Landstad Bodil J, Wendelborg Christian, Hedlund Marianne
Department of Health Sciences, Mid Sweden University, Ostersund, Sweden.
Disabil Rehabil. 2009;31(15):1215-26. doi: 10.1080/09638280802510999.
This study investigates factors that will affect the chances of long-term sick workers returning to work.
The study is based on a representative sample of persons with mental illnesses and musculoskeletal disorders who received a rehabilitation allowance in Norway in 2002. Their occupational status in 2005 and experiences from the rehabilitation process were charted through their responses to a questionnaire in combination with national register data. Our analytical framework is based on three domains: the medical domain, the domain of authoritative bodies and the production domain (working life), as described by Lindqvist (Att sätta gränser: organisationer och reformer i arbetsrehabiliteringen. Umeå: Boréa; 2000).
Our main findings are that earlier work experience, age and other members in household, in addition, to influence over one's own rehabilitation process explains whether workers on long-term sick leave return to work. Furthermore, individual factors such as gender and diagnosis (i.e. musculoskeletal disorder and mental illness) do not explain the probability to return to work. Experience and contact with representatives of the medical, the authoritative bodies and the production domain only explain to a small extent the probability to return to work. It is even interesting to note that regular contact with the social insurance office (SIO) has a negative effect on the probability to return to work. This may indicate that contact with the SIO subjects sick workers to a risk of developing a 'social insurance career' to secure their income.
The findings show that the medical, the authoritative bodies and the production domain might represent different logics that can pull a sick worker in different directions during the rehabilitation process. However, these different logics do not fully explain, which outcome a rehabilitation process takes. It is important to extend the analysis to include how the individuals respond to these logics during the rehabilitation process.
本研究调查影响长期患病工人重返工作岗位几率的因素。
该研究基于2002年在挪威领取康复津贴的患有精神疾病和肌肉骨骼疾病人员的代表性样本。通过他们对问卷的回答以及国家登记数据,记录了他们在2005年的职业状况和康复过程中的经历。我们的分析框架基于三个领域:医学领域、权威机构领域和生产领域(工作生活),如林德奎斯特所描述的(《设定界限:工作康复中的组织与改革》。于默奥:博雷亚;2000年)。
我们的主要发现是,除了对自身康复过程的影响外,早期工作经历、年龄和家庭中的其他成员能够解释长期病假工人是否重返工作岗位。此外,性别和诊断(即肌肉骨骼疾病和精神疾病)等个体因素并不能解释重返工作岗位的可能性。与医学、权威机构和生产领域代表的经历及接触在很大程度上只能解释重返工作岗位的可能性。甚至有趣的是,与社会保险办公室(SIO)的定期接触对重返工作岗位的可能性有负面影响。这可能表明与SIO接触会使患病工人面临发展“社会保险职业”以保障其收入的风险。
研究结果表明,医学、权威机构和生产领域可能代表不同的逻辑,在康复过程中可能将患病工人拉向不同方向。然而,这些不同的逻辑并不能完全解释康复过程会产生何种结果。重要的是将分析扩展到包括个体在康复过程中如何应对这些逻辑。