Self-perceived barriers to returning to work among employees with a low educational level on long-term sick leave: the "NOW WHAT" large-scale interview study.

Abstract

Objective: Because employees with low educational levels have the highest rates of sick leave, this study aimed to identify the self-perceived return-to-work barriers of employees with low educational levels on long-term sick leave.

Methods: Employees on long-term sick leave with primary/secondary educational attainment were included from the NOW WHAT large-scale interview study (n = 122). The World Health Organization's system of classifying functioning, disability, and health guided the deductive content analysis.

Results: 1,942 meaning units describing return-to-work barriers across all classifications were identified. The most frequent components were body functions (n = 552, 28%, mean = 4.5), with mental functions (e.g., sleep, tiredness, emotional and cognitive functioning) the most frequent barriers; environmental factors (n = 414, 21%, mean = 3.4), with services, systems ,and policies (e.g., social security, healthcare system) the most prevalent barriers; activity limitations (n = 352, 18%, mean = 2.9); and personal factors (n = 323, 17%, mean = 2.6).

Conclusion: Employees with low educational levels on long-term sick leave described a wide range of return-to-work barriers and combinations thereof. In addition to health-related functional barriers, identifying environmental, activity-limitation, and personal barriers is important to enhance understanding of this group's potential determinants of absence from work.