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Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.ORCID iD: 0000-0001-7346-1674
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2017 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 790Article in journal (Refereed) Published
Abstract [en]

Background: The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual’s ability to work. The aim of this study was to investigate clients’ experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. 

Methods: A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis.

Results: The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support.  2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development.

Conclusions: The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

Place, publisher, year, edition, pages
2017. Vol. 17, article id 790
Keywords [en]
Sick leave, vocational rehabilitation, motivational interviewing, cooperation, return-to-work, qualitative study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-328791DOI: 10.1186/s12889-017-4804-8ISI: 000412684800001PubMedID: 29017504OAI: oai:DiVA.org:uu-328791DiVA, id: diva2:1137649
Available from: 2017-08-31 Created: 2017-08-31 Last updated: 2018-01-19Bibliographically approved
In thesis
1. Self-efficacy, Vocational Rehabilitation and Transition to Work
Open this publication in new window or tab >>Self-efficacy, Vocational Rehabilitation and Transition to Work
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine the relationship between self-efficacy, individually tailored vocational rehabilitation and transition to work or studies.

Study I was a cross-sectional study based on questionnaire- and registry data, investigating whether factors related to sick leave predict self-efficacy in women on long-term sick leave (n= 337) due to pain and/or mental illness. General self-efficacy was low. Anxiety and depression were the strongest predictors for low self-efficacy.

Study II used longitudinal data from a randomised controlled trial, comprising partly the same women (n=401) as in Study I. Participants were allocated to either 1) assessment of multidisciplinary team and multimodal intervention (TEAM), 2) acceptance and commitment therapy (ACT), or 3) control group. Self-efficacy increased in the TEAM group in comparison with the control group.

Study III had a descriptive qualitative design with individual interviews, studying participants’ (n=14) experiences with an individually tailored vocational rehabilitation project, and encounters with professionals working in it. The participants, who were on long-term sick leave due to mental illness or pain reported overall positive experiences with the project. The project was based on collaboration between authorities and motivational interviewing. The positive experiences were based on four categories: Opportunities for receiving various dimensions of support, Good overall treatment by the professionals, Satisfaction with the working methods of the project, and Opportunities for personal development.

Study IV was a prospective cohort study investigating perceived self-efficacy in unemployed young adults (n= 249) aged 19-29 year with disabilities, and the association between self-efficacy and transition to work or studies. The study used questionnaire- and registry data from a vocational rehabilitation project. Higher levels of self-efficacy were associated with increased odds for ‘transition to work’. General self-efficacy was low, and young adults with lower self-efficacy reported worse self-rated health compared with those with higher self-efficacy.

This thesis showed that multidisciplinary assessment with a multimodal intervention had positive effects on self-efficacy. Individually tailored vocational rehabilitation, based on cooperation and motivational interviewing, may be beneficial for individuals on long-term sick leave and the interactions between participants and the professionals may affect participants’ self-efficacy positively. Mental health needs to be considered when targeting self-efficacy in vocational rehabilitation. Furthermore, research is needed to a) clarify which components in the multidisciplinary team intervention can increase self-efficacy, b) study the effects of vocational rehabilitation based on an individual design, cooperation and motivational interviewing on self-efficacy, health and transition to work, and c) develop interventions that can increase self-efficacy and support transition to work/ studies in young adults with disabilities.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. p. 86
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1366
Keywords
Self-efficacy, Vocational Rehabilitation, Sick leave, Women, Multidisciplinary rehabilitation, Chronic pain, Mental illness, Motivational interviewing, Young adults, Disability, Unemployment
National Category
Medical and Health Sciences
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-328796 (URN)978-91-513-0059-7 (ISBN)
Public defence
2017-10-20, B/A1:111a, Biomedicinskt centrum, Uppsala Universitet, Husargatan 3, Uppsala, 12:15 (Swedish)
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Available from: 2017-09-28 Created: 2017-08-31 Last updated: 2018-01-18

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Andersén, ÅsaAnderzén, IngridKristiansson, PerLarsson, Kjerstin

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