Early-return-to-work in the context of an intensification of working life and changing employment relationships

J Occup Rehabil. 2015 Mar;25(1):74-85. doi: 10.1007/s10926-014-9526-5.


Purpose: Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy.

Methods: Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis.

Results: Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support-a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers' return-to-work, depending on how they valued the worker. While managers used the discourse of 'new opportunities' and 'healthy change' to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust.

Conclusions: In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Employment*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Organizational Policy
  • Personnel Management
  • Return to Work*
  • Sick Leave
  • Sweden