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

Abstract

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.