The aim of this study is to investigate the perceptions of female employees on long-term sickness absence due to common mental disorders (CMDs), in relation to what they perceive would best help them to return to work. Data were collected through a survey answered by employees at a municipality in Sweden on long-term sick leave. Results of the current study are based on a part of that material, namely from 56 women with CMDs who responded to the final open question. The analysis involves two steps. Initially, we explored themes that form the accounts in the findings. Secondly, based on the themes, collective narratives, storylines were identified. Three different storylines were found to be prominent in the findings. The storylines describe how the participants collectively expressed themselves in relation to the possibilities for return to work, and the following storylines were derived: It feels like too much, Things are moving too fast, and I have to get out of here!. The findings are related to perceived demands, control and support. From a disability management perspective, we have learned the importance of restoring the balance between demands, control and support — not only to prevent absence from work, but also to facilitate return to work after a period of long-term sickness.

There is a growing consensus that professional action in occupational rehabilitation should be research-based, and that practice-based knowledge is needed to achieve contextual insight and new theoretical understanding. Few study design examples exist to help inform an evaluation plan and develop research-practice interactions to examine process complexity of targeted occupational rehabilitation programs. This study design article is a proposal on a theory-driven and interactive research methodology for a process evaluation of a pragmatic intervention trial, known as STAiR. The aim of the process evaluation is to examine the delivery and implementation of an inpatient and an outpatient occupational rehabilitation program, and explore active mechanisms pertaining to patient experiences of the return to work (RTW) process. Qualitative and interactive data collection methods will include (a) participant observation of program setting and activities; (b) participatory dialogue conferences with program providers to facilitate initial logic modelling; (d) individual patient interviews at program intake and follow up; and (d) focus groups with rehabilitation teams and external stakeholders. The qualitative data will be supplemented with description of program activities and patient questionnaires. Program logic modelling is suggested to inform a logic analysis of how expected RTW outcomes and delivery of program activities are aligned and how contextual characteristics may clarify differences in achieved RTW outcomes. The proposed process evaluation approach may inform future design discussions and theoretical understanding, and it is expected that the applied knowledge gained through this study may help rehabilitation professionals better navigate potential challenges in clinical evaluation efforts.

Many organisations strive to make disability management (DM) responses to prevent work disability and promote return-to-work (RTW). However, a deeper appreciation of methods that can ensure equitable worker participation in the development and change of RTW policy and practice is needed. Using an action research approach, this study expands the concept of participation in disability management (DM) creating new insights into the resources, dilemmas and aspirations of RTW policies in organisations. Empirical data was gathered from a development and change process conducted together with managers and workers at a large health care workplace. A series of workshops were conducted, studying the common history of RTW policy evolvement and configuration, and encouraging the creation of worker-driven proposals for alternative actions to current management. Action research protocols were used to document knowledge creation. Analysis of action research processes reveals how workers insisted on discussing their work environment as an important factor for maintenance of RTW, and how consistent participatory possibilities and team oriented RTW coordination among all levels of the organisation are perceived as critical features for supportive and sustained job retention. Participatory processes created relevant knowledge of the importance of work environments in coordination of stay at work, which may strengthen RTW capacity building and advance DM in organisations.

Aim: This exploratory study examined the relationships among different types of social support accessed by patients with traumatic spinal cord injury (SCI). Method: Using a cross-sectional study design, 20 SCI patients of workforce age discharged from the Royal Talbot Rehabilitation Hospital, Melbourne, Australia during 2007 were assessed on a range of demographic, injury and social support variables. Results: Higher quality interactions (i.e., actual social support) were significantly associated with greater social integration (i.e., structural social support) and higher perceived social support. However, community integration and social integration, which measure different aspects of structural social support, were essentially unrelated. Conclusions: Actual social support influences perceived social support and social integration. Theoretically, these results suggest that actual social support influences the two main opposing models that explain the relationship between social support and wellbeing: the stress-buffering model (for perceived social support) and the main-effects model (for structural social support). From a research perspective, the use of well-defined types of social support, and psychometrically sound measures, is critical for assessing the influence of social support on rehabilitation outcomes. To effectively match rehabilitation efforts with SCI survivors' needs, future research should examine which types of social support best predict particular rehabilitation outcomes.

An estimated 14,000 persons who are deaf (PWAD) reside in Barbados, many of whom are believed to live below the poverty line. Data on the employment status of PWAD in Barbados is sparse; this research seeks to fill a gap in the literature and inform social policy. Qualitative methodologies were utilized to understand how participation in the labour market influences the lives of PWAD in Barbados. The current research seeks to inquire into the phenomenological field of five persons who are deaf through a multiple case study strategy using focus group interviews. Data were analysed to derive themes common across participants and ecological systems theory was used to understand how PWAD cope in the world of work. The following research questions are addressed in an attempt to capture the unique perspectives of PWAD: (1) What are the experiences of persons who are deaf and employed? and (2) How does having a disability impact the lives of PWAD? The data revealed a relationship between environmental stressors such as attitudinal barriers and discrimination in the workplace and their psychological and behavioural impact in the form of resignation, frustration, isolation and creative coping among PWAD.

In Norway various welfare state authorities assist in disability management (DM) of long-term sick workers. This study provides empirical-based knowledge about the Norwegian DM process. The data are based on focus-group interviews with health care providers and case-workers in welfare state authorities. A key issue outlined in this article is that long-term sick workers can easily become ‘stuck’ in the rehabilitation system. The focus is on topics that can explain difficulties of re-employing long-term sick workers. Furthermore, we look at what challenges are typical for DM of these workers in Norway, with respect to re-employment issues.

This study examined return-to-work in a sample of 468 compensatable injury cases. These included amputees, brain damage, hearing loss, mental disorders, musculoskeletal problems, nervous system, paraplegia, sight loss and miscellaneous conditions. Around 35% returned to work. It was substantially higher for work-related injuries compared to motor vehicle accidents or general insurance claims. Those who underwent surgery or were admitted to hospital had higher return-to-work rates than those never attending hospital. Psychiatric adjustment factors were a major influence on low rates of return-to-work. Other social and demographic factors were considered (gender, age, city vs. rural location, whether a spinal injury was involved, family status, years of schooling, qualifications, job status at time of accident, occupation). Eight out of 17 possible factors were more statistically significantly related than the remainder to whether someone was working but the substantive limitations of even relevant pre- or post-accident indicators are outlined.

Early intervention of the biopsychosocial model as a framework to achieve sustainable employment outcomes following injury, illness or disease is well documented in the International research. However in some areas of disability management the term early intervention is consistently applied exclusively within the medical model with early access to treatment and diagnostic tools.

However in Australia, whilst the knowledge of the Health benefits of work consensus statement is gaining traction, we remain lagging in effective implementation of early intervention models of the biopsychosocial model to return to work and return to life. This paper explores the structural challenges associated with successful implementation of the model and provides International learnings and applications for consideration and adaption to the Australian context. Further this paper will provide learnings from a pilot program being run in NSW that has been successful in the early triage and referral into a structured Return to Work program that is achieving strong results.

Disability management is now recognised as an effective means of managing the increasing global costs of injury and disability. However, research on disability management particularly employee perceptions of its value, are sparse. This paper reports on the Australian findings of a large international project that included Canada, China, Switzerland and Australia, which examined employee perspectives of disability management related to job satisfaction, physical and mental health, workplace morale and reduced sickness absence. Data was collected from 365 employees in 10 large private and public companies using an online survey tool that focused on three components of a disability management program — disability prevention (DP), stay at work (SAW) and return to work (RTW) programs — in relation to the dependent variables of job satisfaction, physical and mental health, workplace morale, sickness absence. Multivariate regression was used to predict disability management's influence on the dependent variables. Results demonstrated positive perceptions regarding the perceived benefits of disability management to both individual employees and their perceptions of coworkers. It was apparent that each component of a disability management program (DP, SAW, and RTW) is positively related to job satisfaction, physical and mental health, workplace morale and reduced sickness absence Disability management programs were perceived as more beneficial in private, as opposed to public, workplaces; however, no differences were evident according to union status or gender of the respondent. It is possible disability management may impact on organisational productivity via variables associated with workplace culture, as well as through the direct benefits flowing from preventing and managing injury. Given the significant costs associated with absenteeism, an outcome of interest to many employers was the finding that employees perceived SAW programs as the most beneficial in terms of reducing absenteeism for both themselves and their coworkers.

A Canadian sample was collected as an aspect of a large international project, with representation from Australia, Canada, China, and Switzerland. In each country, interview and survey data were collected using team-created research tools. Canadian survey data on disability management (DM) perceptions were collected from 218 employees in both public and private organisations. Our Canadian employee sample reported perceived influence of disability prevention on job satisfaction, physical health, mental health, and morale for both themselves and their coworkers. Return to work programs were seen as valuable for job satisfaction of both the employee and coworkers, as well as the physical health of coworkers. Similarly, stay at work programs were seen as valuable for mental health and morale of coworkers. There was no relationship between perceived influence of DM interventions and reduction of sickness absence. The influence of DM was perceived as more positive for private and/or nonunionised workplaces. No gender differences were evident.

The costs of occupational stress are rising and employers increasingly need to address occupational stress, prevention and rehabilitation issues. However, there is a relative lack of understanding about implementing strategies within specific organisational contexts. Extant literature indicates a need for integrated prevention and rehabilitation strategies that address specific organisational climates that contribute to stress. The Queensland Police Service (QPS) is one policing organisation facing significant occupational stress issues requiring organisational solutions. This article describes a Participatory Action Research case study, the aim of which is to develop an occupational rehabilitation system within the QPS to address identified stress issues. A combination of background information, interview and focus group data is being used to determine stress issues and provide potential solutions to specifically address the needs of the QPS. The findings of this study emphasise the importance of participant involvement in identifying issues and generating solutions, as well as demonstrating the value of taking a systemic approach. The findings suggest that the use of the Participatory Action Research approach is invaluable in promoting the long-term success of the QPS change process.

Purpose: This article focuses on occupation and employment after basic vocational training for people with cognitive disabilities. The aim is to reveal supporting and hindering factors of different forms of workplace integration as perceived by those with disabilities. Method: Both quantitative and qualitative methods were used, consisting of an easy-to-read questionnaire completed by 412 graduates of practical vocational training, and in-depth interviews with 27 graduates. Results: The key findings show that workplace integration of people with disabilities takes place through a combination of various factors and materialises in different ways in terms of workplace, employment status, activity and further perspectives. Our findings suggest that supporting and accompanying people with disabilities in their work activities should always take into account both their desire for self-determination and their dependence on structural conditions.

In 2014, the health and productivity team of the disability insurance provider, Unum, conducted a mixed methods study that included qualitative interviews with internal mental health disability claims professionals, and external interviews with employers. Quantitative data of 15 employers were analysed to identify descriptive statistics involving mental health short-term disability (STD) claims. Workplace factors were examined to understand best practices among companies, related to mental health STD, to identify work environments that may increase or decrease mental health disabilities. Quantitative data found workers aged 40 to 49 had the highest rates of mental health STD claims and workers aged 50 to 59 had the longest duration of absence. Anxiety and depression were the main reasons for mental health absences from work. Results from the qualitative interviews showed a supportive work culture (i.e., work–life balance, good benefits, successful wellness programs) may lead to higher STD claim rates, demonstrating workers in these environments may feel more comfortable disclosing and seeking help for mental health disabilities. Conclusions from this study indicate that although presenteeism rates for mental health are high and impact employers financially, having higher STD claim rates may be more cost effective than having employees with mental health conditions remain at work instead of filing STD claims, seeking treatment and returning to productive employment. Employee age can impact rate and duration of mental health STD claims, meaning employers should implement workplace practices that support overall mental health of employees.

The guidelines published by the International Social Security Association, ISSA Guidelines: Return to Work and Reintegration, provide a policy imperative towards early intervention for people with nonoccupational health conditions at risk of exiting the workforce and moving to disability dependency. Socioeconomic and fiscal imperatives have been demonstrated by the Organisation for Economic Co-operation and Development's (OECD) review on sickness, disability and work (OECD, 2010), and by an accumulating evidence base for effectiveness. This study explored how social protection agencies are responding in terms of employment rehabilitation services for employed people with acquired disabilities. Specifically, this study reviewed job retention and return processes for workers with nonoccupational health conditions from the perspective of the ISSA guidelines in four jurisdictions with differing system frameworks. The methods used included a review of relevant literature and web resources and gathering detailed system descriptions from national respondents. Although the jurisdictions differed in the concepts used, service context, the structure of welfare systems and eligibility criteria, there was evidence of an acknowledgement of the needs of employed people with disabilities. This was not, however, consistently reflected in procedures, processes or outcome measurements. While some promising characteristics were identified, there was substantial room for improvement in the job retention and return to work strategies of the relevant agencies in all four jurisdictions. It was concluded that the deployment of the ISSA Guidelines: Return to Work and Reintegration, published in 2013, had yet to make a substantial impact on services and approaches in the domain of nonoccupational health conditions in these jurisdictions.

In Western countries, an increasing number of companies has difficulties with recruiting and retaining employees, along with growing employer responsibilities in the workplace. Therefore, companies’ interest in disability management programs has increased. This article examines employee perspectives of disability management and how it is related to job satisfaction, physical and mental health, workplace morale and sickness absence. Employees from seven Swiss companies (N=482), from the private and public sector, participated in either an online and paper-and-pencil survey for this present study. The survey asked employees to report their views of how disability management is related to job satisfaction, mental health, physical health, workplace morale and absenteeism. The Swiss employees participating in the study knew about disability management and related programs, which are implemented in their company. They valued them as moderately helpful for a variety of factors related to workplace wellbeing, and regarded the programs generally as high quality and wanted them to continue, because they contribute to job satisfaction, mental health, physical health, workplace morale and reduced sickness absence. However, employees also saw more value in disability prevention (DP) and stay at work (SAW) programs than in return to work (RTW) programs. Male employees and those working for public organisations saw more benefit in disability management programs than female employees and those working in the private sector.

A common suggestion in the disability management research literature is that consultative relationships between disability manager specialists and key union personnel can significantly enhance disability management services provided in unionised workplaces. However, the findings of previous knowledge validation studies have indicated that a sizeable proportion of disability managers believe they are under-prepared to provide services in unionised environments. Plausibly, these findings could reflect the dearth of existing outcome studies that expressly describe characteristics associated with the successful provision of disability management services in unionised workplaces. As a first step towards addressing the aforementioned gap in the disability management research literature, the current study reports the results of a Delphi procedure designed to provide information regarding possible factors that impact disability management services provided in unionised workplaces. The goal of the study was to develop a preliminary survey that could be used in subsequent research studies that address disability management best practises. Four thematically classified domains were identified that included: (a) disability managers' and disability management client characteristics, (b) rate of union representatives' participation in disability management services, (c) disability management service characteristics in unionised environments, and (d) disability managers' attitudes regarding working with labour union representatives. Implications of the findings are discussed in terms of rehabilitation counsellor education and development of empirically based disability management practice strategies.

Information and communication technologies (ICTs) have become an element of strategic importance to all countries. Researchers argue that ICTs may open up new avenues for economic growth, competitiveness and human development. It is widely recognised that ICTs have the potential of overcoming many of the barriers faced by people with visual impairment (VI). Based on an interpretive study using the narrative interview method, this article contributes to this literature by presenting perceptions and understandings of how the use of ICTs can be used to promote the ‘development’ of people with VI in Bangladesh. We approached this study through the economist and Nobel Laureate Amartya Sen’s work on ‘development as freedom’ that focuses on, among other themes, five dimensions of freedom — social, economic, protective, political and transparency. We collected stories from 18 people with VI who had received ICTs training and support from resource centres, and from some disability rights activists and leaders who use ICTs. Our findings suggest that ICTs can be used as tools for improving the wellbeing of people with VI by enhancing different aspects of freedom suggested by Sen. ICTs tools assist people with VI by providing them with educational and work opportunities, and thus increase the potential for social inclusion and economic development. We conclude that governments, nongovernment organisations and development partners in countries such as Bangladesh may use ICTs to expand different types of ‘freedom’ for marginalised groups such as people with VI and persons with disabilities in general.

The purpose of this article is to contribute to knowledge about workplace-based prevention and rehabilitation programs by investigating effects on outcomes concerning employee health, psychosocial working conditions, sickness absence, sick-cases and rehabilitation indicators in 19 Swedish public human service workplaces including 311 individuals. Interviews with middle managers and an examination of documentation about prevention and rehabilitation interventions at the workplaces made it possible to group the workplaces in two workplace program groups — high versus low quality workplace-based prevention and rehabilitation programs. Statistical methods used were reliability tests, correlation analyses and t tests. Results indicate significant associations between changes in employee-judged stress and psychosocial working conditions, and changes in employee-judged health. The results concerning changes in employees’ health, stress and psychosocial working conditions (after workplace-based programs) showed significant differences between workplaces with high quality workplace-based programs compared with workplaces with low quality workplace-based programs, with the former having more favourable results. The study indicates that workplace-based prevention and rehabilitation programs with a broad change strategy and high levels of management and employee involvement can apply to small public sector workplaces.

This article presents results from a survey aimed at identifying the extent of alcohol prevention efforts in Swedish workplaces focusing on the dissemination of a model for secondary prevention — the ‘Risk Drinking model’. From a random sample of 929 human resource managers at Swedish workplaces, 374 answered a web-based questionnaire (response rate = 40%). Results showed that about 70% had an alcohol policy at their workplace, 51% were engaged in alcohol prevention efforts and about 19% used the Risk Drinking model. Regression analyses showed that large workplaces, workplaces where employees received training on alcohol, public sector and female-dominated workplaces were significantly associated with alcohol prevention activities. We conclude that training is important for the implementation of alcohol prevention at Swedish workplaces, and is of particular importance in small enterprises.