A qualitative study of perpetuating factors for long term sick leave and promoting factors for return to work: chronic work disabled patients in their own words.

OBJECTIVE Chronic work disability generates high financial costs for society and causes personal suffering to patients and their families; however, crucial knowledge about the factors associated with long-term sick leave is still missing. This study provides insight, from the perspective of chronic work disabled patients, into the perpetuating factors for long-term sick leave and promoting factors for return to work. PATIENTS AND METHODS Five focus group interviews were conducted with 27 patients with different disorders who had been on long-term sickness absence (18 months or more). Qualitative data analysis was performed using a conceptual framework to identify barriers and enablers for return to work. RESULTS Four main themes of important perpetuating factors for long-term sick leave were identified: health-related obstacles, personal obstacles, social obstacles, and work-related obstacles. Four main themes of important promoting factors for return to work were identified: favourable working conditions, positive personal characteristics of the employee, the influence of the social environment, and the influence of the personal economic situation. CONCLUSION Besides sickness, several non-medical factors are recognized barriers for return to work. Factors such as illness perceptions and self-efficacy expectations are reported to be promoting factors for return to work.