Towards a parsimonious program theory of return to work intervention.

Area of Science:

• Occupational Health
• Psychology
• Sociology

Background:

• Return to work (RTW) is a complex process influenced by various individual and workplace factors.
• Existing theories often focus on risk factors rather than salutogenic (health-promoting) aspects.
• Understanding the determinants of successful RTW is crucial for public health and workplace interventions.

Purpose of the Study:

• To present a salutogenic theory of return to work (RTW).
• To identify prognostic factors influencing RTW among employees on sick leave.
• To propose an ecological model integrating health promotion for RTW.

Main Methods:

• Longitudinal, non-randomized study design with baseline data from an intervention study.
• Participants included 118 unskilled Danish public employees and house-cleaners on sick leave.
• Data analyzed to identify factors influencing RTW after one year follow-up.

Main Results:

• High work ability, social support from colleagues, and self-efficacy significantly promote RTW.
• Active coping style and a strong Sense of Coherence (SOC) increase RTW.
• Over-commitment and hostility were found to decrease RTW; work ability and active coping mediate health and stress associations.

Conclusions:

• Work ability, reflecting comprehensibility, meaningfulness, and manageability, is decisive for RTW intention.
• Personal outlook, attitudes, and workplace interactions influence work ability and RTW.
• An ecological theory integrating health promotion is proposed for future intervention and validation.