Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury

Return to work among workers recovering from severe COVID-19 in Slovenia: a focus group study

PURPOSE

For working age adults, return to work (RTW) after severe COVID-19 can be an essential component of rehabilitation. We explored the expectations and experiences related to RTW in a group of workers recovering from severe COVID-19 in Slovenia.

MATERIALS AND METHODS

Four focus groups were conducted between May 2021 and August 2021. Fifteen men and three women, aged between 39 and 65 years, participated. We analysed data using reflexive thematic analysis.

RESULTS

Four main themes were developed in the analysis, pertaining to (1) work identity, (2) challenges to work re-entry, (3) personal strengths and support systems, and (4) possible adaptations at work. The disruption of work triggered sentiments about its role in identity. Workers' personal agency and self-advocacy helped participants cope with various barriers that were beyond their control, such as physical limitations and lack of systematic routines to address RTW. Workers recovering from severe COVID-19 were at risk of developing negative expectations regarding their work re-entry.

CONCLUSIONS

RTW after severe COVID-19 involves different personal, organizational and systemic dimensions that need to be considered and carefully aligned. Due to the individuality of the process, the worker should be involved as a key partner in the RTW process.IMPLICATIONS FOR REHABILITATIONLack of clinical pathways can negatively impact return to work (RTW) after severe COVID-19.RTW processes should start early but timely and include individual follow up.Patients expect the interdisciplinary team of experts to work together and involve them in all phases of decision-making regarding their rehabilitation and RTW process.Positive expectations regarding work re-entry are essential for the RTW process.

Stakeholders' Expectations of Return-to-Work After Spinal Cord Injury: A 1-Year Follow-Up

Understanding the process of return-to-work is key to supporting people's social participation and health after a disability. This phenomenographic study aimed to explore the expectations and ways of understanding return-to-work from the perspectives of three stakeholder types: three workers with spinal cord injuries, their employers, and an occupational therapist coordinator. Participants were interviewed twice, at 6 and 12 months, after having participated in a research-based return-to-work intervention in Sweden. A phenomenographic approach was used to analyze the data. The findings highlight how stakeholders' different expectations prevented them from openly discussing more flexible arrangements to make return-to-work viable and sustainable. The study contributes to occupational therapy practice by raising awareness of the challenges of work reintegration. It also adds to the body of knowledge in occupational science by illuminating how normative social expectations and policy concerning work/productivity influence the return-to-work process.

Return to work after COVID-19: Experiences and expectations from the first wave of COVID-19 in Stockholm

BACKGROUND

In Stockholm (Sweden) a substantial number of persons who were infected with SARS-CoV-2 during spring 2020, and received intensive care followed by rehabilitation due to COVID-19, were of working age. For this group, return to work (RTW) is an important part of the rehabilitation, however this is an area that thus far has received little scholarly attention. The Aim of this study was two-fold. First, to descriptively look at self-reported work ability over time using the Work Abilty Index among working age adults who recovered from severe COVID-19, and secondly, to explore experiences and expectations concerning RTW among working age adults who recovered from severe COVID-19.

METHODS

Focus group interviews and qualitative thematic analyses were utilized. In addition, the study populations' self-reported work ability index was recorded over one year.

FINDINGS

Qualitative analysis of data resulted in 5 themes: a) Initial experiences after discharge from in-patient rehabilitation, b) Disparate first contact with work, c) Uncertainties about own role in RTW process, d) Working situation for those who had started getting back to work, and e) A need to reprioritize expectations for work in the context of everyday life. There were no statistical differences in work ability index scores between 18 and 52 weeks after discharge from an in-patient rehabilitation unit.

CONCLUSION

RTW after COVID-19 can require systematic support for several months as well as be initiated earlier in the rehabilitation process. Further research in the area is needed.

How People with Multimorbidity and Psychosocial Difficulties Experience Support by Rehabilitation Coordinators During Sickness Absence

Purpose

People with multimorbidity face a range of barriers in healthcare, and there is little knowledge about their challenges with regard to return-to-work (RTW). Rehabilitation coordinators, a new function in Swedish healthcare, support people in the RTW process. The present study had two aims: to explore what problems and barriers people with multimorbidity experience during their rehabilitation and RTW process and to explore in which domains the coordinators’ support is perceived to be of importance.

Methods

Interviews were conducted with 12 persons with multimorbidity who had contact with a rehabilitation coordinator during their sickness absence. Thematic analysis was guided by the case-management ecological model; this analysis was revised and adapted to the Swedish context.

Results

The participants experienced problems in all domains of the model, namely: “the healthcare system”, “the labor market and the workplace system”, “the sickness insurance system”, and “the personal system”. Rehabilitation programs that did not accommodate combinations of diseases, social complexities and needs were felt to lead to worse symptoms, thus hindering rather than promoting RTW. An overall finding regarding support by coordinators is that interventions, regardless of domain, were felt to be valuable for people with multimorbidity. The coordinator was perceived to give most support by providing advice about and coordination with healthcare and employers. Sometimes the coordinator gave advice and coordination regarding the Social Insurance Agency, very occasionally the Public Employment Services. The coordinator gave least advice and coordination about social difficulties that hindered rehabilitation and RTW processes.

Conclusion

People with multimorbidity perceive rehabilitation coordinator interventions as important in all domains investigated. Lack of advice and coordination, or rehabilitation programs that were not modified to the complexities of individual’s circumstances, were associated with prolonged sickness absence, worse health, or social risk factors not being recognized.