Who Returns to Work? - Exploring the Role of Interpersonal Problems in Occupational Rehabilitation

2020

Background: Current interventions to facilitate return to work (RTW) after long-term sick leave

show weak effects, indicating the need for new approaches to the RTW process. The importance

of social relationships in the workplace is widely recognized in existing RTW literature, but

virtually no studies exist on the role played by the interpersonal problems of the returning

worker. Current research indicates that a subset of these – hostile-dominant interpersonal

problems – give particular disadvantages in several life areas.

Aims: This prospective cohort study aims is to test if (H1) higher levels of interpersonal

problems pre-admission predict lower likelihood of RTW in the year following occupational

rehabilitation, independently of symptom levels; if (H2) higher levels of hostile-dominant

interpersonal problems specifically predict such an effect; and whether (H3) any significant

associations found in H1 and H2 are weakened when controlling for changes in relational

impairment.

Methods: 189 patients on long-term sick leave completed a 3½-week transdiagnostic RTW

programme. Before treatment, self-reported interpersonal problems, relational impairment,

chronic pain, common psychological problems, insomnia and fatigue levels were collected. RTW

data for the following year was collected from the Norwegian Labour and Welfare

Administration.

Results: Three logistic regression analyses found that (H2) hostile-dominant interpersonal

problems significantly predicted RTW (AOR 0.618, 95% CI 0.41-0.93, p < .05), while (H1)

general interpersonal problems did not. (H3) Changes in relational impairment during the

rehabilitation stay had no impact on the strength of the relationship.

Conclusion: Hostile-dominant interpersonal problems negatively predict RTW after long-term

sick leave, indicating a potentially overlooked factor in the field of occupational rehabilitation.

The findings could help improve future research, intervention design and focus.

NTNU