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Andersén Å, Carpentsier B, Berglund E, Carlsson M. Healthcare professionals' perceptions of the contributions of rehabilitation coordinators to patients in Swedish psychiatric care: a qualitative descriptive study. BMC Psychiatry 2024; 24:437. [PMID: 38867196 PMCID: PMC11167818 DOI: 10.1186/s12888-024-05895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Rehabilitation coordinators have gradually been introduced into Swedish psychiatric care to support individuals on sick leave to return-to-work or enter work. AIM To explore healthcare professionals' perspectives on the contributions a rehabilitation coordinator can make to patients in psychiatric care. MATERIALS AND METHODS A descriptive qualitative design was used, and data were collected through interviews. Twelve healthcare professionals in psychiatric care participated in individual semi-structured interviews. Data were analysed using thematic analysis. RESULTS An overarching theme evolved: "The rehabilitation coordinator promotes security and reduces stress in the vocational rehabilitation process", based on two themes: (1) "Adaptations and support based on the patient's needs" and (2) "Rehabilitation coordinator efforts as relevant for care". The themes, in turn, consist of six subthemes. CONCLUSIONS This study showed that healthcare professionals perceived employment as important for patients' health and well-being. Therefore, the rehabilitation coordination efforts were not only seen as beneficial for addressing patients' challenges and needs in managing the vocational rehabilitation process but also as an integral part of the patient's care.
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Affiliation(s)
- Åsa Andersén
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22 UPPSALA, Sweden.
| | - Beatrice Carpentsier
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22 UPPSALA, Sweden
| | - Erik Berglund
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22 UPPSALA, Sweden
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Maria Carlsson
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, Uppsala, SE-751 22 UPPSALA, Sweden
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Rasmussen L, Nielsen MBD, Garde AH, Kristiansen J. Exploring the Role of Sickness Absence Coordinators in Implementing Interventions to Reduce Sickness Absence in Public Sector Workplaces in Denmark. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10183-1. [PMID: 38519778 DOI: 10.1007/s10926-024-10183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE In 2019, an initiative to reduce sickness absence in public sector workplaces in Denmark was introduced. The initiative involved appointing a sickness absence coordinator (SA coordinator) to oversee the implementation of workplace-based sickness absence interventions. Since the role of the SA coordinator is a novel concept introduced as part of the initiative, this study investigates the responsibilities of SA coordinators and the challenges they experienced in fulfilling this role during the implementation process. METHODS Semi-structured interviews with and observations of SA coordinators from four public sector workplaces were carried out. We collected the first four interviews and observations during the implementation process with follow-up interviews collected at the end of the process. The data were analyzed using thematic analysis. RESULTS The SA coordinators all experienced challenges in terms of lack of commitment among the line managers to participate in the intervention. They experienced being seen as a burden rather than a helping hand, and felt that the line managers might have difficulty recognizing the value of the SA coordinators. Potential ways to improve the collaboration between the SA coordinators and the line managers include considering hiring the SA coordinator in-house and incorporation of intervention components into existing activities to accommodate the busyness of the line managers. CONCLUSIONS To support the SA coordinators in carrying out their role and responsibilities, this study suggests that it is important to ensure commitment to the role, especially among the line managers in order to enhance good working relationships.
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Affiliation(s)
- Lene Rasmussen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Maj Britt Dahl Nielsen
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark
| | - Anne Helene Garde
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Jesper Kristiansen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
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Rydland HT, Bentsen HL, Ervik R, Grønning K, Islam K, Kjerstad E, Skogedal Lindén T. Promoting labour market inclusion of the chronically ill: a scoping review of Scandinavian countries' efforts. Scand J Public Health 2023; 51:1097-1107. [PMID: 35535443 PMCID: PMC10642227 DOI: 10.1177/14034948221096005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This article is a scoping review of efforts in labour market inclusion of the chronically ill in the Scandinavian countries, a research area that has received much political as well as research attention in recent years. The aim of the review was to identify promising strategies and the need for further research. METHODS Six electronic databases were searched for literature published between 2015 and 2020. We included peer-reviewed articles that studied the effect of measures, aimed at the workplace or at the individual, that are intended to increase participation. Our search resulted in 2718 articles; our screening procedures resulted in 47 included articles. RESULTS Among the included studies, musculoskeletal problems (17 articles) and mental health problems (29 articles) were the most frequent chronic conditions. Multimodal occupational rehabilitation programmes directed towards the individual employee were the most frequent interventions (30 articles). Return to work (24 articles) and sickness absence (12 articles) were the most common outcomes. About half (25 articles) of the included studies reported a positive impact of the intervention on work inclusion of the chronically ill. CONCLUSIONS Our review found little evidence of how government programmes directed towards the supply side of the labour market succeed in including the chronically ill. Our review further indicated that multidisciplinary workplace interventions have a substantial effect. We also identified a significant lack of research on the effect of various governmental policies and programmes, including local health, work and welfare services, and limited coordination and cooperation between health and work services professions.
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Affiliation(s)
| | | | - Rune Ervik
- NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamrul Islam
- NORCE Norwegian Research Centre AS, Bergen, Norway
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Hällås E, Skoglund I, Nordeman L. "That's probably how you would want care to be" - experiences of sick leave teams at a health center, a mixed method study. BMC PRIMARY CARE 2023; 24:243. [PMID: 37978438 PMCID: PMC10655286 DOI: 10.1186/s12875-023-02192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The health center where this study was performed the management wanted to test whether a sick leave team provided the physicians with better conditions for the task of assessing sick leave. The goals were to ensure the quality of the assessment of patients with sick leave needs and to improve the work environment. The aim of this study was to take part in the staff's experiences of having access to and working in sick leave teams and how the working method affected the number of sick leave patients and sick leave pattern. METHODS A mixture of qualitative and quantitative methods. Two focus groups were conducted with a total of 11 participants. The head of the health center formed the focus groups, which consisted of 6 doctors, 3 district nurses, 1 rehab coordinator and 1 psychologist. Aggregated sick leave data for full-time and part-time sick leave of more than 90, 180 and 360 days, respectively, were obtained and compiled at project start and end, and from the corresponding period 18 months before project start. RESULTS The introduction of sick leave teams with physicians and rehabilitation coordinator for patients who turn to the health center for mental illness and / or musculoskeletal problems emerged three main categories from the analysis of the focus group discussions: working environment, clear roles and in-depth competence. The total number of people who were on sick leave more than 365 days decreased by 27% between start and the end of the project, and the proportion of women increased by 11%. CONCLUSIONS The study shows that the complex task of sick leave can be perceived as positive by physicians with the support of teamwork. The working method is similar to that applied in occupational health care, where the physician is not alone with this task. This can also be a way to make primary care a more attractive workplace.
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Affiliation(s)
- E Hällås
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden.
| | - I Skoglund
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden
- Primary Health Care/School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L Nordeman
- Research Education Development and Innovation Primary Health Care Region Västra Götaland, Borås, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Berglund E, Friberg E, Engblom M, Svärd V. Physicians' experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden. Disabil Rehabil 2023:1-9. [PMID: 37772755 DOI: 10.1080/09638288.2023.2261851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians' experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics. MATERIALS AND METHODS Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs. RESULTS Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06-4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification. CONCLUSIONS Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs' facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians.Implications for RehabilitationThis study of physicians' experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators.The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic.These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance.
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Affiliation(s)
- Erik Berglund
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Emilie Friberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Monika Engblom
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Svärd
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Social Work in Health, Karolinska University Hospital, Stockholm, Sweden
- Department of Social Sciences, Division of Social Work, Södertörn University, Huddinge, Sweden
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Coordination and Perceived Support for Return to Work: A Cross-Sectional Study among Patients in Swedish Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074040. [PMID: 35409721 PMCID: PMC8997974 DOI: 10.3390/ijerph19074040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/21/2022] [Accepted: 03/26/2022] [Indexed: 12/02/2022]
Abstract
Background: Receiving support from a return-to-work (RTW) coordinator (RTWC) may be beneficial for people on long-term sick leave. The aim of this study was to investigate whether the number of contacts with an RTWC and their involvement in designing rehabilitation plans for the patients were associated with perceiving support for RTW, emotional response to the RTWC, and healthcare utilization. Methods: In this cross-sectional study, 274 patients who had recently been in contact with an RTWC in Swedish primary or psychiatric care answered questions regarding their interaction with an RTWC, perceived support for RTW, and emotional response to the RTWC. Results: Having more contact with an RTWC was associated with perceiving more support in the RTW process (adjusted OR 4.14, 95% CI 1.49–11.47). RTWC involvement in designing a rehabilitation plan for the patient was associated with perceiving more support in the RTW process from an RTWC and having a more positive emotional response to the RTWC. Conclusions: From the patient’s perspective, this study indicates that the involvement of an RTWC and receiving a rehabilitation plan that an RTWC has helped to design might be perceived as important in the RTW process.
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Kausto J, Oksanen T, Koskinen A, Pentti J, Mattila-Holappa P, Kaila-Kangas L, Nevala N, Kivimäki M, Vahtera J, Ervasti J. 'Return to Work' Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:831-839. [PMID: 33829365 PMCID: PMC8558281 DOI: 10.1007/s10926-021-09970-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Purpose Employers increasingly use 'return to work' (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013-2015 and risk of sickness absence after (2013-2015) vs. before (2009-2011) intervention by case-control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30-0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12-0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14-1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97-1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.
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Affiliation(s)
- Johanna Kausto
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland.
| | - Tuula Oksanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, and Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Leena Kaila-Kangas
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland
| | - Nina Nevala
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Topeliuksenkatu 40, 00250, Helsinki, Finland
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Dol M, Varatharajan S, Neiterman E, McKnight E, Crouch M, McDonald E, Malachowski C, Dali N, Giau E, MacEachen E. Systematic Review of the Impact on Return to Work of Return-to-Work Coordinators. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:675-698. [PMID: 33881671 DOI: 10.1007/s10926-021-09975-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 05/26/2023]
Abstract
Purpose We conducted a systematic review to understand the impact that return-to-work coordinators (RTWCs) have on return to work (RTW) outcomes for sick/injured workers. Methods MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and ABI Inform were searched from January 1, 2000 to September 16, 2020. Of 2,927 retrieved and screened citations, 14 quantitative articles fulfilled the eligibility and quality criteria. Quality assessment, data extraction, and evidence synthesis followed article screening. Results We focused on the impact of RTWCs for outcomes of work absence, RTW rates, quality of life, and cost-benefit. Our final synthesis included 14 articles. We found strong evidence that work absence duration was reduced when workers had face-to-face contact with a RTWC. As well, there was strong evidence linking face-to-face RTWC interventions with higher RTW rates and moderate evidence that this reduced intervention costs. RTWC interventions involving the identification of barriers and facilitators to RTW also showed promising results. However, only limited evidence was found that RTWCs improved quality of life for workers. Conclusions Our synthesis identifies key features of RTW interventions that improve RTW outcomes. Future high-quality research should measure long-term outcomes of RTWC interventions to evaluate sustainability and consider the nature of work. They should also focus on RTWC impact on worker quality of life assessments and for older workers and workers with chronic health conditions.
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Affiliation(s)
- M Dol
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - S Varatharajan
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E Neiterman
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E McKnight
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - M Crouch
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E McDonald
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - C Malachowski
- University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada
| | - N Dali
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E Giau
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - E MacEachen
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
- University of Ontario Institute of Technology, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada.
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Holmlund L, Hellman T, Engblom M, Kwak L, Sandman L, Törnkvist L, Björk Brämberg E. Coordination of return-to-work for employees on sick leave due to common mental disorders: facilitators and barriers. Disabil Rehabil 2020; 44:3113-3121. [PMID: 33280451 DOI: 10.1080/09638288.2020.1855263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To identify facilitators of and barriers to the coordination of return-to-work between the primary care services, the employee, and the employers from the perspective of coordinators and employees on sick leave due to common mental disorders (CMDs). MATERIAL AND METHODS Descriptive qualitative study. Semi-structured interviews were conducted with eighteen coordinators and nine employees on sick leave due to CMDs. The Consolidated Framework for Implementation Research (CFIR) was used as a starting point for the interview guides and in the thematic analysis of data. RESULTS The results show facilitators and barriers related to the CFIR domains "intervention characteristics," "outer setting," "inner setting," and "characteristics of individuals." Positive attitudes, an open dialogue in a three-party meeting, and a common ground for the sick leave process at the primary care centre facilitated coordination, while an unclear packaging, conflicts at the employee's workplace, and a lack of team-based work were examples of barriers. CONCLUSION The results indicate a need for the detailed packaging of coordination; formalization of coordinators' qualifications and levels of training; and acknowledgement of the role of organizational factors in the implementation of coordination. This is important to further develop and evaluate the efficacy of coordination.IMPLICATIONS FOR REHABILITATIONPositive attitudes to coordination, an open dialogue in a three-party meeting, leadership engagement, routines for the return to work (RTW) process at the primary care centre, and collegial alliances were identified as facilitators.An unclear packaging of the intervention, conflicts at the employee's workplace, lack of team-based work, and lack of coordinator training were identified as barriers.A detailed intervention packaging adapted for the specific setting and formalization of coordinators' qualifications and training is necessary for coordination of RTW.Recognizing organizational factors were identified as being important for the implementation of coordination of RTW for persons on sick leave due to CMDs.
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Affiliation(s)
- Lisa Holmlund
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Therese Hellman
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Monika Engblom
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Sandman
- Department of Health, Medicine and Caring Sciences, National Centre for Priorities in Health, Linköping university, Linköping, Sweden
| | - Lena Törnkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Returning to work in lung cancer survivors-a multi-center cross-sectional study in Germany. Support Care Cancer 2020; 29:3753-3765. [PMID: 33211206 PMCID: PMC8163665 DOI: 10.1007/s00520-020-05886-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022]
Abstract
Purpose To investigate the work situation of lung cancer survivors and to identify the factors associated with their returning to work. Methods Descriptive analysis and logistic regression were used to evaluate study population characteristics and independent factors of subsequently returning to work. To analyze time to return to work, Cox regression was used. Results The study sample included 232 lung cancer survivors of working age from 717 enrolled participants in the multi-center cross-sectional LARIS (Quality of Life and Psychosocial Rehabilitation in Lung Cancer Survivors) study. About 67% of the survivors were not employed during the survey. More than 51% of the survivors who were employed before their illness did not return to their work. The survivors who had returned to their careers were younger, associated with higher household income, lower fatigue score, and stable relationship and vocational training. Patients who received social service counseling showed a higher chance of regaining their career. Conclusions Lung cancer survivors were found to be associated with a high risk of unemployment and very low professional reintegration after interruption due to illness. More comprehensive studies are needed to support lung cancer survivors and targeting of patients in need of special attention in rehabilitation that would benefit from the findings in the present study. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-020-05886-z.
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Björk Brämberg E, Sandman L, Hellman T, Kwak L. Facilitators, barriers and ethical values related to the coordination of return-to-work among employees on sick leave due to common mental disorders: a protocol for a qualitative study (the CORE-project). BMJ Open 2019; 9:e032463. [PMID: 31530623 PMCID: PMC6756367 DOI: 10.1136/bmjopen-2019-032463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Diagnoses related to common mental disorders such as anxiety, depression, adjustment disorders and stress-related disorders are one of the leading causes of long-term sick leave for both women and men in Organisation for Economic Co-operation and Development countries. To increase the rate of return-to-work workplace involvement in a coordinated return-to-work process has been included in recent best practice guidelines. This form of cooperation is a complex process, involving political structures and a wide range of stakeholders. The study's first aim is to describe facilitators and barriers to the coordination of return-to-work from the perspectives of: (A) employees on sick leave due to common mental disorders, (B) employers, (C) rehabilitation coordinators, (D) physicians and (E) other stakeholders. The second aim is to identify ethical issues that arise in the coordination of return-to-work and analyse how these can be resolved. METHODS AND ANALYSIS The study has a qualitative design using interviews with employees on sick leave due to common mental disorders, employers, rehabilitation coordinators, physicians and other stakeholders. The study is conducted in the Swedish primary healthcare. Employees, employers and rehabilitation coordinators are recruited via primary healthcare centres. Rehabilitation coordinators receive information about the study and those who consent to participation are asked to recruit employees and employers. Interview guides have been developed from the consolidated framework for implementation research and ethical values and norms found in Swedish healthcare, social services and workplace legislation. Data will be analysed with qualitative content analysis reflecting manifest and latent content, and ethical issues will be analysed by means of reflective equilibrium methodology. ETHICS AND DISSEMINATION The study was approved by the Regional Ethical Review Board in Stockholm, Sweden (Reg.no 2018/677-31/2 and 2018/2119-32). The findings will be disseminated through publication in scientific journals, social media, seminars and national and international conferences.
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Affiliation(s)
| | - Lars Sandman
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Therese Hellman
- Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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