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Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships

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Abstract

Purpose Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy. Methods Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis. Results Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support—a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers’ return-to-work, depending on how they valued the worker. While managers used the discourse of ‘new opportunities’ and ‘healthy change’ to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust. Conclusions In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

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References

  1. MacEachen E, Ferrier S, Kosny A, Chambers L. A deliberation on ‘‘hurt versus harm’’ logic in early return to work policy. Policy Pract Health Saf. 2007;5(2):41–62.

    Google Scholar 

  2. Irvine A. Fit for work? The influence of sick pay and job flexibility on sickness absence and implications for presenteeism. Soc Policy Adm. 2011;45(7):752–69.

    Article  Google Scholar 

  3. Salais R, Villeneuve R. Europe and the politics of capabilities. United Kingdom: Cambridge University Press; 2004.

    Google Scholar 

  4. OECD. Sickness, disability and work: breaking the barriers. A synthesis of findings across OECD countries. Paris: OECD; 2010.

    Google Scholar 

  5. MacEachen E, Kosny A, Scott-Dixon K, Facey M, Chambers L, Breslin C, Kyle N, Irvin E, Mahood Q, 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.

    Article  PubMed  Google Scholar 

  6. Burke RJ, Cooper CL. The organization in crisis: downsizing, restructuring, and privatization. Oxford: Blackwell; 2000.

    Google Scholar 

  7. Gowing MK, Kraft JD, Quick JC, editors. The new organizational reality: downsizing, restructuring, and revitalization. Washington: American Psychological Association; 1997.

    Google Scholar 

  8. Gallie D, White M, Cheng Y, Tomlinson M. Restructuring the employment relationship. Oxford: Clarendon Press; 1998.

    Google Scholar 

  9. Howard A. The changing nature of work. San Francisco: Jossey-Bass; 1995.

    Google Scholar 

  10. Garsten C. Workplace vagabonds. Basingstoke: Palgrave Macmillan; 2008.

    Book  Google Scholar 

  11. 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 

  12. Blonk RWB, Brenninkmeijer V, Lagerveld SE, Houtman ILD. Return to work: a comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed. Work Stress. 2006;20(2):129–44.

    Article  Google Scholar 

  13. van der Klink JJ, Blonk RWB, Schene AH, van Dijk FJ. Reducing long-term sickness absence by activating intervention in adjustment disorders: a cluster randomised controlled design. Occup Environ Med. 2003;60(6):429–37.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Anema JR, Steenstra IA, Bongers PM, de Vet HCW, Knol DL, van Mechlen W. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine. 2007;32(3):291–8.

    Article  PubMed  Google Scholar 

  15. Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Giosselin L. A populationbased, randomised clinical trial on back pain management. Spine. 1997;22(24):2911–8.

    Article  CAS  PubMed  Google Scholar 

  16. Abenhaim L, Rossignol M, Valat JP, Nordin M, Avouac B, Blotman F, et al. The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain. Spine. 2000;25(4):1S–33S.

    Article  CAS  PubMed  Google Scholar 

  17. Friedman PJ. Predictors of work disability in work-related upper-extremity disorders. J Occup Environ Med. 1997;39(4):339–43.

    Article  CAS  PubMed  Google Scholar 

  18. Kuoppala J, Lamminpaa A. Rehabilitation and work ability: a systematic literature review. J Rehabil Med. 2008;40(10):796–804.

    Article  PubMed  Google Scholar 

  19. Franche R-L, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J, et al. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15(4):607–31.

    Article  PubMed  Google Scholar 

  20. Krause N, Dasinger LK, Neuhauser F. Modified work and return to work: a review of the literature. J Occup Rehabil. 1998;8(2):113–39.

    Article  Google Scholar 

  21. Shaw W, Robertson MM, McLellan RK, Verma S, Pransky G. A controlled case study of supervisor training to optimize response to injury in the food processing industry. Work. 2006;26(2):107–14.

    PubMed  Google Scholar 

  22. Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M, Webster B. Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil. 2005;15(4):507–24.

    Article  PubMed  Google Scholar 

  23. Costa-Black KM. Core components of return-to-work interventions. In: Loisel P, Anema H, editors. Handbook of work disability: prevention and management. New York: Springer; 2013.

    Google Scholar 

  24. MacEachen E, Kosny A, Ferrier S, Chambers L. The, “toxic dose” of system problems: why some injured workers don’t return to work as expected. J Occup Rehabil. 2010;20(3):349–66.

    Article  PubMed  Google Scholar 

  25. Ståhl C, Svensson T, Petersson G, Ekberg K. The work ability divide: holistic and reductionistic approaches in Swedish interdisciplinary rehabilitation teams. J Occup Rehabil. 2009;19(3):264–73.

    Article  PubMed  Google Scholar 

  26. Seing I, Ståhl C, Nordenfelt L, Bülow P, Ekberg K. Policy and practice of work ability. A negotiation of responsibility in organizing return to work. J Occup Rehabil. 2012;22(4):553–64.

    Article  PubMed  Google Scholar 

  27. Young AE, Roessler RT, Wasiak R, McPherson KM, van Poppel MN, Anema JR. A developmental conceptualization of return to work. J Occup Rehabil. 2005;15(4):557–68.

    Article  PubMed  Google Scholar 

  28. De Vries G, Koeter MWJ, Nabitz U, Hees HL, Schene AH. Return to work after sick leave due to depression; A conceptual analysis based on perspectives of patients, supervisors and occupational physicians. J Affect Disord. 2012;136(3):1017–26.

    Article  PubMed  Google Scholar 

  29. Haafkens JA, Kopnina H, Meerman MGM, Van Dijk FJH. Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers. BMC Health Serv Res. 2011;11(104):1–11.

    Google Scholar 

  30. Holmgren K, Ivanoff SD. Supervisors’ views on employer responsibility in the return to work process. A focus group study. J Occup Rehabil. 2007;17(1):93–106.

    Article  PubMed  Google Scholar 

  31. Lemieux P, Durand M, Hong QN. Supervisors’ perception of the factors influencing the return to work of workers with common mental disorders. J Occup Rehabil. 2011;21(3):293–303.

    Article  PubMed  Google Scholar 

  32. Nieuwenhuijsen K, Verbeek JHAM, De Boer AGEM, Blonk RWB, Van Dijk FJH. Supervisory behavior as a predictor of return to work in employees absent from work due to mental health problems. Occup Environ Med. 2004;61(10):817–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Tjulin Å, MacEachen E, Ekberg K. Exploring workplace actors experiences of the social organization of return-to-work. J Occup Rehabil. 2009;20(3):311–21.

    Article  Google Scholar 

  34. Wynne-Jones G, Buck R, Porteous C, Cooper L, Button LA, Main CJ. What happens to work if you’re unwell? Beliefs and attitudes of managers and employees with musculoskeletal pain in a public sector setting. J Occup Rehabil. 2011;21(1):31–42.

    Article  PubMed  Google Scholar 

  35. Tjulin Å, MacEachen E, Stiwne EE, Ekberg K. The social interaction of return to work explored from co-workers experiences. Disabil Rehabil. 2011;33(21–22):1979–89.

    Article  PubMed  Google Scholar 

  36. Dunstan D, MacEachen E. Bearing the brunt: co-workers’ experiences of work reintegration processes. J Occup Rehabil. 2013;23(1):44–54.

    Article  PubMed  Google Scholar 

  37. Bengtsson M, Berglund T. Labour market policies in transition: from social engineering to standby-ability. In: Larsson B, Letell M, Thörn H, editors. Transformation of the swedish welfare state from social engineering to governance. Basingstoke: Palgrave; 2012.

    Google Scholar 

  38. Björnberg U. Social policy reforms in Sweden: new perspectives on rights and obligations. In: Larsson B, Letell M, Thörn H, editors. Transformation of the swedish welfare state from social engineering to governance?. Basingstoke: Palgrave; 2012.

    Google Scholar 

  39. Hetzler A. Labor market activation policies for the long term ill—a sick idea? Eur J Soc Secur. 2010;11(4):369–403.

    Google Scholar 

  40. Socialförsäkringsutredningen P. Sveriges socialförsäkringar i jämförande perspektiv En institutionell analys av sjuk-, arbetsskade- och arbetslöshetsförsäkringarna i 18 OECD-länder 1930 till 2010 [Sweden’s social insurances in a comparative perspective: An institutionaö analyzis of the sickness-workplace injury- and unemployment insurance in 18 OECD-contries 1930 until 2010]. Stockholm: Statens offentliga utredningar 2010.

  41. Proposition. En reformerad sjukskrivningsprocess för ökad återgång i arbete [A reformed sick-leave process for increased return to work] 2007/08:136.

  42. SOU. Mera försäkring och mera arbete [More insurance and more work]. Stockholm: Ministry of Health and Social Affairs 2006:86.

  43. Lippel K, Lötters F. Public insurance systems: a comparison of cause–based and disability‐based income support systems. In: Loisel P, Anema H, editors. Handbook of work disability: prevention and management. New York: Springer; 2013.

    Google Scholar 

  44. Ståhl C, Müssener U, Svensson T. Implementation of standardized time limits in sickness insurance and return-to-work: experiences of four actors. Disabil Rehabil. 2012;34(16):1404–11.

    Article  PubMed  Google Scholar 

  45. Iseskog T. Arbetsgivarens rehabiliteringsansvar [the employer’s rehabilitation responsibility]. Mölnlycke: Norsteds Juridik AB; 2009.

    Google Scholar 

  46. Waddell G, Burton AK. Is work good for your health and wellbeing? The Stationery Office; 2006.

  47. Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):209–30.

    Article  Google Scholar 

  48. Patton MQ. Qualitative research and evaluation methods. 3rd ed. London: Sage; 2002.

    Google Scholar 

  49. Burchell B, Ladipo D, Wilkingson F, editors. Job insecurity and work intensification. London: Routledge; 2002.

    Google Scholar 

  50. Hellgren J, Sverke M, Näswall K. Changing work roles: new demands and challenges. In: Näswall K, Hellgren J, Sverke M, editors. The individual in the changing working life. Cambridge: Cambridge University Press; 2008.

    Google Scholar 

  51. Hood C. A public management for all seasons? Public Administr. 1991;69(1):3–19.

    Article  Google Scholar 

  52. Hughes OE. Public management and administration: an introduction. New York: Palgrave; 2003.

    Google Scholar 

  53. Pollitt C, Bouckaert G. Public management reform. 2nd ed. New York: Oxford University Press; 2004.

    Google Scholar 

  54. Sandberg Å, editor. Nordic lights. Work, management and welfare in Scandinavia. Falun: SNS Förlag; 2013.

    Google Scholar 

  55. Bohle P, Quinlan M, Mayhew C. The health and safety effects of job insecurity: an evaluation of the evidence. Econ Labour Relat Rev. 2001;12(1):32–60.

    Article  Google Scholar 

  56. Vahtera JKM, Pentti J, Theorell T, Effect of change in the psychosocial work environment on sickness absence: a seven year follow up of initially healthy employees; 2000.

  57. Vahtera JKMPJ. Effect of organisational downsizing on health of employees. Lancet. 1997;350(9085):1124–8.

    Article  CAS  PubMed  Google Scholar 

  58. Semmer NK, Tschan F, Meier LL, Facchin S, Jacobshagen N. Illegitimate tasks and counterproductive work behavior. Appl Psychol. 2010;59(1):70–96.

    Article  Google Scholar 

  59. Eakin JM. Leaving it up to the workers: sociological perspectives on the management of health and safety in small workplaces. Int J Health Serv. 1992;22(4):689–704.

    Article  CAS  PubMed  Google Scholar 

  60. Eakin J, MacEachen E, Clarke J. ‘Playing it smart’ with return to work: small workplace experience under Ontario’s policy of self-reliance and early return. Policy Pract Health Saf. 2003;1(2):19–42.

    Google Scholar 

  61. Garsten C, Jacobsson K. Sorting people in and out: the plasticity of the categories of employability, work capacity and disability as technologies of government. Ephemera. 2013;13(4):825–50.

    Google Scholar 

  62. Jacobsson K, Seing I. En möjliggörande arbetsmarknadspolitik? Arbetsförmedlingens utredning och klassificering av klienters arbetsförmåga, anställbarhet och funktionshinder [An enabling labour market policy? The public employment service’s assessment and classification of clients’ work ability, employability and disability]. Arbetsmarknad och Arbetsliv [Labour market and Working life]. 2013;19(1):9–24.

    Google Scholar 

  63. Arbetsförmedlingen. Statistikenheten [The statistical unit]; 2011.

  64. Holmqvist M. Medicalization of unemployment: individualizing social issues as personal problems in the Swedish welfare state. Work Employ Soc. 2009;23(3):405–21.

    Article  Google Scholar 

  65. Peralta Prieto J. Den sjuka arbetslösheten [The sick unemployment]. Uppsala: Uppsala University; 2006.

    Google Scholar 

  66. Anderson N, Schalk R. The psychological contract in retrospect and prospect. J Organiz Behav. 1998;19:637–47.

    Article  Google Scholar 

  67. Conway N, Briner RB. Understanding psychological contracts at work: a critical evaluation of theory and research. New York: Oxford University Press; 2005.

    Book  Google Scholar 

  68. Miller P, Rose N. Governing the present. Cambridge: Polity; 2008.

    Google Scholar 

  69. Rose N. Powers of freedom. Cambridge: Cambridge University Press; 1999.

    Book  Google Scholar 

  70. Garsten C, Lindvert J, Thedvall R, editors. Arbetets marknad: Arbetsmarknandens nya organisering [The labour’s market: The labour market’s new organization]. Liber: Malmö; 2011.

    Google Scholar 

  71. SSIA. Sjukskrivningar i olika yrken under 2000-talet: Antal ersatta sjukskrivningsdagar per anställd år 2002–2010 [Sick-listed in different occupations during 2000s: Amount of compensated sickness days per employee in year 2002–2010]. Stockholm: Swedish Social Insurance Agency 2012 Contract No.: ISSN 1654-8574.

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Acknowledgments

This work was supported by The Swedish Research Council for Health, Working Life and Welfare. The Canadian Institutes of Health Research (CIHR) grant FRN: 53909, Work Disability Prevention Strategic Training Program.

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Seing, I., MacEachen, E., Ståhl, C. et al. Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships. J Occup Rehabil 25, 74–85 (2015). https://doi.org/10.1007/s10926-014-9526-5

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