Review Team. Workplace health understandings and processes in small businesses: a systematic review of the qualitative literature. J Occup Rehabil. 2010;20(2):180–98.Google Scholar
  30. 30.
    Kaye H, Jans LH, Jones EC. Why don’t employers hire and retain workers with disabilities? J Occup Rehabil. 2011;21(4):526–36.PubMedCrossRefGoogle Scholar
  31. 31.
    Baril R, Berthelette D, Massicotte P. Early return to work of injured workers: multidimensional patterns of individual and organizational factors. Saf Sci. 2003;41:277–300.CrossRefGoogle Scholar
  32. 32.
    Krause N, Dasinger LK, Neuhauser F. Modified work and return to work: a review of the literature. J Occup Rehabil. 1998;8:113–39.CrossRefGoogle Scholar
  33. 33.
    Johansson G, Lundberg O, Lundberg I. Return to work and adjustment latitude among employees on long-term sickness absence. J Occup Rehabil. 2006;16(2):181–91.CrossRefGoogle Scholar
  34. 34.
    Pransky G, Shaw W, Franche R. Disability prevention and communication among workers, physicians, employers, and insurers—current models and opportunities for improvement. Disabil Rehabil. 2004;26(11):625–34.PubMedCrossRefGoogle Scholar
  35. 35.
    Loisel P, Durand M-J, Berthelette D, Vézina N, Baril R, Gagnon D, Larivière C, Tremblay C. Disability prevention: new paradigm for the management of occupational back pain. Dis Manage Health Outcomes. 2001;9(7):351–60.CrossRefGoogle Scholar
  36. 36.
    Pollitt C, Bouckaert G. Public management reform. 2nd ed. New York: Oxford University Press; 2004.Google Scholar
  37. 37.
    Hughes OE. Public management & administration: an introduction. New York: Palgrave; 2003.Google Scholar
  38. 38.
    Hood C. A public management for all seasons? Publ Adm. 1991;69(1):3–19.CrossRefGoogle Scholar
  39. 39.
    Power M. The audit society. Rituals of verification. Oxford: Oxford University Press; 1997.Google Scholar
  40. 40.
    Sahlin-Andersson K. National, international and transnational constructions of new public management. In: Christensen T, Laegreid P, editors. New public management: the transformation of ideas and practice. Ashgate: Aldershot; 2001.Google Scholar
  41. 41.
    Brunsson N, Sahlin-Andersson K. Constructing organizations: the example of public sector reform. Organ Stud. 2000;21(4):721–46.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ida Seing
    • 1
    Email author
  • Christian Ståhl
    • 1
    • 2
  • Lennart Nordenfelt
    • 3
  • Pia Bülow
    • 4
  • Kerstin Ekberg
    • 1
    • 2
  1. 1.Department of Medical and Health SciencesNational Centre for Work and Rehabilitation, Linköping UniversityLinköpingSweden
  2. 2.HELIX VINN Exellence CentreLinköping UniversityLinköpingSweden
  3. 3.Division of Health and Society, Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
  4. 4.Department of Behavioral Science and Social Work, School of Health SciencesJönköping UniversityJönköpingSweden

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