Period Of Sickness Absence Research Articles

Experiences of workers with long-term disabilities on employer support throughout the RTW process in The Netherlands: a qualitative study

Purpose The aim of this qualitative study was to explore ways that employer support influenced successful return to work (RTW) in workers with disabilities. Methods We conducted a semi-structured interview study among 27 workers with disabilities in the Netherlands who received a partial disability benefit two years after sick leave and who continued working in paid (part-time) employment after a period of long-term sickness absence (> 2 years). We analyzed data by means of thematic analysis. Results We identified four types of employer support that were experienced as factors of successful RTW: 1. Supervisor accessibility; 2. Supervisor engagement; 3. Supervisor strategies; and 4. Supervisor-initiated work accommodations. More specifically, during the preparations for RTW phase, the supervisor’s active role involved having a positive and open attitude toward facilitating RTW; during the initial RTW phase, the supervisor’s role involved being creative in finding solutions for work accommodations; and during the sustained RTW phase, the supervisor’s role included helping workers who still needed changes in their work situations. Conclusion The elements of successful employer support reveals that the pressure on the shoulders of the supervisor is high. Future research should further investigate whether supervisors need more phase-specific training from their organization.

Implementing Indicators and Trajectories of Return to Work After Breast Cancer Diagnosis: A Mixed-Methods Study Using the French National Healthcare Insurance Database and Stakeholder Consultation

PurposeReturn to work (RTW) is important for quality of life after breast cancer but its analysis at the population-level remains limited in France. This study aimed to implement Electronic Healthcare Data (EHD)-based indicators and trajectories to measure RTW after breast cancer diagnosis, and to examine stakeholders’ perspectives regarding these indicators. MethodsWe followed a mixed-methods approach that consisted of (i) implementing RTW indicators and identifying clusters of trajectories using state sequence analysis with data from a representative sample of the French National Health Data System and (ii) exploring, through qualitative focus group and interviews, stakeholders’ perceptions on the interpretation, limitations, and utility of these indicators. ResultsWe extracted data from 317 women aged 25-55 years with a first diagnosis of early-stage breast cancer. The median number of sickness absence periods was 2 for a total of 434 days during the 3-year follow-up, and the median time to sustainable RTW was 240 days. Three clusters of RTW trajectories were identified: “early RTW” (49.5% of the population), “RTW after partial resumption” (37.5%) and “continuous compensation” (12.9%). Feedback from stakeholders highlighted the multi-factorial nature of RTW and underscored the added value of EHD for studying RTW, despite certain limitations. ConclusionsWe demonstrated the feasibility of calculating RTW indicators and identifying trajectories using the French National Health Data System. These indicators can serve as outcome measures in RTW promotion and provide a basis for designing targeted interventions for breast cancer survivors.

Returning to Work After Sickness Absence Due to Low Back Pain: A Poetic Representation

The purpose of this project was to capture the voices of clients through a poetic representation of their experiences and perceptions as they shared their stories of returning to work after a period of sickness absence following an episode of LBP. A retrospective evaluation of electronic chart notes of clients at an occupational health clinic in London, United Kingdom presenting with LBP who were returning to work were reviewed over a six-month period from January 2023 to June 2023. Verbatim comments of clients about their experiences and perceptions were extracted from the electronic chart notes and analysed thematically. A total of 68 electronic chart notes were retrieved and reviewed by a senior physical therapist. A poem called “The struggle within” was developed to represent the experiences and perceptions of clients as they shared their stories. Healthcare professionals should engage not only in evidence-based interventions, but also with the narratives and stories of individuals to ensure a more holistic approach. A poetic representation is one way that healthcare professionals can frame these dialogues.

Constructing therapeutic support and negotiating competing agendas: A discourse analysis of vocational advice provided to individuals who are absent from work due to ill-health.

Work participation is known to benefit people's overall health and wellbeing, but accessing vocational support during periods of sickness absence to facilitate return-to-work can be challenging for many people. In this study, we explored how vocational advice was delivered by trained vocational support workers (VSWs) to people who had been signed-off from work by their General Practitioner (GP), as part of a feasibility study testing a vocational advice intervention. We investigated the discursive and interactional strategies employed by VSWs and people absent from work, to pursue their joint and respective goals. Theme-oriented discourse analysis was carried out on eight VSW consultations. These consultations were shown to be complex interactions, during which VSWs utilised a range of strategies to provide therapeutic support in discussions about work. These included; signalling empathy with the person's perspective; positively evaluating their personal qualities and prior actions; reflecting individuals' views back to them to show they had been heard and understood; fostering a collaborative approach to action-planning; and attempting to reassure individuals about their return-to-work concerns. Some individuals were reluctant to engage in return-to-work planning, resulting in back-and-forth interactional negotiations between theirs and the VSW's individual goals and agendas. This led to VSWs putting in considerable interactional 'work' to subtly shift the discussion towards return-to-work planning. The discursive strategies we have identified have implications for training health professionals to facilitate work-orientated conversations with their patients, and will also inform training provided to VSWs ahead of a randomised controlled trial.

Burden of idiopathic inflammatory rheumatic diseases in occupational healthcare: increased absenteeism and healthcare resource utilization.

Patients with idiopathic inflammatory rheumatic diseases (IIRD) often have decreased working capacity resulting in indirect costs. However, data on patients' short-term sick leave has been limited. This retrospective cohort study evaluated the number and length of sick leave, including short-term leave, and occupational healthcare resource utilization (HCRU) of the working-aged patients with IIRD compared to controls. The data on sick leave and occupational HCRU were gathered from the electronic medical records of the largest occupational healthcare provider in Finland from January 2012 to December 2019. Employed patients with an IIRD (including rheumatoid arthritis, spondyloarthritis, psoriatic and enteropathic arthritis, juvenile arthritis, and reactive arthritis) with at least a 12-months follow-up were identified and compared to age-, sex-, and follow-up matched controls without IIRD. Altogether 5405 patients with IIRD were identified and compared with an equal number of controls. The patients incurred approximately 2.5 times more sick leave than controls: 21.7 versus 8.5 days per patient year, respectively. Short-term sick leave was common: 83% of sickness absence periods of the patients lasted 1-9 days and represented 30% of the total absenteeism. Loss of productivity due to lost workdays was on average €4572 (95% confidence interval €4352-4804) per patient year. Occupational HCRU was approximately 1.8 times higher among IIRD patients than controls. Workers with an IIRD incur considerably more sick leave and use more occupational healthcare services than controls. Short sick leave not registered in national insurance registers constitute a significant portion of days off work among patients with IIRD.

Effect, economic and process evaluation of a mental health return to work intervention: study design

Abstract Background In Germany, the sickness absence duration for mental disorders lasts on average more than twice as long as for all other diseases. Interventions that link medical-therapeutic approaches with organisation-directed methods to improve a sustainable return to work (RTW) have hardly been evaluated. The aim is to present the study design, which evaluates the (cost-)effectiveness and feasibility of an 18-month intensified RTW aftercare delivered by German psychiatric outpatient clinics to employees with mental disorders. Methods A two-arm multicentre randomised controlled study is carried out. Sick-listed employees with mental disorders are recruited within psychiatric hospitals (n = 506). Besides care as usual, the intervention group receives a multimodal treatment consisting of individual RTW-support, RTW-aftercare groups, and web-based aftercare. At five time points over a 24-month observation period, quantitative effectiveness and health economic evaluation data from a societal perspective will be obtained. Intervention fidelity, reach, context, satisfaction and dose delivered will be examined in a multi-method process evaluation. A qualitative evaluation using pre-and post-interviews from a sub-sample (n = 30) will complement the effectiveness and process evaluation findings. Results Recruitment is currently ongoing. The intervention is expected to improve the employeés achievement of a sustainable RTW, defined as the 12-month remain and participation at work without having sickness absence periods of > 6 weeks (after RTW). It is hypothesized that the intervention is preferable in terms of costs compared to care as usual. The interviews allow for a better understanding of subjective experiences with the intervention. Discussion This study evaluates the (cost-)effectiveness and implementation process of an intensified RTW aftercare. If successfully implemented and evaluated, it might be adopted as standard care for employees with mental disorders in Germany. Key messages

What can I do for you? Line managers’ behaviors to support return to work for workers with common mental disorders

Purpose Sustainable return to work remains challenging for workers returning after long-term sick leave due to common mental disorders (CMDs): stress, anxiety and depression. Line managers play a significant role in supporting returned workers. Therefore, the purpose of this qualitative study was to examine the supportive behaviors of line managers in supporting returned workers.Design/methodology/approach The authors conducted a longitudinal study with up to three semi-structured interviews with 20 line managers with experience managing returned workers. In these interviews, the authors asked questions about the supportive behaviors line managers enacted to support workers and the role of the context. The authors conducted reflexive thematic analysis.Findings The analyses revealed five key strategies, including managing workload, flexible working time arrangements, location of work, mental health check-ups and long-term support. The interviewed line managers reported their own lived experiences and that being aware of the limitations of their role, together with training and support from senior management and human resources (HR), enabled them to provide appropriate support.Practical implications The five strategies and the barriers and facilitators to implementing these may enable HR to develop policies and procedures to support line managers, including training of line managers.Originality/value This is the first study in the UK on line managers’ behaviors to support workers who have returned to work after a period of long-term sickness absence due to CMDs. The identification of such behaviors is paramount to developing organizational policies and practices. The question, however, remains whether employees see these behaviors as effective.

Transition back to work after mild TBI: A qualitative study

Background While many persons who sustain a mild traumatic brain injury (MTBI) can resume work shortly after their injury, some experience persisting symptoms leading to longer-term sickness absence. In-depth knowledge about how these persons experience the return to work (RTW) process is needed. Aims To explore how persons with MTBI experience the process of returning to ordinary competitive work after a prolonged period of sickness absence. Material and methods Semi-structured interviews were conducted with six persons (four women) approximately 12 months after sustaining an MTBI. Data were analysed using a stepwise-deductive inductive method. Results When starting work the participants experienced a crisis. They described the importance of making the actual decision to RTW. Being present at the workplace was significant. In the process of increased workload, they expressed having challenges related to time perception and capacity restrictions. The importance of being seen and valued was emphasised. When reintegrated into the workplace revaluing work tasks and priorities shaped the RTW process as well as a further professional career. Conclusions and significance The process of RTW contained the experience of unpredictability and incompatibility with own identity and performance. Working had an impact on social participation, self-worth, daily structure, as well as reconstructing occupational biography.

Educational qualification differences and early labor market exit among men: the contribution of labor market marginalization measured across the working life

BackgroundThe present study aims to investigate the association between educational qualification and early labor market exit among men and to examine the contribution of labor market marginalization measured across the working life on this association.MethodA register-linked cohort study was conducted including men who completed military service in 1969/70 (born between 1949 and 1951) and were alive at age 55 and not disability pension beneficiaries (n = 40 761). Information on the highest level of educational qualification and the outcome of early exit (disability pension, sickness absence, unemployment, and early old-age pension) was obtained from Swedish nationwide registers between the ages of 55 and 64 years. Labor market marginalization was defined as periods of long-term unemployment and sickness absence over the working life and up to follow-up. Cox regression analyses were used to obtain hazard ratios (HR) with 95% confidence intervals (CI).ResultsLow-educated men were more likely to leave the labor force early due to disability pension or sickness absence (HR: 2.48), unemployment (HR: 2.09), and early old-age pension with- (HR:1.25) and without -income (HR: 1.58). Labor market marginalization across the working life explained a large part of the association for the more involuntary early exit routes (disability pensions, sickness absence, unemployment) and explained very little with regards to the more voluntary early exit routes (early old-age pension with and without income).ConclusionExposure to labor market marginalization across the working life was important in explaining educational differences in early labor market exit due to disability pension or sickness absence and unemployment. This study underscores the importance of identifying and implementing preventive measures in the workplace (e.g. adaptions) to prevent new spells of sickness absence and unemployment, especially among low educated individuals.

Sickness absence and return to work among employees with knee osteoarthritis with and without total knee arthroplasty: a prospective register linkage study among Finnish public sector employees.

Objective:This study aimed to examine duration of sickness absence due to knee osteoarthritis (OA) and sustained return to work (RTW) among municipal employees who had at least one compensated sickness absence period due to knee OA. The contribution of sociodemographic characteristics, diabetes and previous sickness absence were assessed. We differentiated between participants with and without total knee arthroplasty (TKA).Methods:Data from 123 506 employees in the Finnish Public Sector Study were linked with national health and mortality register information. There were 3 231 sickness absence periods (2372 participants) due to knee OA in 2005−2011. Kaplan-Meier curves for sustained RTW were obtained and median time with inter-quartile range (IQR) calculated for those with and without TKA. Cox regression analyses were carried out in multivariable analyses.Results:The median time to RTW from the beginning of sickness absence was 21–28 days when TKA was not related to sickness absence and 92–145 days when it was. Among participants with no TKA, age 60−64, non-sedentary work, diabetes, and previous sickness absences predicted longer time to RTW, while pain medication predicted a shorter time. Among participants with TKA, non-sedentary work and previous sickness absences predicted a longer time to RTW.Conclusions:The clinical relevance of the difference in time to RTW between employees with or without TKA was substantial. Employees with knee OA working in physically demanding jobs need work modifications after TKA, and this calls for a dialog between occupational health care professionals and workplaces.

Employment and earnings trajectories before and after sickness absence due to major depressive disorder: a nationwide case–control study

ObjectivesTo examine employment and earnings trajectories before and after the first sickness absence period due to major depressive disorder (MDD).MethodsAll individuals (n=158 813) in Finland who had a first sickness...

Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study.

Harassment and discrimination in the National Health Service (NHS) has steadily increased over the past 5 years with London being the worst performing region. There is a lack of data and research on the impact this is having on staff health and job satisfaction. Such data are necessary to inform the development of effective workplace interventions to mitigate the effects these experiences have on staff. Examine the impact of harassment and discrimination on NHS staff working in London trusts, utilising data from the 2019 TIDES cross-sectional survey. In total, 931 London-based healthcare practitioners participated in the TIDES survey. Regression analysis was used to examine associations between the sociodemographic characteristics of participants, exposure to discrimination and harassment, and how such exposures are associated with physical and mental health, job satisfaction and sickness absence. Women, Black ethnic minority staff, migrants, nurses and healthcare assistants were most at risk of discrimination and/or harassment. Experiencing either of the main exposures was associated with probable anxiety or depression. Experiencing harassment was also associated with moderate-to-severe somatic symptoms. Finally, both witnessing and experiencing the main exposures were associated with low job satisfaction and long periods of sickness absence. NHS staff, particularly those working in London trusts, are exposed to unprecedented levels of discrimination and harassment from their colleagues. Within the context of an already stretched and under-resourced NHS, in order to combat poor job satisfaction and high turnover rates, the value of all healthcare practitioners must be visibly and continuously reinforced by all management and senior leaders.

Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment

Abstract Background Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees. Methods The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support). Results In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02). Conclusions This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence. Key messages We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.

Suicide among ambulance service staff: a review of coroner and employment records.

Background:There is growing evidence to suggest that ambulance service staff may be at increased risk for suicide; however, few studies have explored risk factors within this occupational group.Aim:To investigate factors commonly associated with ambulance staff suicides.Method:Eleven ambulance service trusts across the United Kingdom were asked to return details of staff suicides occurring between January 2014 and December 2015. Coroners were then contacted to request permission to review the records of the deceased.Results:Fifteen suicides were identified (73% male, mean age 42 years). Inquest data were available on 12 deaths. The most common method used was hanging. Possible risk factors identified included recent return to work following a period of sickness absence, poor mental health, relationship and debt problems, history of self-harm and the loss of a driving licence/change in job role.Conclusion:Identifying characteristics of suicide among this high-risk group is important to inform the development of suicide prevention initiatives. Additional research is needed with an adequate control group to further explore the risk factors identified in this study.

Do gender and psychosocial job stressors modify the relationship between disability and sickness absence: An investigation using 12 waves of a longitudinal cohort.

Objectives A considerable proportion of the working population reports a disability. These workers may be at risk of adverse outcomes, including longer periods of sickness absence. This study examined the causal effect of disability on sickness absence and the role of psychosocial job stressors and gender as effect modifiers. Methods Data on paid and unpaid sick leave, disability (yes/no) and psychosocial job stressors were available from 2005 to 2017 from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Negative binomial models were used to model the rate of sickness absence in a year. Results In the random effects model, workers with disability had 1.20 greater rate of sickness absence in a year [95% confidence interval (CI) 1.17-1.23, P<0.001] after adjustment for confounders. The rate was slightly lower in the fixed effects model. There was evidence of multiplicative interaction of the effect by gender and job control. The effect of disability on sickness absence was greater among men than women, and higher for people with low job control compared to those with high job control. Conclusions There is a need for more research about the factors that can reduce sickness leave among workers with disabilities.

Workplace Interventions can Reduce Sickness Absence for Persons With Work-Related Neck and Upper Extremity Disorders: A One-Year Prospective Cohort Study.

The objective of this study was to investigate whether workplace interventions are effective in reducing sickness absence in persons with work-related neck and upper extremity disorders and whether disorder improvement after intervention reduces sickness absence. This study was a prospective cohort study of workers with work-related neck pain or upper extremity disorders. Data were obtained from the Swedish "Work-related disorders" and "Work environment" surveys. Register data on sickness-absence 1 year after the surveys were made and obtained from the Swedish health insurance database. A significant lower number of sickness-absence days were found for workers reporting improvement after intervention. The findings in this study suggest that workplace intervention can reduce sickness absence for workers with neck or upper extremity disorders only if the intervention improves the disorder. The interventions were most effective in reducing medium long sickness absence periods.

Self-certification versus physician certification of sick leave for reducing sickness absence and associated costs.

Self-certification versus physician certification of sick leave for reducing sickness absence and associated costs.

Perceived stress and sickness absence: a prospective study of 17,795 employees in Denmark

ObjectivesThe aims were to examine (1) the prospective association between perceived stress and sickness absence, and if this association (2) differed by sex, and (3) was stronger when only long-term sickness absence (≥ 31 days) instead of all-length sickness absence (≥ 1 day) was included. Moreover, different cut-points for the length of the sickness absence periods were applied.MethodsWe followed respondents (10,634 women and 7161 men) from the ‘Work Environment and Health in Denmark’ 2014-survey for up to 18 months in the ‘Register of Work Absences’ from Statistics Denmark. Perceived stress was measured by a single question: “In the last 2 weeks, how often have you felt stressed?” We used Cox-regression with repeated events, adjusted for age, sector, education, and previous sickness absence.ResultsThe hazard ratio (HR) for all-length sickness absence (≥ 1 day) for “Often/Always” stress compared to “Seldom/Never” stress was statistically significant among both men (HR = 1.25 [1.13–1.38]) and women (HR = 1.43 [1.34–1.51]). The HR was statistically significant for women (HR = 2.26 [1.89–2.70]), but not for men (HR = 1.22 [0.86–1.73]), when the analyses were restricted to long-term sickness absence (≥ 31 days). The sex-difference was statistically significant. Additional analyses with cut-points at ≥ 2, ≥ 4, ≥ 6, ≥ 8, ≥ 11, ≥ 15, ≥ 20, and ≥ 25 sickness absence days showed that among women, the HR increased gradually with increasing lengths of the sickness absence periods.ConclusionsThe prospective association of perceived stress with risk of sickness absence was stronger among women than men. Among women, perceived stress was more strongly associated with long-term sickness absence than with all-length sickness absence.

Alcohol use and sickness absence due to all causes and mental- or musculoskeletal disorders: a nationally representative study

BackgroundPrevious studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders.MethodsThe data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30–55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 − 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work.ResultsDuring an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 − 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 − 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 − 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 − 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders.ConclusionsThese results highlight the need to distinguish between former drinking and lifelong abstinence, as only former drinking was associated with sickness absence. Alcohol use disorder and high-volume drinking were strongly predictive of sickness absence due to mental disorders. Identifying people with excessive alcohol use e.g. in occupational health care, and mapping and supporting their mental health may help in preventing sickness absences.

Periods of Unexplained Higher Deaths and Medical Admissions Coexist with Changes in Staff Sickness Absence

National Health Service (NHS) staff sickness absence in England shows unique on/off switching leading to successive and prolonged periods of higher and lower sickness absence. This on/off switching shows evidence for spatiotemporal spread and the expected stochastic-based variation in the magnitude of the ‘outbreak’ in different locations. Effects due to summer/winter and temperature can be excluded. A unique type of infectious event is proposed. Based on the range of conditions affected the sub-acute effects of the immune-modifying virus cytomegalovirus may be involved.