Abstract
Much of what has been written about decreased work ability is based on quantitative studies and has been written from the perspective of professionals, service providers or authorities. In our qualitative study, we sought to understand how affected individuals themselves perceive and experience the multifaceted factors that are related to their decreased work ability. Sixteen individuals in Finland with musculoskeletal diseases (MSD) participated in semi-structured interviews. The participants were potential clients of a multi-professional service pilot model, the TOIKE Work Ability Centre. Narrative and thematic analyses were utilised. The study found that individuals with decreased work ability have differing perspectives towards returning to work and often complex life situations. Five distinctive groups were identified based on self-assessed health, work ability and orientation towards work or pension: (1) the Successful; (2) the Persevering; (3) the Forward-looking; (4) the Stuck; and (5) the Pension-oriented. Health problems, unemployment, age discrimination, financial difficulties and skill deficits were the major challenges of the interviewees. Furthermore, they perceived the service and benefit systems as complicated. The TOIKE service proved useful to some of them. However, many had not utilised it due to a lack of understanding of its purpose. Identifying the distinctive groups and their needs may improve interventions. Ultimately, this may help to achieve Target 8.5 of the UN Sustainable Development Goals, which advocates the right to employment for all ages and for those with disabilities.
Highlights
The ageing of populations leads to increasing proportions of old-age pensioners and higher morbidity among workers [1,2,3]
Using data from 16 interviews to elicit data-driven narrative analysis, this study identified five distinctive groups among individuals with musculoskeletal disorders based on their self-assessed health and work ability, orientations towards work or pension and perceptions concerning the future
A closer look at the situations of those in the Pension-oriented group revealed that their situations were complex: They had multiple morbidities and contextual hindrances, such as outdated professional skills, a history of unstable work contracts, having gone bankrupt or living in a small town where job opportunities were scarce. Due to their advanced age, they were in the most disadvantaged situation in the current labour market, in which competition for job vacancies is harsh, and age discrimination exists [2]. They had given up hope of returning to work and instead clearly were inclined towards retirement
Summary
The ageing of populations leads to increasing proportions of old-age pensioners and higher morbidity among workers [1,2,3]. Many countries in the Global North are concerned about labour productivity and shortages, and worsening dependency ratios [3,4]. In this context, governments are interested in supporting sustainable working life [5] by preventing work disability [2,6,7] and increasing the retirement age [2]. It is of importance to this article that the target notes those with disabilities. Studies have found that health problems, long-term sickness absences, are strong predictors of filing for disability pensions [2,14,15]
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