Self-perceived barriers to returning to work among employees with a low educational level on long-term sick leave: the "NOW WHAT" large-scale interview study.
Linn V Lervik, Elisabeth Frostestad, Kine Strømstad and 5 others
PMID 40375537WHAT IT FOUND
Employees with low education on long-term sick leave reported barriers far beyond their diagnosis.
They described mental fatigue, pain, and physical demands, but also cited struggling with welfare paperwork, waiting lists, and employers refusing to adjust work.
Key findings
01Participants most frequently identified body functions as barriers, specifically mental issues like sleep disturbance and tiredness, followed by pain and movement difficulties.
02Environmental barriers were highly prevalent, with participants describing struggles with social security forms, demanding application processes, and long waiting times for medical treatment.
03Activity limitations were commonly reported, particularly regarding major life areas such as being unable to perform physically heavy work tasks required by their jobs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was not fully representative and included more men than women, which may limit findings regarding barriers specific to female workers, such as work-family imbalance. Almost half of the participants had musculoskeletal disorders, so the findings may not generalize well to other diagnostic groups. Some participants were no longer on sick leave at the time of the interview, which could introduce recall bias. The study used a theory-driven analysis (ICF), which may have influenced which barriers were identified and how they were categorized.
Declared interests
The study was funded by the Norwegian Research Council and the Norwegian Labour and Welfare Administration. The authors declared no conflicts of interest, and the funding bodies had no role in the study design, data collection, analysis, or interpretation.
The easy way to misread this
Do not interpret the high frequency of mental function barriers as evidence that these patients have primary mental health diagnoses. The study reports that employees on long-term sick leave across various conditions, including musculoskeletal disorders, frequently experience sleep and tiredness issues as barriers to returning to work.