Return To Work Research Articles (Page 1)

Return to work (RTW) is a goal of many patients with colorectal cancer (PwCRC) attending inpatient rehabilitation. In German rehabilitation clinics, physicians conduct the socio-medical assessment of work capacity (SMWC) with the aim of assessing the current ability to work. We tested how well it also predicts the actual RTW of PwCRC. This study combined a nationwide physician survey (n = 38) with longitudinal data from a cohort study of PwCRC (n = 172) aged 65 or younger who were employed prior to CRC diagnosis. Physicians were asked about their use of validated tools for the SMWC and their attitudes toward a standardized assessment checklist. PwCRC completed baseline and 9-month follow-up questionnaires about their employment status. SMWC results of the cohort study's participants were extracted from rehabilitation discharge reports. While 97% of PwCRC were predicted to be capable of working ≥ 6h/day, only 70% actually returned to work 9months after rehabilitation. The SMWC showed high sensitivity (98%) but low specificity (6%) for predicting RTW, with a positive predictive value (PPV) of about 70%. Most physicians (73%) at least partly saw the need for an evidence-based structured checklist for an improved SMWC, and almost all (95%) would use it if it did not take more than 10min to apply it. The SMWC for PwCRC in German rehabilitation clinics is not standardized and overestimates the return-to-work rate. There is a need for a standardized checklist, and most physicians would be willing to use it.

Osteopathic manipulative treatment (OMT) can be utilized as a primary or adjunctive treatment for headaches associated with musculoskeletal disorders. Although previous systematic reviews investigated the effectiveness of manual therapies for treating headaches, they did not focus specifically on OMT or perform a pooled meta-analysis to evaluate the effectiveness of outcomes. The aim of this study is to systematically evaluate the effectiveness of OMT for managing headaches associated with musculoskeletal dysfunction and to assess the associated harm outcomes. In September 2023, the following databases were searched for randomized controlled trials (RCTs) of adult patients with headaches associated with musculoskeletal dysfunction who were treated with OMT: Allied and Complementary Medicine Database, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica (EMBASE), Osteopathic Medicine Digital Library (OSTMED), Ovid Emcare, Ovid MEDLINE, Physiotherapy Evidence Database (PEDro), PsycINFO, and PubMed. The search terms included osteopathic manipulative medicine, manual therapy, osteopath, headache, concussion, and head injury. The studies had to compare OMT techniques (e.g., articulatory [ART]; high-velocity, low-amplitude [HVLA]; soft tissues [ST]) to another form of treatment or a different type of OMT technique. Our primary outcomes included headache severity, headache frequency, disability associated with headaches, quality of life, and return to work (RTW); harm outcomes included all-cause dropout (ACD) rates, dropouts due to inefficacy, and adverse effects. The Cochrane Risk of Bias (ROB) tool was utilized to assess the ROB in the reviewed studies, and the quality of evidence was assessed utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Outcomes data were pooled for analysis and reported as standardized mean difference (SMD) and 95 % confidence interval(CI). Our search identified 11,657 RCTs. After removing duplicates and screening titles and abstracts, 167 underwent full-text review, and 18 were included in our review. None of the reviewed RCTs metall of the Cochrane ROB criteria. Moderate-quality evidence indicated that combined ART-HVLA (SMD=-0.61, 95 % CI=-1.0 to-0.23) and ST HVLA-ART (SMD=-0.48, 95 % CI=-0.83 to-0.13) effectively reduced the severity of headache. Moderate-quality evidence also indicated that the combined techniques of ART-HVLA (SMD=-0.43, 95 % CI=-0.74 to-0.13) and ST-ART-HVLA (SMD=-0.62, 95 % CI=-0.89 to-0.35) effectively reduced the frequency of headaches. Moderate-quality evidence indicated that quality of life was improved with combined ART-HVLA (SMD=0.57, 95 % CI=0.14 to 0.99). Low-quality evidence indicated no significant associations of OMT with disability or harm outcomes (all p>0.26). Results of our systematic review and meta-analysis suggested that a combination of multiple types of OMT techniques effectively reduced the frequency and severity of headaches and improved quality of life. However, high-quality RCTs with large sample sizes utilizing a variety of technique modalities and combinations of technique modalities are necessary to better evaluate the effectiveness of OMT for managing headaches.

Background: The aim of this study was to separately assess return to work (RTW) and return to sports (RTS) rates and timelines following surgical and conservative treatment of tibial plateau fractures (TPF). A secondary objective was to identify factors associated with faster recovery. Methods: All patients with TPF treated at a single level I trauma center between 1 January 2008 and 31 December 2016 were retrospectively reviewed. Standardized questionnaires were used to evaluate pre- and postoperative work and sports activity. Subgroup and correlation analyses were performed to investigate the influence of demographic and treatment-related factors on RTW and RTS duration. Results: A total of 105 patients were included, of whom 85% (n = 89) received surgical treatment and 15% (n = 16) were treated conservatively. RTW was achieved by 100% of surgically treated and 93% of conservatively treated employed patients, with a mean duration of 11.3 ± 9.5 weeks and 6.5 ± 4.2 weeks, respectively. RTS was achieved by 85% of surgically treated and 86% of conservatively treated previously active patients, occurring after a mean of 22.1 ± 17.9 weeks and 12.2 ± 8.8 weeks, respectively. Male sex, lower fracture complexity, absence of external fixation, and shorter operative times were associated with faster recovery. A general shift toward low-impact and recreational sports and a reduction in sport types and weekly training sessions were observed. Conclusions: Independent of the treatment modality, high RTW and RTS rates are observed within six months following TPF. The identified factors may help guide patient counseling and improve individual rehabilitation planning.

This scoping review study aimed to provide a comprehensive overview of the literature on collaboration between sickness benefit offices and general practice in return to work (RTW) processes, to map existing research, and to identify facilitators and barriers to successful collaboration. This review adhered to established scoping review methodologies. A systematic search of peer-reviewed literature was conducted across six databases. Two researchers independently performed screening and data extraction. Facilitators and barriers were thematically analysed, and tentative findings were discussed with a reference group. The search yielded 8477 unique studies, of which 22 met the inclusion criteria. The findings revealed persistent challenges over the past two decades. Most studies used qualitative methods, and the majority were conducted in a Scandinavian context. Written communication was the predominant collaborative activity reported in the studies. Barriers were more frequently identified than facilitators. Commonly reported barriers to successful collaboration included stereotyping, differing priorities, and an over-reliance on written communication. Facilitators included face-to-face meetings and high-quality written communication. Although facilitators have not been extensively studied, our findings emphasize the interconnection between barriers and facilitators, indicating that facilitators can provide strategies to address these barriers. Furthermore, we observed a lack of consensus in the literature regarding key concepts, such as'collaboration'. Based on the findings, we recommend that future research focus on achieving conceptual clarity and examining the underlying conditions that influence the potential for collaboration between general practice and sickness benefits offices in RTW processes.

ABSTRACTBackgroundEmployment is a critical determinant of quality of life, social reintegration, and financial stability for breast cancer survivors. International studies have shown that return‐to‐work (RTW) rates vary widely, ranging from 27% to over 80% within the first 3 years postdiagnosis, and are strongly influenced by sociodemographic and systemic factors. In Brazil, however, there is a scarcity of data on employment outcomes after breast cancer, despite pronounced disparities in healthcare access between public and private systems. Understanding these dynamics is crucial to identify vulnerable groups and to inform strategies that promote equitable reintegration into the workforce.MethodsWe conducted a multicenter cross‐sectional study including 454 women with nonmetastatic ER+ breast cancer who were employed at diagnosis and receiving endocrine therapy. Employment status, sociodemographic and clinical variables, and quality‐of‐life scores were collected through patient‐reported questionnaires and medical records. Univariate and multivariate generalized logit models were applied.ResultsAmong 774 participants, 454 (67.1%) were employed at diagnosis. Of these, 87 (19.2%) continued working during treatment, 233 (51.54%) stopped and returned, and 134 (29.29%) stopped and did not return. Compared with privately treated patients who remained employed, those treated in public hospitals had significantly higher odds of stopping work and returning (OR = 5.93) and of stopping work and not returning (OR = 2.39). Younger age (≤ 60 years) was associated with permanent work interruption (OR = 2.39). Lower education was associated with temporary interruption (OR = 3.12). Treatment duration ≥ 2 years was associated with not returning to work (OR = 2.18).ConclusionsTreatment in public hospitals, lower education, younger age, and prolonged treatment were associated with a higher risk of job loss. Addressing barriers and fostering workplace adaptations is vital for improving return‐to‐work rates among cancer survivors, as nearly one‐third do not return to work within 2 years postdiagnosis.

Work-related determinants of return to work (RTW) after breast cancer (BC) have been poorly studied. We analysed data from 2095 patients with primary BC enrolled in the French multi-center prospective cohort CANTO between 2012 and 2018. We investigated the association between administrative, physical and psychosocial working conditions and RTW two years after diagnosis using Poisson regression with robust variance. All models were adjusted for age, education, having a partner or children, and clinical variables at diagnosis. Analyses stratified by education (up to/higher than high school) and by chemotherapy were conducted. Multiple imputations were performed. Having no weekly rest period of 48 consecutive hours (RR = 1.36 95% CI:1.09-1.81), strenuous work postures (RR = 1.48 95% CI:1.19-1.87) and shift work (RR = 1.40 95% CI:1.11-1.75) as well as low independence of decision making (RR = 1.33 95% CI:1.04-1.81) were associated with increased non-RTW. Not perceiving her own job as boring (RR = 0.61 95% CI:0.39-0.86) was associated with decreased non-RTW. Administrative working conditions did not impact RTW. Working conditions emerged as potential levers to help women RTW. Our results underline the need for more targeted rehabilitation programs and personalized interventions to effectively help women in their RTW journey after BC.

Background/Objectives: Ultrasound-guided carpal tunnel release (UGCTR) has emerged as a minimally invasive alternative to open surgery for the treatment of carpal tunnel syndrome (CTS). This study aimed to evaluate the clinical outcomes, complication rates, and recovery profiles associated with UGCTR in a large multicenter cohort. Methods: A retrospective observational study was conducted across Italian hand surgery centers, including 735 patients who underwent UGCTR between January 2012 and April 2025. Data were collected on demographics, comorbidities, ultrasound measurements, and surgical outcomes. Primary endpoints included pain (measured using the Visual Analog Scale [VAS]), symptom severity and function (assessed via the Boston Carpal Tunnel Questionnaire [BCTQ]), complication rates, time to return to daily activities (RDA), and return to work (RTW). Follow-up assessments were performed at 1, 4, and 12 weeks postoperatively. Results: A significant improvement in pain was observed, with mean VAS scores decreasing from 6.37 preoperatively to 0.58 at 12 weeks. The mean cross-sectional area (CSA) of the median nerve decreased from 12.81 mm2 to 8.83 mm2 at 4 weeks. Both the BCTQ Symptom Severity Scale (BCTQ-SS) and Functional Status Scale (BCTQ-FS) scores showed significant improvement by week 1. The mean RDA was 5.7 days, and RTW was 14.5 days. Complication rates were low and decreasing over time, from 8.7% at 1 week to 3.4% at 12 weeks. Conclusions: UGCTR is a safe and effective technique for the treatment of CTS, offering rapid functional recovery and a favorable complication profile. Its feasibility in outpatient settings and potential for cost-effectiveness support its role as a viable alternative to open surgery and as a model of image-guided, minimally invasive intervention.

Degenerative cervical myelopathy (DCM) is a progressive disorder that leads to significant neurological deficits, often requiring surgical decompression to prevent further decline. There are only a handful of studies analyzing return-to-work (RTW) outcomes after cervical spine surgery for DCM. This study seeks to elucidate RTW outcomes and to identify predictors preventing RTW in patients surgically treated for DCM in a nationwide prospective registry. A nationwide cohort analysis was conducted using prospectively gathered data from patients surgically treated for DCM, from the Swedish Spine Registry. Patients with documented postoperative outcomes focusing on RTW rates from 1 to 5 years were included. To identify predictive factors affecting RTW at 1 year postoperatively, separate univariable and multivariable logistic regression models were developed, incorporating demographic, functional and clinical, as well as preoperative and postoperative data and occupational characteristics. A total of 789 patients were included with an average age of 52 years, with most patients working in moderate intensity jobs and nearly half were on sick leave before surgery. Most surgeries were elective, using an anterior approach. The RTW rate at 1 year was 76%, separating into 54% who had resumed full-time employment and 23% who had returned to a part-time capacity. In this cohort, 24% had not returned to work at the 1-year mark. Older age, physically demanding work, higher preoperative Neck Disability Index Score, reduced walking distance, and sickness benefits were significant predictors of a lack of RTW. 75% of the patients surgically treated for DCM returned to work within 1 year. Higher age, physically demanding work, higher Neck Disability Index Score, and full-time sickness benefits were all associated with a decreased likelihood of RTW. Recognizing these risk factors can help identify patients who may benefit from additional physical therapy, behavioral interventions, counseling, or work-place adjustments to support RTW.

BackgroundThe MiLES intervention is a digital employer-based tool aimed at enhancing return to work (RTW) of employees with cancer through interactive videos, conversation checklists and tips and information. In a previous study, the MiLES intervention proved to be a useful intervention that aligns with employers’ daily practice. The hypothesis is that the MiLES intervention will enhance the employers’ willingness, ability and self-efficacy in providing RTW support, which in turn will enhance the RTW of employees with cancer. This paper describes the design of a randomized controlled trial (RCT), aimed at evaluating the effectiveness, cost-effectiveness and return on investment of the MiLES intervention. Parallel to the RCT, a process evaluation of the delivery of the MiLES intervention in a real-world setting will be conducted.MethodsAn RCT with a 12-month follow-up period will be conducted involving 140 employer-employee dyads. The employees are diagnosed with cancer (< 2 years earlier), aged 18–67 years, in paid employment with an employer, and currently fully or partly sick-listed (< 2 years). The employer provides RTW support to the included employee. All dyads will either be allocated to the intervention group, of which the employer will get access to the MiLES intervention, or to the control group in which care as usual will be provided. The primary outcome will be successful RTW (encompassing the employee’s perspectives on RTW) at the level of the employee; secondary outcomes will include the following: time to RTW, quality of life and quality of working life, received work-related support, and satisfaction with work-related support. At the level of the employer, the secondary outcomes will include the following: self-efficacy in providing RTW support and satisfaction with the RTW process. All outcomes will be assessed using questionnaires at baseline and at 3, 6 and 12 months of follow-up. Both the cost-effectiveness and the return on investment analysis will be conducted from the employers perspective. For the process evaluation, the UK MRC framework will be used.DiscussionThis RCT will study the effectiveness, cost-effectiveness and return on investment of the MiLES intervention. This knowledge is needed to formulate recommendations regarding the implementation of the MiLES intervention beyond the research setting.Trial registrationClinicalTrials.gov, NCT06672887. Registered on October 25, 2024.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09092-2.

IntroductionLong COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals’ labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary.ObjectivesTo synthesize evidence on RTW interventions for people living with Long COVID and to identify ‘promising’ interventions for enhancing work ability and RTW.MethodsWe followed Arksey & O’Malley’s methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW).ResultsTwelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy.ConclusionMany uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.

Abstract Background Very early exercise (VEE) after stroke has shown short-term benefits on clinical recovery and inflammation; however, its long-term effects on real-world outcomes remain underexplored. This study evaluated whether initiating rehabilitation within 24 h of ischaemic stroke provides sustained benefits in return to work (RTW), work ability (WA), community participation (CP), and health-related quality of life (HRQoL), compared with delayed exercise (DE) at one year post-stroke. Methods In the original randomised controlled trial (Pan African Clinical Trial Registry: PACTR202406755848901), 48 patients with first-ever mild-to-moderate ischaemic stroke were randomised (1:1) to VEE (within 24 h of onset) or DE (after one week), followed by an identical 3-month, 90-min, progressive supervised exercise program. In this one-year observational follow-up, 41 participants (21 VEE; 20 DE) were reassessed on RTW status (full-time or part-time), Work Ability Index (WAI), social participation domain of the Stroke Impact Scale (SIS), and overall SIS scores. Results At one year, a higher proportion of participants in VEE successfully returned to work, though the difference was not statistically significant (61.9% vs. 40.0%; p = 0.161). VEE participants resumed work significantly earlier (4.96 ± 0.99 vs. 6.50 ± 1.19 months; p = 0.005) and demonstrated significantly higher WAI scores (6.24 ± 2.43 vs. 4.35 ± 2.72; p = 0.024). They also reported greater CP and HRQoL, with significantly higher scores in the SIS social participation domain (62.7 ± 19.8 vs. 48.6 ± 16.5; p = 0.018) and overall SIS scores (65.9 ± 16.9 vs. 55.3 ± 14.5; p = 0.038). Conclusion These findings suggest that VEE may confer meaningful long-term advantages in occupational reintegration, participation, and quality of life. Integrating VEE into stroke rehabilitation protocols could enhance functional recovery and societal reintegration.

Many patients with cardiovascular disease show no obvious physical disability after hospital discharge, making it difficult to recognize functional decline and adapt appropriate accommodations. Therefore, this study examined return-to-work (RTW) outcomes and barriers after hospital discharge. We conducted a questionnaire among patients aged 18-64 years who underwent inpatient cardiac rehabilitation and were discharged between January 2018 and March 2023. Of 133 eligible patients, 54 responded (response rate 41%). Respondents were classified as: (1) returned to their original job; (2) returned to a different job; and (3) did not return to any job. The overall RTW rate was 96%, with 92% returning to their original job within 3 months. However, 81% of the respondents reported anxiety, mainly about physical strain and limited workplace understanding. Physicians were the most frequently consulted professionals, while other healthcare providers were rarely sought for advice. Although most patients successfully returned to work, substantial anxiety persisted regarding workplace reintegration. A structured vocational support system is required, wherein healthcare providers proactively identify at-risk patients and deliver comprehensive guidance to support sustainable RTW outcomes.

This study investigated the return-to-work (RTW) rates and associated factors following endoscopic transsphenoidal surgery (eTSS) among patients with pituitary and hypothalamic tumors in Japan. The primary research question aimed to determine the variables affecting early RTW post-surgery. A retrospective analysis was conducted on 44 preoperatively employed patients who underwent eTSS at a single center between April 2018 and January 2025. Clinical data, including demographics, tumor characteristics, comorbidities, and perioperative variables, were extracted from the medical records. The primary outcome was RTW within 3 months of surgery. Statistical analyses were performed using t-tests and Fisher’s exact tests. The median time to RTW was 5 weeks, and the RTW rates were 38.6%, 69.5%, and 75.0% at 1, 3, and 6 months, respectively, with an overall RTW rate of 84.1%. Factors such as a prolonged length of hospital stay (LOS), mental disorders, and the absence of prior TSS were significantly linked to delayed RTW at 3 months. Mental disorders also tended to decrease RTW at 6 months. No significant associations were found between adequate hormone replacement and age, sex, tumor type, or endocrinological dysfunction. Patients receiving multidisciplinary support for RTW tended to experience longer recovery periods, possibly reflecting a greater need. In patients undergoing eTSS for pituitary region tumors, a history of mental disorders, prolonged LOS, and no history of prior TSS were key factors could be associated with delayed RTW. Early identification of these factors may facilitate tailored multidisciplinary RTW support strategies.

The impacts of surgically treated acetabular and pelvic fractures on return to work and to sports.

Return-to-work (RTW) counseling is a critical part of rehabilitation of sick-listed employees with common mental disorders (CMD). In the Netherlands it is mandatory that RTW counseling with an occupational physician (OP) starts within two weeks, but current literature and guidelines provide little empiric support. This study aims to answer the questions "Is starting RTW counseling within two weeks associated with faster RTW?" and "Is there a dose-response effect (i.e. the earlier the better)?". In an observational design, sick-listed employees (n = 12,169) seen by an OP within two weeks of onset of sick leave were compared to those seen later using Cox proportional hazards analysis. Next, per week effects were examined, reporting pairwise comparisons of weeks 1 through 6 if the omnibus test was significant. Earlier RTW counseling was associated with earlier RTW (HR: 0.89, 95%CI: 0.86-0.93). There was a dose-response effect (LLR χ2: 46.08, df = 5, p < 0.001) with significant earlier RTW when RTW counseling was started in week 1 versus week 3 (HR: 0.90(95%CI 0.85-0.96), p < 0.001), week 1 versus week 5 (HR: 0.88(95%CI 0.81-0.94), p < 0.001), week 1 versus week 6 (HR: 0.82(95%CI 0.77-0.88), p < 0.001), and week 2 versus week 6 (HR: 0.84(95%CI 0.79-0.89), p < 0.001). However, subgroup analyses showed these findings only held for employees with adjustment disorders. There is a modest benefit to starting RTW counseling earlier. However, this effect is limited to those seen very early and there are no significant differences between weeks 2 through 5. Whether these modest benefits warrant strict adherence to a two-week deadline should be re-evaluated.

In 2017, China initiated the Rural Revitalization Strategy (RSS) to revive rural regions. It aims to revitalize rural areas and the farming sector through modernization and infrastructure enhancement. This led to the return of many migrant workers. This study examines the economic opportunities available to returning migrants in Liaoning, analyzes their success rate in terms of integration, and highlights the challenges they face during resettlement. The study entailed a secondary data analysis, and the data were analyzed using statistical tools and SPSS software. The study found that migration was influenced by education and its role in economic opportunity. Employment status was found to be a significant factor in economic opportunity, particularly in the labor market. Notably, the majority of migrants chose to remain in Liaoning, suggesting that rural rehabilitation initiatives had been effective. The findings highlight the complex reintegration processes of returning migrants and underscore the need to understand these dynamics for effective policymaking.

Purpose People with spinal cord injuries (SCI) face reduced access to work opportunities compared to individuals without disabilities. This study explored how people with SCI experience barriers and facilitators to work participation during return-to-work (RTW) and their quality of work participation in Spain’s post-COVID-19 context. Methods A qualitative phenomenological design was used. Eight women and nine men participated in three focus groups between February and June 2023. Data was video and audio recorded and analysed using a six-step Interpretative Phenomenological Analysis approach. Results Three main themes emerged: (1) intersectional factors contributing to unemployment and poverty risks, (2) lack of post-rehabilitation services and RTW planning, and (3) the need for policy reforms. Findings highlighted inequities such as inadequate job search support, inaccessible work environments, and insufficient subsidies for technical aids, adaptations, and teleworking. The post-COVID-19 context legitimised teleworking, which was previously unfeasible. Intersectional analysis revealed heightened unemployment and work precarity among young adults, women, and migrants. Conclusions Personalised RTW programs are essential for people with SCI, addressing systemic barriers and incorporating an intersectional approach to transform policies and improve employment outcomes.

Abstract Objectives Cardiovascular diseases (CVDs) are a leading cause of morbidity worldwide. Returning to work (RTW) after CVD enhances individual well-being and societal productivity. This review maps the existing literature, identifies key factors influencing RTW, and highlights evidence gaps to guide future research. Methods The review followed PRISMA checklists and Cochrane-GESI guidelines, including studies published from January 2019 to February 2025 on RTW after CVD. The research was conducted across four databases and five journals, using the terms “RTW,” “stroke,” and “CVD." Results After the screening process, sixty-nine studies met the eligibility criteria, focusing on working-age patients affected by acute CVDs (mainly TIA and minorly MI and other). Among these, forty-one articles explored key factors influencing RTW, including age, sex, smoking, anxiety, depression, family support, comorbidities, job type, and recurrence. Nineteen studies examined patient perspectives, highlighting the need for constant support and clear communication between employees, employers, caregivers, and rehabilitation professionals, whose perspectives were reviewed in three articles. Lastly, eighteen articles analyzed strategies aimed at optimizing RTW outcomes by analyzing various approaches for patient management (n = 11), and/or quantifying the patient's status before and after RTW by evaluating either QoL or functional status (n = 7). A clear consensus on which approach is the most effective is still lacking, aside from the recognized importance of a multidisciplinary intervention integrating physical and psychological factors along with workplace adjustments. Discussion Clear RTW after CVD guidelines lack. Future research should validate the most effective strategies and assessment tools, ensuring an optimized RTW pathway. Key messages • Guidelines on RTW after cardiovascular events are lacking. • A multidisciplinary approach and work adjustments have been found crucial for a better return to work.

This study, commissioned by the European Health and Digital Executive Agency and DG SANTE under the funding of EU4Health programme, addresses the critical issue of job retention and return to work (RTW) for those with a history of cancer in Europe. With over 12 million cancer survivors in Europe, enhancing individuals’ quality of life, including the ability to remain in or return to work, is more important than ever. This study's primary objective is to map policies in EU Member States and EEA EFTA countries that support job retention and RTW for cancer patients and survivors, identifying best practice approaches. A mixed-methods approach combined primary research (interviews, an online survey, and two workshops) with secondary research (a literature review). The evidence collected was analysed and triangulated to identify existing measures, gaps, obstacles, and good practices. The study found a lack of national legislative frameworks for job retention and RTW specifically for people with a history of cancer. Legislation for persons with disabilities or chronic illnesses, which may also apply to those affected by cancer, was more common. The vast majority of (policy) measures identified were from individual service providers, and included workplace accommodations, measures supporting partial work resumption, and cancer-specific reintegration services. Key obstacles to job retention and RTW identified include health-related complications, a lack of support for work reintegration, and financial pressures forcing early RTW. Stigma and discrimination also pose significant challenges. The study recommends strengthening national policies to include more cancer-specific measures, reinforcing monitoring and enforcement mechanisms, and increasing awareness and training for both cancer patients and employers. Enhanced cooperation and communication among stakeholders and improved financial incentives for employers are also important, as is further research into the topic.Key messages• Expanding national policies to include cancer-specific job retention and RTW measures is crucial for improving the quality of life of those with a history of cancer.• Good practices include reintegration support, cooperation between medical and occupational health providers, information and assistance services, and job retention and RTW measures in MS policies.

Abstract Background Employees who return to work (RTW) after mental health leave are a vulnerable, yet understudied population. Work adjustments that were implemented during the process of RTW, may need to be sustained after RTW. However, these adjustments can be at odds with the interests of supervisors. The present study aims to understand (1) the perspectives of supervisors on those work adjustments made during the RTW process that conflict with their own interests after the employees’ RTW; (2) how supervisors manage these conflicts, and (3) how they reflect on their management of these conflicts. The theoretical framework for this study was the Dual Concern Model, which describes styles of managing interpersonal conflict. This model consists of two intersecting axes showing that conflict styles can be concerned with other people and with oneself. Methods This qualitative study was based on semi-structured interviews with 15 supervisors from various sectors. Verbatim transcriptions of the interviews were analyzed thematically. Results (1) The interviewed supervisors mentioned two types of work changes of returned employees that conflicted with their managerial interests, namely adaptations of the employee's tasks and changing jobs. (2) To manage their conflicts of interests with employees, supervisors primarily aimed for win-win solutions and compromises. Secondarily, other strategies were also used, such as pursuing supervisors’ own interests at the expense of that of employees, possibly justified by a moral self-licensing process. (3) The majority of the supervisors had a nuanced view on their management of perceived conflicts. Conclusions The study results suggest that supervisors have a substantial impact on the extent to which employees can sustain their work changes after mental health leave. The results of this study can be used to inform policy, and education for supervisors on how to support their employees who have returned to work after CMD-related leave. Key messages • When confronted with employees’ work adjustments that conflict with their own interests, supervisors tend to play a prominent role in the type of resolution (win-win or otherwise) that is achieved. • Supervisors can have a substantial impact on the extent to which employees can sustain their work changes after sickness absence due to common mental disorders.