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Barriers and facilitators to return to work

Barriers to return to work

Medical or rehabilitation barriers

  • Worker's fears and beliefs about their condition
  • Worker's fears and beliefs about the impact of re-entry to the workplace on their health
  • When the patient attributes the cause of the illness or injury to the workplace
  • The health provider fails to accurately represent the clinical situation to the insurer or employer

Workplace barriers

  • When there are multiple previous episodes of absence, and when periods of absence are lengthy
  • Low or inadequate support from supervisors and colleagues
  • Stressful work and low job satisfaction
  • High psychological job demands
  • Lack of availability of modified work
  • Physical job characteristics
  • Demographic factors

Individual worker (psychosocial) barriers

  • Older or increasing age
  • Inability to adapt to injury-related impairments and accept changes in occupational activities or new job skills
  • Negative expectations about the injury, and prospects for recovery and/ or return to work
  • When the self-rated symptoms are severe

Facilitators to return to work

Medical or rehabilitation facilitators

  • Advising the patient to continue usual activities as normally as possible despite pain
  • Communication, cooperation and establishing common agreed goals between the injured worker, health providers, supervisors and management
  • Promotion of self-responsibility and self-care
  • Providing evidence based treatment
  • Early intervention
  • Multidisciplinary rehabilitation, including a workplace visit or more comprehensive occupational health care intervention [1]
  • Promoting return to work at an appropriate stage
  • Incorporating return to work goals and timelines into treatment from the outset [2]
  • Providing the worker with a realistic and accurate understanding of their condition and expected recovery [3]

Workplace facilitators

  • Providing modified jobs in the workplace to accommodate workers
  • Contact by the medical practitioner with the workplace and /or workplace rehabilitation provider [4]
  • High support by supervisors and co-workers
  • Worker has control over work and rest periods

Individual worker (psychosocial) facilitators

  • Positive role models to encourage the worker
  • When the worker has a positive expectation about their recovery and ability to manage at work
  • When the worker has access to social supports, ie, friends and family

In 2006, WorkCoverSA commissioned LaTrobe University to undertake a literature review of research into facilitators and barriers to return to work. For more information on barriers and facilitators, access the full review: Facilitators and barriers to return to work: A literature review [5].

References

  1. Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, et al. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults. Cochrane Database Syst Rev 2003(2):CD002193.
  2. Cotton P. Occupational wellbeing: Management of injured workers with psychosocial barriers. Australian Family Physician 2006;35(12):958 - 61.
  3. Sullivan MJ, Ward LC, Tripp D, French DJ, Adams H, Stanish WD. Secondary prevention of work disability: community-based psychosocial intervention for musculoskeletal disorders. J Occup Rehabil 2005 Sep;15(3):377-92.
  4. Kosny A, Franche RL, Pole J, Krause N, Cote P, Mustard C. Early healthcare provider communication with patients and their workplace following a lost-time claim for an occupational musculoskeletal injury. J Occup Rehabil 2006 Mar;16(1):27-39.
  5. Foreman P, Murphy G, Swerissen H. Facilitators and barriers to return to work: A literature review. Melbourne: Australian Institute of Primary Care, LaTrobe University; 2006.