Experiences of rehabilitation coordination among people on sick leave with mental health problems.

PURPOSE: Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination. MATERIALS AND METHOD: The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination. RESULTS: The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person. CONCLUSIONS: People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work.

It is important to make rehabilitation coordination visible within primary health care and actively inform people on sick leave with mental health problems that it is an option, as they often have difficulties finding information. It will increase their accessibility and enable autonomous decisions.A respectful interplay based on a person-centred care approach seems fundamental for rehabilitation coordination. The interplay with rehabilitation coordinators and with other stakeholders affects the sick leave process and all parties need to collaborate for a sustainable return to work.Three-party meetings with the person on sick leave, the rehabilitation coordinator and the employer, as well as teamwork, may provide better conditions for return to work as this can ensure that all stakeholders are working towards prioritised goals.Targeted interventions at the workplace seem to be important and rehabilitation coordination could be a valuable bridge between healthcare and work for creating sustainable conditions for return to work.

Does the Number of Reasons for Seeking Care and Self-Rated Health Predict Sick Leave during the Following 12 Months? A Prospective, Longitudinal Study in Swedish Primary Health Care.

BACKGROUND: Sick leave has major social and economic consequences for both individuals and society. Primary Health Care (PHC) meets people who seek care before they risk going on sick leave. This study examined the impact of self-perceived health on sick leave within 12 months for workers seeking care in PHC. METHODS: The study had a prospective longitudinal design with 271 employed, non-sick-listed patients aged 18-64 years seeking care for physical and/or mental symptoms at PHC. In a logistic regression, an estimation of the odds ratio (OR) for belonging to the group workers with >14 days of sick-leave (W-SL) was made. RESULTS: A high number of reasons when seeking care, with an OR of 1.33 (confidence interval 1.14 to 1.56), and lower self-rated health, with an OR of 1.45 (confidence interval 1.10 to 1.91), were determinants for sick leave at 12 months after adjusting for covariates and confounders. Mental symptoms constituted the main reason for seeking care, followed by musculoskeletal pain, and significant differences in proportions regarding most symptoms were shown between the groups with and without sick-leave >14 days. CONCLUSION: Health care professionals in PHC need to be aware of the risk of future sick leave at comorbidity and low self-perceived health. Preventive rehabilitation interventions should be offered to improve health and prevent sick leave for this group.

A short work-directed rehabilitation to promote work capacity while depressed and anxious: a qualitative study of workers' experiences.

PURPOSE: Most people with common mental disorders are working despite symptoms. This study explores individuals' experiences of a work-directed rehabilitation, provided by occupational therapists and physiotherapists, aiming to promote work capacity in persons with common mental disorders. METHODS: A qualitative content analysis was used, and 11 women and 8 men with depression or anxiety disorder were interviewed. They were 25-66 years old, had different occupations and were working full or part-time. RESULTS: The participants experienced a process interpreted as Increasing belief in one's capacity through supported reflection and practice. This theme reflects the shifting between "reflecting" and "doing" through rehabilitation and the growing hope for change. The increasing belief in one's capacity was developed through three stages, comprised of the categories To be supported by a professional, To realise things about oneself and To try new strategies for change. CONCLUSIONS: Strategies suggested by occupational therapists and physiotherapists have the potential to promote work capacity in people who are working while depressed and anxious. The results may deepen the understanding among rehabilitation professionals about the importance of a person-centred approach to people with common mental disorders, and to combine reflection and practical exercises to support the development of work-related strategies.Implications for rehabilitationWork-directed rehabilitation provided by occupational therapists and/or physiotherapists is beneficial to people with common mental disorders.Rehabilitation professionals should focus on facilitating self-efficacy among people with common mental disorders.An individualised person-centred approach seems important in order to initiate change.

The experience of return to work self-efficacy among people on sick leave.

BACKGROUND: In the complex interaction between individual and environmental factors the return to work self- efficacy (RTWSE) plays a key role. RTWSE is the belief in the capacity to meet the demands required for RTW. OBJECTIVE: The purpose of this study was to explore how individuals on sick leave experience their RTWSE. METHOD: A modified phenomenology method was used. This perspective is useful in qualitative research to understand complex phenomena such as RTWSE. It was designed as an interview study and nine individuals participated in the age from 30 to 60 years. RESULTS: Four main themes with a total of ten sub-themes emerged from the analysis showing different aspects of RTWSE. The experience of working capacity in terms of health perception and the general sense of self-efficacy shaped the more specific RTWSE. The pursuit towards an active and fulfilling life and regaining control together with autonomy and the experience of support from others influenced the RTWSE. CONCLUSIONS: RTWSE is a global phenomenon reflecting the experience of vital parts of the life-world. RTWSE is about working capacity, but also concerns engagement in a meaningful occupation, being independent and participating. A holistic approach is therefore needed in order to strengthen self-efficacy.