Introduction In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee’s health and participation in labour. Methods We performed a keyword search (systematic literature review) in seven databases (period: 1994–2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Results Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Conclusions Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.

BackgroundReturn to work (RTW) after sick leave is considered necessary to support the employees’ health. Cooperation between employees and employers may encourage employees’ RTW, but is hampered by bottlenecks that we do not completely understand. Dutch legislation means to support this cooperation and allows trying RTW during two years. The Resource Dependence Institutional Cooperation (RDIC) model has been developed for studying cooperation in public health. Study aims were to get insight into the degree of cooperation between Dutch sick-listed employees and employers, how this (lack of) cooperation can be understood, and how valid the RDIC model is for understanding this (lack of) cooperation.MethodsThis qualitative study was based on in-depth interviews with 8 employees and 8 employers. Employees reported sick for 1.5-20 months for various reasons. Interviews were analysed using an interpretative approach and pattern matching.ResultsCooperation was lacking early during sick leave. Later on there were regular meetings, but employers decided about RTW without consulting the employees. Particularly employers were motivated to cooperate during the first year, while employees were especially motivated during the second. This could be understood by experienced dependence; employees (first year) and employers (second year) did not consider cooperation to be important for achieving medical recovery (employees) or RTW (employers). These divergent goals may be understood by personal norms about the timing of medical recovery and RTW. Legislation was particularly effective regarding employer behaviour in year 1 and employee behaviour in year 2. Employees distrusted their employers during the first year, while employers reported to distrust the employees during the second year. Besides, employees and employers experienced a moderate ability to cooperate. This could be understood particularly by having moderate knowledge about legislation. The RDIC model appeared to be valid to understand the cases studied, but the additional factor distrust also played a role.ConclusionsLegislation appeared to support cooperation, but awareness of a mutual dependence, trust, knowledge about the legislation and personal norms regarding recovery and RTW are also important. Professionals such as occupational physicians should support this to attain a degree of cooperation that is necessary for effective RTW.

BACKGROUND: Occupational health professionals such as occupational physicians (OPs) increasingly understand that in addition to health improvement, environmental factors (such as work adaptations) and personal factors (such as an employee's attitude towards return-to-work (RTW)) may stimulate employees on sick leave to return to work early. To target their professional interventions more specifically according to these factors, occupational health professionals need further insight into environmental and personal factors that stimulate RTW. OBJECTIVE: The objectives of this study are (1) to identify which and how environmental and personal factors support early RTW, and (2) to examine whether the International Classification of Functioning, Disability and Health (ICF) can be used to describe these factors. METHODS: We performed interviews with 14 employees, 15 employers and 4 OPs from multiple organisations with varying organisational sizes and types of industry such as healthcare and education. We used a qualitative data analysis partially based on the Qualitative Analysis Guide of Leuven. RESULTS:The following environmental factors were found to support early RTW: 'social support from relatives', 'belief that work stimulates health', 'adequate cooperation between stakeholders in RTW' (e.g. employees, employers and OPs) and 'the employers' communicative skills'. One personal factor stimulated RTW: 'positive perception of the working situation' (e.g. enjoyment of work). Most factors stimulated RTW directly. In addition, adequate treatment and social support stimulated medical recovery. Environmental factors can either fully (social support, belief that RTW stimulates health), partially (effective cooperation), or not (employers' communicative skills) be described using ICF codes. The personal factor could not be classified because the ICF does not contain codes for personal factors. CONCLUSIONS: RTW interventions should aim at the environmental and personal factors mentioned above. Professionals can use the ICF to describe most environmental factors.

Extensive evidence indicates that burnout can have detrimental consequences for individuals as well as organizations; therefore, there is a great need for burnout prevention. While burnout prevention interventions initiated by the employer have previously been studied, the proactive behaviors employees deploy themselves to prevent burnout have received less research attention. The purpose of this exploratory qualitative interview study was to enhance our understanding of the self-initiated actions employees undertake to prevent burnout, using the model of proactive motivation and conservation of resources theory as theoretical frameworks. Findings indicated that most participants reported to engage in specific kinds of proactive burnout prevention behaviors. The reported self-initiated proactive actions were aimed at maintaining and/or increasing resources and/or reducing demands in the work, home, and personal domain. The study contributes to the literature by linking the proactive motivation process to the prevention of burnout and by focusing on both work and non-work factors. Results of this study can be used in further research into the (effectiveness of) employees’ proactive burnout prevention behaviors and serve as a starting point for developing interventions aimed at enhancing proactive burnout prevention.

BACKGROUND: To achieve adequate return to work (RTW) after sickness absence, Dutch legislation prescribes cooperation between absent employees and employers. Yet, we lack insight into how employees with low levels of education exercise influence over (i.e. self-direct) RTW. OBJECTIVE: This study aimed to enhance our understanding of: A) the role that employers play in the self-direction of employees with low levels of education over their RTW, B) how employers perceive these employees’ efforts (or lack thereof) to self-direct their own RTW, and how employers understand and interpret the behaviours of these employees. Social cognitive theory served as a framework. METHODS: A qualitative study was conducted with 13 employer representatives using semi-structured interviews. Data were analysed in NVivo12 using a template approach. RESULTS: Employers tend to play a guiding, directive role in employees’ RTW. According to employers, employees generally comply with the employers’ decisions and suggestions, whether or not they have tried to realise their own preferences regarding mode and timing of RTW. Employers interpret such employee behaviours from the perspective of environmental (e.g. financial pressures to RTW) and person-related factors (e.g. sickness and RTW perceptions). CONCLUSIONS: Employers, rather than employees direct the employees’ RTW. Employers should give voice to employees and enable them to have more control over their RTW. Future research should acquire more insight in the employees’ perspective.