A qualitative study into the perspectives of clients on shared decision-making as a method to support return to work

Being able to participate in work is an important determinant of health. Therefore, reintegration professionals provide support to clients to return to work (RTW). Since RTW has a significant impact on a client's life, it is preferred that clients are involved in the decision-making process of RTW. A method to do so, is shared decision-making (SDM), involving the following steps: collaborating as a team, explaining to clients that they can be part of the decision-making process, setting a shared goal, presenting and discussing choice options, and making a shared decision.

We explored how clients experience and prefer these SDM steps in their current and ideal interaction with professionals.

We performed semi-structured interviews with fourteen clients receiving support in their RTW process from four different municipalities.

Clients emphasised the importance of collaborating as team. None of the clients reported having been told that they could be part of the decision-making process, or discussed a shared goal with a professional, which they would prefer. Some clients were presented choice options. When choice options were discussed, frequently only the negative aspects of choice options were explained by the professional. A great number of clients experienced that shared decisions were made, but based this on the shared effort made by the client and professional to RTW.

Clients generally wish to cooperate and participate in the decision-making process, but their ability to do so is limited due to not being fully involved in the SDM steps.