Factors relevant to a return to work: a multivariate approach

This paper contributes to the understanding of the factors that are significant for returning to work, and identifies factors that might be used early on in a period of sick leave to discern whether people are likely to work again. In the design, the multivariate Partial Least Squares (PLS) of Latent Structures method was used to analyse information from a questionnaire containing socio-demographic items, and information on symptoms, consequences on daily life, expectations and psychosocial factors. Data about the incidence of sickness over a four-year period was included. 121 adults aged 18-64 years on sick leave participated, irrespective of their diagnoses. A reliable prediction of a return to work required the combination of many factors: individual psychosocial instruments are not useful when considered in isolation. The strongest predictive factors for a return to work concern the individuals' expectations, the number of days of sick leave taken in the past, somatic disorders, and a high level of life satisfaction and sense of coherence. Many factors influence the outcome for people on sick leave: PLS analysis demonstrated that a multivariate approach using this method could predict the long-term outcome early on in a period of sick leave.     

A new model for vocational rehabilitation at an organizational level -- a pilot study with promising results

Sick leave has negative economic consequences for companies. The aim of this study was to implement the model Organizational Rehabilitation in two departments at an industrial company in the county of J?mtland, Sweden, to see if it was possible to reduce the costs due to sick leave. The rehabilitation model consisted of three steps and combined economy and productivity with a good psychosocial work environment, measuring the result in costs. Step 1 consisted of a problem inventory among all co-workers, step 2 semi structured interviews with all co-workers regarding how they experience their work environment and step 3 individual agreements regarding rehabilitation interventions, i.e. interventions where the individual's specific needs and wishes outlined the foundation for rehabilitation measures with the objective of increasing work capacity. The costs were measured at the start and end of the project. The study showed that it is indeed possible to reduce both sick leave and costs. During the study, the organization reduced current sick leave from 12% (2003) to 3% (Nov. 2004) and the costs per employee from euro1 860 per month (2003) to euro440 per month (Nov. 2004). This will make an estimated saving for 2005 of euro470 000. It should be noted that the study is small and should not be generalized, but may be seen as a positive indication regarding the model organizational rehabilitation. Further research is needed.     

Significant resources needed for return to work after sick leave

There are increasing numbers of people on long-term sick leave, especially with stress-related ill health and musculoskeletal disorders. The main purpose of this study is to, early on in the sick leave, find predictors of individual resources for a return to work. The study group consists of women and men on sick leave compared with reference groups of healthy persons. A questionnaire was used regarding diagnosis given on the doctor's certificate, self-reported symptoms, residential area, education, and kind of work. It also contained open questions about consequences in daily life and beliefs about future. Checklists concerning life satisfaction, sense of coherence, locus of control, coping resources and sick leave information over a four-year period have been used. Significant differences between the study group and the reference groups were found, relating to sense of coherence, locus of control, life satisfaction and coping resources. More than half of the study group were still on sick leave at a two-year follow-up. Important predictive factors turned out to be: previous sick leave, own belief about future and self-reported symptoms.     

Self-reported musculoskeletal pain and working conditions among employees in the Swedish public sector

Musculoskeletal disorders constitute a considerable public health problem, often resulting in sickness absence, particularly in public sector employees. Increased knowledge on how this is related to individual and work-related factors is required. The objective of this study was to investigate the associations between self-reported musculoskeletal pain and the following factors: physical and psychosocial work conditions, lifestyle, psychosomatic symptoms and sick leave. A comprehensive questionnaire was completed by a total of 2523 people, of which 87% were women and 13% men. The participants were employed in public hospitals, educational institutions, home care services for the elderly and domestic/catering services in a Swedish county. The response rate was 92%. Multiple logistic regression analyses showed that the high level of self-reported musculoskeletal pain was highly associated with strenuous physical and psychosocial work conditions. The physical factor with the highest odds ratio (OR) was working in a forward-bent position. High work demands was the most prominent psychosocial factor and distinctly associated with musculoskeletal pain among men. Physical work strain and other demanding working conditions, which were associated with musculoskeletal pain, were frequent among employees in home care services for the elderly and domestic/catering services. There was a strong association between long-term sick leave and high musculoskeletal pain. Furthermore, there was a strong association between a high level of musculoskeletal pain and the exhibition of psychosomatic symptoms in both women and men; this is an interaction that may intensify the total experience of illness and thus needs to be further investigated.     

Individual status at the start of rehabilitation: Implications for vocational rehabilitation programs

This research investigated the situation of 143 unemployed sick leavers at the start of vocational rehabilitation in Sweden. It is argued in this paper that in order to gain a meaningful picture of the vocational rehabilitation process it is necessary to know and understand something of individual differences and status at the onset. In doing so, assessment was carried out of the possible influence of one contextual factor and five individual factors on health, duration of sick leave and unemployment. Findings suggest that individual differences exist in health status, length of sick leave and unemployment, at the upstart of vocational rehabilitating. Locus of control was found to exert important influence on the differences between the individuals in the study sample, with persons of external locus of control having a less favourable point of departure at the start of vocational rehabilitation compared to other groups. It is therefore assumed that these persons will be in greater need of support during the vocational rehabilitation process. The level of unemployment within a geographical area was also found to influence the length of sick leave. CONCLUSIONS: Our suggestion is for rehabilitation programs to be developed and selected to match the special needs and differences whether they are of individual or of social nature.     

Sick leave -- Cushion or entitlement? A study of age cohorts' attitudes and practices in two Australian workplaces

Stereotypes of older people suggest that they may experience more sickness and injury therefore may not be as productive as younger employees. The present paper attempts to test these stereotypes and reports research into patterns of sick leave in different age cohorts and attitudes towards the use of sick leave. The research was carried out at two case study sites. Managers were interviewed and focus groups were held with workers. A complex pattern was found, suggesting structural issues such as sick leave entitlements, workplace organisation, and flexible work patterns interacted with managers' and workers' attitudes, age, gender and family responsibilities. Flexible workplace hours, and part payment for unused sick leave and insecurity of employment appeared as important factors in reducing absenteeism. The most striking finding was that older workers past pensionable age took the least sick leave. Older workers were careful to conserve sick leave as a 'cushion' for serious illness. Workplace pressures especially those resulting from the failure of management to replace absent workers resulted in work pressure on peers and thus reluctance of workers to take leave.     

A comprehensive workplace intervention and its outcome with regard to lifestyle, health and sick leave: the AHA study

This study is a prospective multicentre cohort study entitled Work and Health in the Processing and Engineering Industries, the AHA Study (AHA is the Swedish abbreviation for the study). Four large workplaces in Sweden participated during the years from 2000 to 2003. The present report has two objectives: (1) to present a comprehensive occupational health intervention programme and (2) to evaluate this programme with a focus on lifestyle (smoking and exercise), health related quality of life (HRQoL) and sick leave. Interventions were provided on an individual and group level, including evidence-based methods for four health/focus areas (individual level) and a group intervention based on a survey-feedback methodology. The analyses in this report were exclusively employed at an organizational level. The proportion of smokers decreased at three companies and the course of the HRQoL was advantageous at two of the companies as compared to a gainfully employed reference group. A significant decrease in sick leave was revealed at one company, whereas a break in an ascending sick-leave trend appeared at a second company as compared to their respective corporate groups. This comprehensive workplace intervention programme appears to have had positive effects on smoking habits, HRQoL and sick leave.     

Intentions to leave supervision among social work supervisors: contributing factors

The study shows the evolution of intentions to leave supervision among students’ supervisors in their first year of supervision. A total of 168 social work supervisors in 10 academic institutions in Israel, during their first year of supervision, answered the questionnaires at the beginning (October 2014) and end (June 2015) of their supervisors training course. The findings indicate that the most powerful predictor of intentions to leave supervision at T2 was intentions to leave supervision at T1. This interesting finding shows that the supervision course does not necessarily address the issue of long-term commitment to supervision, and it is crucial that more attention be paid to this issue. Furthermore, we also found a significant contribution of organizational climate at T1 and of role overload at T2. Practical implications challenge the current structure of supervision courses, in order to encourage students’ supervisors to retain their supervisory role over time.     

Can Family Policy Reduce Mothers’ Sick Leave Absence? A Causal Analysis of the Norwegian Paternity Leave Reform

This paper was motivated by the high absentee rate due to sickness among women and the assumption that mothers’ combination of gainful employment and family obligations may results in higher levels of sick leave absence. One popular policy used in Norway to encourage more equal sharing of domestic work between parents is paternity leave. Using Norwegian register data, we took advantage of the introduction of a Norwegian paternity leave reform in 1993 to empirically examine the importance of fathers’ involvement in childcare an attempt to explain the relationship between mothers’ stress in reconciling their work and family life and sick leave absence. Sick leave absence was measured in the number of days paid by the National Insurance Administration at 15 days and above. The reform raised the total leave period by 7 weeks, but reserved 4 weeks for the father. The reform process was fast, so all mothers were already pregnant at the time of the policy announcement. The results indicate that we can reject an effect of the paternity leave reform on mothers’ sick leave absence.     

RELIGIOUS REFERENCE GROUPS AND THE PERSISTENCE OF NORMATIVE BEHAVIOR: AN EMPIRICAL TEST

Reference groups and significant others are vitally important in both the formation and the persistence or change of normative as well as deviant behavior patterns. Thus one's initial religious beliefs and behavior (or lack thereof) reflect the socializing influence of the family. However, the situation may change when young people leave home for education or work, as demonstrated by research that shows decreases in religious beliefs or church attendance when young people leave home to attend college. In contrast to the pattern whereby religiosity declines in a college or university environment, we maintain that students who develop close ties with others who are religious, especially in a highly religious community, will maintain the same patterns of high commitment developed in their families. Specifically, we hypothesize that religious beliefs and participation will be positively related to (1) parents' religious beliefs and practices and (2) current friends' religious beliefs and participation. These hypotheses were tested with a sample of college students living on campus (n = 339). The data support the argument that students' current religious beliefs and behavior are related to both their parents' religiosity and the reinforcing effects of the religiosity of their current friends.     

Preferences,constraints or schemas of devotion? Exploring Norwegian mothers' withdrawals from high‐commitment careers1

Despite decades of focus on gender equality and work–family balance, parenthood still affects mothers' and fathers' careers differently. Drawing on in‐depth interviews with Norwegian mothers who are relinquishing high‐commitment careers of law and consultancy, this paper questions the adequacy of established explanations emphasizing constraints vs. individual preferences. Our sample of female professionals living in a well‐developed welfare state is particularly apt to explore the processes and mechanisms upholding the statistically gendered pattern of women reducing their work commitment after childbirth. These doubly privileged mothers might be considered to have the best odds for combining career and work commitment with motherhood. Thus, we argue that the approach emphasizing practical constraints does not sufficiently account for the withdrawal from high‐commitment careers among these female professionals. Nevertheless, we are not content with the claim of Preference Theory that this shift in commitment is merely a matter of ‘not‐so‐dedicated’ women discovering their ‘genuine’ preferences. Rather, in order to understand why and how this shift occurs, we explore the culturally constructed rationalities and schemas of both work and family devotions. We specifically examine the circumstances, mechanisms and steps in a seemingly individual process of making the shift in commitment from a promising career to a family‐friendly job. Moreover, the analysis demonstrates how generous parental leave arrangements designed to enhance gender equality and work–family balance by simply reducing practical constraints may have limited – or even counterproductive – impact within high‐commitment occupations where the ‘irreplaceability’ of workers is taken for granted. Our findings indicate that unless the culturally (re)produced discourses, demands and expectations of both work and family are exposed and challenged, even intentionally gender neutral work–family policies will continue to facilitate mothers' career withdrawals, expressed as modified individual preferences.     

Work-related factors contributing to chronic disability in low back pain

Low back pain is a costly and incapacitating musculoskeletal disorder. Prospective studies documenting the capacity of work-related factors to predict chronicity are few in number, the methodology used is very diversified, and the results obtained diverge. The aim of the present study is to investigate the capacity of work-related objective (non-psychosocial) and psychosocial factors to predict chronic disability related to low back pain. A longitudinal prospective study with two measurement times was carried out. The sample (N = 258) consisted of workers with subacute low back pain who were on sick leave and receiving compensation from the CSST (Quebec Workers' Compensation Board). Of all the work-related variables measured, perceived stress and fears and beliefs about work were associated with return to work status at the six-month follow-up. The results obtained show the importance of considering fears and beliefs about work when identifying people in the subacute phase of low back pain who are at risk of developing chronic disability.     

Maternal Work Absence: A Longitudinal Study of Language Impairment and Behavior Problems in Preschool Children

Combining work and family responsibilities is challenging when children have special needs, and mothers commonly make employment‐related adjustments. In this study, the authors examined associations between maternal work absence and child language impairment and behavior problems in preschool children. Questionnaire data at child age 3 years from 33,778 mothers participating in the prospective population‐based Norwegian Mother and Child Cohort Study were linked to national register data on employment and long‐term physician‐certified sick leave at child age 3–5 years. Mothers who reported having a child with language impairment had a consistently higher risk of not being employed and were at increased risk of taking long‐term sick leave at child age 5 years. Co‐occurring problems were associated with excess risk. Language impairments in preschool children, in particular when they are co‐occurring with behavior problems, are likely to have a range of negative short‐ and long‐term consequences for the financial and overall health and well‐being of mothers and their families.     

Violence towards caregivers of persons with developmental disabilities

OBJECTIVE: Violent and disruptive acts committed by persons with developmental disabilities are a potential work environment problem for caregivers. This study developed and tested an instrument for describing and analyzing violence among persons with developmental disabilities. METHODS: Personnel from four units of one facility recorded daily on a simple form all violent and disruptive acts occurring in a limited range of situations. RESULTS: Acts of violence were associated with a small minority of individuals, but grossly underreported and unrecognized in formal reporting systems. None of the nearly 3000 incidents recorded during the six-week study required sick leave. Violent and disruptive acts occurred most often when an individual was requested to do something he or she did not want to do, when the individual was denied the opportunity to do something they did want to do and when waiting or under-stimulated. Personnel used the data in discussing countermeasures that could be integrated with the care and treatment of the individual. CONCLUSION: Hitting, kicking, pinching etc. of personnel are a work environment problem due to their high frequency and effects upon employee morale. The instrument and procedures can be used to reduce incidents of violence, which would improve the working environment of employees and assist persons with developmental disabilities as they move from institutional environments.     

‘Family Friendly’ Employment Policies: A Route to Changing Organizational Culture or Playing About at the Margins?

Formal ‘family friendly’ policies, including flexible or reduced hours of work and periods of leave, designed to help employees to balance work and family demands have the potential to challenge traditional models of work and organizational values. However, while these policies can reduce stress for individual employees, it is argued that there is less evidence of widespread organizational culture change. This paper draws on case studies of organizations at various stages of developing ‘family friendly’ policies to identify two barriers to fundamental shifts in organizational culture; low sense of entitlement to consideration of family needs, and organizational discourses of time as representing productivity, commitment and value. Some conditions under which broader culture change may be achieved are explored.     

The experience of returning to work

The purpose of this qualitative study was to explore from an environmental perspective the experiences of returning to work of former unemployed sickness absentees. Five separate focus-group interviews were carried out with themes concerning different environmental areas. The findings showed that the participants in their process of being off work and then attempting returning to work experienced a personal transition manifesting itself as a negative self-image, change of life-rhythm and restrictions in their roles and activities. In their progression, the participants experienced a need for reorientation and expressed feelings of alienation, and for that reason felt need of support from a network, especially a professional one. Regarding attitudes in society, the participants reported experiences of social stigmatization, both in mass media and in their immediate social environment, and an increasing egocentricity among their fellow-workers. They perceived their progression back to work as a 'time quarantine' and as a long and destructive wait for support. The findings indicate that the phenomenon of 'returning to work' after unemployment and sick leave could not be reduced to a single issue. It should rather be seen as a dynamic problem with individual and structural, environmental aspects.     

Ethnic Identity and Psychosocial Functioning in Navajo Adolescents

The current study assessed associations among theoretically driven measures of ethnic identity and psychosocial adjustment among 137 Navajo adolescents. For both sexes, measures of students' sense of affirmation and belonging to their ethnic heritage emerged as a strong predictor of positive psychosocial functioning. Less-consistent patterns of association emerged between other measures of ethnic identity and psychosocial adjustment. Students with achieved ethnic identity status, characterized by high levels of exploration of their ethnic heritage and high levels of affirmation or commitment to their Navajo culture, reported the most positive functioning on several measures. Interesting interactions with biological sex suggested that ethnic identity may function differently for male and female Navajo adolescents. Implications of results for educators, parents, and policy makers are discussed.     

An Interpersonal Influence Model of Traditional Religious Commitment*

Typically, explanations of traditional religious commitment have relied on economic deprivation or sociodemographic variables. An alternative explanation was developed based on social control and participation in the activities of the congregation. It was predicted that the most important determinant of individual religious commitment would be denominational affiliation; the denomination establishes the expectations with regard to religious belief. It was also predicted that social participation variables, which determine the extent to which the individual is integrated into the congregation, would also be important. Testing the model with data broadly representative of the Protestant churchgoing population, it was found that denominational affiliation, church attendance and intra-congregational friendships were generally the three most important predictors of three traditional religious commitment measures. Other variables—education, occupation, gender, age and region of birth—made insignificant or small contributions to explained variance.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

The psychosocial benefits of work for people with severe and enduring mental health problems

Perceptions of the value of work for people with severe and enduring mental health problems have changed frequently over the last two decades. With the new social inclusion agenda manifest in the Disability Discrimination Act and in the NHS modernization agenda, work is once again in vogue. There is a need for a way of evaluating work which draws on its potential contribution to psychological well-being as well as its provision of a valued social role and which is less susceptible to fluctuations in health and social policy. Jahoda's work on the psychosocial functions of work provides such a framework and this study sets out to explore its utility among workers who are severely disabled by mental health problems. Twelve of the psychosocial functions of work were rated by 50 people attending two sheltered work placements according to how important they were perceived to be and the extent to which the functions were fulfilled through their attendance. Satisfaction of the psychosocial functions through work was compared with their satisfaction through other aspects of the respondents’ lives. All functions were perceived as important, but self-confidence/self-esteem was rated as more important than most of the others. Structure to the day, self-confidence and social contact were better satisfied through work than were decision making, practising old skills and having goals to aim for. In general, the results showed that the functions were fulfilled better by work than by other aspects of the respondents’ lives. The study supports the notion that work is of value in the rehabilitation of people with severe and enduring mental health problems and offers a possible framework for the further exploration of this theme, both within mental health services and the community at large.