Thulesius Hans O, Grahn Birgitta E
Department of Clinical Sciences Malmö, Division of Family Medicine, Lund University, Sweden.
BMC Health Serv Res. 2007 Jul 3;7:100. doi: 10.1186/1472-6963-7-100.
Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave.
We used classic grounded theory for analyzing data from >130 interviews with people working or on sick leave, physicians, social security officers, and literature. Several hundreds of typed and handwritten memos were the basis for writing up the theory.
In this paper we present a theory of work incentives and how to deal with work absence. We suggest that work disability can be seen as hurt work drivers or people caught in mode traps. Work drivers are specified as work capacities + work incentives, monetary and non-monetary. Also, people can get trapped in certain modes of behavior through changed capacities or incentives, or by inertia. Different modes have different drivers and these can trap the individual from reincentivizing, ie from going back to work or go on working. Hurt drivers and mode traps are recognized by driver assessments done on several different levels. Mode driver calculations are done by the worker. Then follows employer, physician, and social insurance officer assessments. Also, driver assessments are done on the macro level by legislators and other stakeholders. Reincentivizing is done by different repair strategies for hurt work drivers such as body repair, self repair, work-place repair, rehumanizing, controlling sick leave insurance, and strengthening monetary work incentives. Combinations of these driver repair strategies also do release people from mode traps.
Reincentivizing is about recognizing hurt work drivers and mode traps followed by repairing and releasing the same drivers and traps. Reincentivizing aims at explaining what is going on when work absence is dealt with and the theory may add to social psychological research on work and work absence, and possibly inform sick leave policies.
工作能力与疾病概念之间的关联较弱，而疾病概念又不足以解释病假行为。我们的数据主要来自瑞典，这是一个病假缺勤率较高的福利国家，我们的目标是建立一种解释性理论，以理解和应对工作缺勤和病假情况。
我们运用经典的扎根理论，分析了对在职或休病假人员、医生、社会保障官员的130多次访谈数据以及相关文献。数百份打印和手写的备忘录是撰写该理论的基础。
在本文中，我们提出了一种关于工作激励以及如何应对工作缺勤的理论。我们认为，工作能力丧失可被视为工作驱动力受损或陷入行为模式陷阱的人。工作驱动力具体定义为工作能力加上货币和非货币的工作激励。此外，人们可能会因能力或激励的变化，或因惯性而陷入某些行为模式。不同的模式有不同的驱动力，这些驱动力可能会使个体无法重新获得激励，即无法重返工作岗位或继续工作。通过在几个不同层面进行的驱动力评估，可以识别出受损的驱动力和模式陷阱。模式驱动力的计算由员工完成。随后是雇主、医生和社会保险官员的评估。此外，立法者和其他利益相关者会在宏观层面进行驱动力评估。对于受损的工作驱动力，可通过不同的修复策略进行重新激励，如身体修复、自我修复、工作场所修复、人性化、控制病假保险以及强化货币工作激励。这些驱动力修复策略的组合也能使人们摆脱模式陷阱。
重新激励就是要识别受损的工作驱动力和模式陷阱，然后修复并消除这些驱动力和陷阱。重新激励旨在解释在处理工作缺勤时所发生事情的原因，该理论可能会丰富关于工作和工作缺勤的社会心理学研究，并可能为病假政策提供参考。
