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Purpose The Fit Note (FN) may help people return to work and avoid prolonged sickness absence. However, its utilisation by physiotherapists is not understood. This study explored physiotherapists' views and practices regarding work-focused health care and FN use. Methods Design: A mixed methods study involving an online survey followed by six online focus groups. Participants: United Kingdom (UK) physiotherapists (n = 401) working in a variety of settings responded to the survey. Sixteen also participated further in the focus groups. Results Participants (89%) viewed supporting patients to stay-in or return-to-work as part of their role, yet only 31% regularly issued FNs. Key themes were developed: physiotherapists recognise work as integral to care, and those issuing FNs do so in line with guidance, recommending strategies to help patients remain in or return to employment. Barriers included organisational, individual factors, such as limited recognition of physiotherapists' role and lack of confidence or knowledge, and perceived patient barriers including lack of awareness. Facilitators included training, organisational support, and a multidisciplinary approach to work-related issues. Conclusion This study, the largest of its kind in the UK, indicates that physiotherapists regard work and health as integral to their professional responsibilities; however, FN implementation remains inconsistent. Qualitative findings reveal organisational, practitioner, and perceived patient barriers. Recommendations include improved mentorship and consistent digital FN access across all clinical settings. Further research should explore task-shifting consequences and patient perspectives.

© Brown TM; Eleryan N; Parker C; Shawcross P; Cook PA; Martin R.  Physiotherapy. 132:101892, 2026 Jan 27.

Purpose To explore the motivations, barriers and potential solutions from professionals' perspectives for achieving effective interdisciplinary practice, focusing on communication and collaboration to support work participation and facilitate patients' return-to-work (RTW). Methods Design: Qualitative exploratory interview study using thematic analysis. Setting: Primary and work-focused healthcare. Participants: 22 healthcare professionals, including occupational physicians (n=5), social insurance physicians (n=5), general practitioners (n=7) and occupational physiotherapists (n=5), were purposively recruited. All participants had at least 1 year of experience and were actively involved in patient care. Interventions: None. Primary outcome measures: Identified motivations, experienced barriers and proposed solutions for improving communication and collaboration across disciplines in work-focused healthcare. Results Participating healthcare professionals emphasised the importance of early, proactive and person-centred communication across care domains, particularly in complex or stagnating RTW trajectories. Key barriers included a lack of shared knowledge and common goals, limited understanding of each other's roles, time constraints, fragmented systems and regulatory restrictions. Proposed solutions focused on clearer coordination of care, improved role clarity and development of a secure, cross-domain digital communication platform to streamline information exchange. Conclusions Effective work-focused healthcare requires improved interprofessional communication and patient-centred collaboration. This study highlights when collaboration is most valuable, identifies key barriers and outlines feasible practical solutions. Future research should focus on developing and implementing guidelines that clarify communication pathways and coordination mechanisms within interdisciplinary teams.

© Zipfel N; Colkesen E; Hagendijk ME; Melles M; van der Burg-Vermeulen SJ. BMJ Open. 16(3):e103881, 2026 Mar 19.

Purpose The return to work (RTW) process of worker absent due to common mental disorders (CMD) or musculoskeletal disorders (MSD) represents a complex challenge that involves multiple stakeholders. The aim of this study was to examine how managers perceive the factors that facilitate or hinder communication with other stakeholders during the RTW process. Methods This qualitative study was based on four focus groups conducted in Canada (Quebec and Ontario) with 18 managers. Results Thematic analysis identified five themes related to facilitators and seven themes related to communication obstacles. Among the main facilitators, trust, clarity, and collaboration emerged as key elements that support effective coordination and the development of shared solutions. Obstacles, on the other hand, included distrust, ambiguity, and fragmentation, which can compromise the success of the process and increase the risk of tensions or relapses. The manager emerges as a bridging figure, central to the design of workplace accommodations, but whose role depends on the quality of relationships with the employee, colleagues, and other organizational stakeholders, as well as on the institutional support received. Conclusion The findings highlight that strengthening inter-stakeholder communication not only fosters the sustainable reintegration of employees with health conditions but also contributes to the development of more inclusive and resilient organizational environments.

© Bertolini H; Corbiere M; Negrini A; Lariviere N; Villotti P; Prevost D; Caiada M; Amorim J; O'Hagan F.  Journal of Occupational Rehabilitation.  2026 Apr 20.

Purpose Work-related musculoskeletal disorders are among the leading occupational diseases, often resulting in prolonged work absences and complicating the return-to-work process. These absences can result in social, economic, and psychological consequences, making reintegration into work more challenging. Factors such as age, education, motivation, and workplace environment also influence the return process. Objective: To identify, through a systematic review, the main challenges influencing the return and retention in work for employees on leave due to work-related musculoskeletal disorders. Methods This review was conducted in accordance with the updated PRISMA. Qualitative and mixed-methods studies published in English, Spanish, or Portuguese between 2012 and 2022 were included in the following databases: Web of Science, PubMed, Virtual Health Library, and Scopus. The risk of bias was assessed using an adapted CASP tool to evaluate the methodological quality of the studies. Results A total of 671 records were identified, and after screening and eligibility assessment, 11 studies were included in the qualitative synthesis. The main challenges identified included: emotional aspects, functional capacity, sociodemographic factors (age, education, economic factors), health system access, worker protection policies, workplace organization, and work relationships. Conclusions The study highlights the complexity of returning to work and its impact on workers, emphasizing the need for improved public health policies and worker protection measures.

© de Almeida Silva DP; Lancman S; de Lima Barroso BI; do Carmo Alonso CM; Azevedo de Souza MBC.  Work. 10519815261437683, 2026 Apr 08.
 

Purpose Physiotherapists are frontline providers in supporting the return-to-work process of individuals with musculoskeletal disorders. However, many report feeling unprepared for work rehabilitation following entry-level training. This study explored recent physiotherapy graduates in Quebec, Canada, perceived preparedness to practice in work rehabilitation and its influencing factors. Methods A convergent mixed methods design grounded in a competency-based framework was used. Recent graduates from physiotherapy programs completed a cross-sectional survey rating their perceived preparedness across seven work rehabilitation competencies. Semi-structured individual interviews explored how their training prepared them for work rehabilitation practice. Quantitative data were analyzed descriptively, and interviews were thematically analyzed. Findings were integrated through a joint display to contextualize preparedness ratings with qualitative insights. Results Twenty-five recent graduates from five physiotherapy programs across the province of Quebec completed both the survey and the interview. Perceived preparedness was highest for competencies on person-centered care and collaborative treatment planning, and lowest for psychosocial factors management, collaboration with involved actors, compensation system navigation, and return-to-work support. Three overarching themes influenced perceived preparedness: (1) role perceptions in work rehabilitation, (2) enablers such as supportive curriculum elements, and (3) challenges including stigma toward injured workers and limited work rehabilitation-specific training. A fourth theme described strategies to improve work rehabilitation training. Conclusions Recent physiotherapy graduates reported varying levels of perceived preparedness for work rehabilitation, with the lowest ratings associated with managing psychosocial factors, collaborating with involved actors, navigating compensation systems, and supporting return to work. These gaps were linked to limited work rehabilitation training, perceived role ambiguity, and exposure to stigma. Future research should develop strategies to improve work rehabilitation training in physiotherapy programs.

© Longtin C; Hong QN; Coutu MF; Alpdogan NY; Singer L; Cooper L; Bussieres A; Carriere J; Bertrand-Charette M; Perreault K; Hudon A; Wideman TH.  Journal of Occupational Rehabilitation.  2026 Apr 30.
 

Purpose Many individuals with work disability due to musculoskeletal disorders struggle to achieve a sustainable return to work. Although self-management interventions offer promising avenues to support work participation, their content, delivery characteristics and evaluation approaches remain unclear. This scoping review aimed to map the self-management interventions evaluated in relation to work participation among individuals with work disability due to musculoskeletal disorders, including their components, delivery methods and evaluation approaches. Methods A scoping review was conducted in 10 databases (Academic Search Complete, AMED, SPORTDiscus, Medline, PsycINFO, CINAHL, Embase, Scopus, Cochrane Library, Physiotherapy Evidence Database) from inception to July 2025. Primary studies involving working-age individuals with musculoskeletal disorders, a self-management intervention and an assessment of work participation were included. Results Out of 8310 records, 31 studies representing 23 self-management interventions were included with a median of 10 components (range 3-16). Most studies included non-specific musculoskeletal disorders (n = 13, 41.9%) or low back pain (n = 8, 29%). Less than half of interventions included content specific to work (n = 10, 43%), lifestyle changes (n = 9, 39%), resource utilization (n = 8, 35%), and communication skills (n = 7, 30%). Interventions were typically delivered in person (n = 12, 52%), individually (n = 14, 61%), and with clinician involvement (n = 15, 65%), while 43% (n = 10) incorporated digital health. Most studies focused on intervention effectiveness (n = 23, 72%), assessing work ability (n = 10, 30.4%), sick leave and return to work (n = 9, 39.1%), and work disability (n = 7, 30.4%). Fewer studies included process outcomes (n = 14, 45%) or participant views (n = 8, 26%). Conclusion This review revealed considerable heterogeneity in self-management components, delivery and evaluation methods. It identifies key gaps, suggesting the potential value of workplace-integrated self-management interventions to better support work participation.

© Longtin C; Spence LA; Hong QN; Hutting N; Decary S. Journal of Occupational Rehabilitation. 2026 Apr 30.
 

Purpose Occupational injuries are associated with great work-ability loss and disability for workers. Occupational injuries decrease work-ability and are associated with reduced income, becoming a social and health problem among laborers in Taiwan. This pilot program is to use one-stop services to help occupational injured subjects with physical disability return to work earlier or adjust to new working conditions. The purpose of this study is to describe and evaluate of this services program. Methods The study design of this study is a services program description and evaluation. The One-Stop to Help All-labors (OSHA) occupational medicine, case management and vocational reconstruction program was implemented in a medical center at southern Taiwan. The OSHA program includes an occupational medicine clinic, a referral system from physical injury/disease to occupation-related injury/disease, an evaluation of return-to-work readiness, case management, recruiting a vocational reconstruction program, setting a rehabilitation therapy and a follow up post returning to work. We used a single-item 11-point numeric rating scale (NRS) to evaluate the self-perceived work competency. The scored changed more than 2.0 points or greater than 30% will consider as significant. In total, 2,923 subjects received education on their rights related to occupational injuries during hospitalization, 700 subjects visited our occupational medicine out-patient clinic from January 01, 2023 to December 31, 2024. Among them, 401 subjects (330 injury and 71 disease) were recruited by the Collaboration Center of Occupational Medicine for services. There are 236 subjects included in the vocational reconstruction program for consultation, 129 subjects received needs assessment for planning. Among these 129 subjects, 104 subjects were evaluated, 101 subjects received physical work hardening, 24 subjects received psychological work hardening, 21 subjects received job accommodation services and 84 subjects successfully completed the training. Results There are 84 subjects who completed the vocational reconstruction program. At the end of program, the evaluation showed that more than 98.1% of the 84 subjects considered this OSHA program helpful for their return to work. The very satisfaction rate was near 98% for this one-stop program. Among these 84 subjects, the score of self-perceived competence to work was 3.5 points (total 10 points) at the beginning of rehabilitation program, about 7.8 points after completing the work hardening training program, and about 8.6 points 3 months after returning to work. Conclusion Results of this pilot OSHA program showed that the very satisfaction rate is more than 98% for the whole program and their self-perceived work competency increased twice for those with severe occupational injuries and disabilities. This program may be applied to workers with occupational injuries and disabilities; participation of the program may also be promoted among workers with occupational injuries and disabilities as early as possible to reach health equity.

© Chu, N.-F., Yin, Y.-R., Chu, C.-M., Chen, H.-C., Chen, J.-L. et Huang, Y.-H. BMC Public Health 26(1), 1096. doi.org/10.1186/s12889-026-26850-2
 

Purpose Common mental disorders are a leading cause of work disability and long-term income protection claims in Australia. Although recovery-oriented approaches are increasingly embedded in mental health care, their relevance to return-to-work within disability-based insurance systems remains underexplored. This study explored the mental health recovery-related return-to-work experiences of people with common mental disorders engaged with Australia's income protection insurance system. Methods Semi-structured interviews were conducted with 25 adults who had sustained their return-to-work for at least six months following a common mental disorder-related income protection claim. Data collection and analysis occurred iteratively, and data were analysed inductively using constant comparative analysis. Results Participants' recovery-related return-to-work experiences comprised three overarching processes: (1) an internal and personal process of growth; (2) negotiating and navigating workplace environments and roles; and (3) accessing and engaging with helpful supports. These processes were shaped by (4) broader contextual influences. Conclusion Findings indicate that recovery constructs, widely used in mental health service contexts, also resonate within this specific return-to-work context. However, recovery-related return-to-work is shaped not only by individual recovery processes but also by workplace conditions, relational supports, and broader contextual influences such as financial circumstances and stigma. Supporting sustainable return-to-work for people living with common mental disorders may therefore require approaches that integrate recovery-oriented principles into workplace and system-level practices. Further exploration is needed to understand system-level barriers and enablers influencing the income protection return-to-work workforce's ability to adopt the recovery-oriented supports and practices highlighted by participants.

© Green F; Hancock N; Scanlan JN; Matthews LR.  Journal of Occupational Rehabilitation.  2026 Apr 20.
 

Purpose Long COVID is a frequent post-infectious chronic condition that impacts quality of life and work performance. Whether individuals with comorbidities experience a greater functional impact of long COVID is unknown. We evaluated the functional impact of long COVID among healthcare workers (HCWs) with chronic cardiovascular diseases, chronic respiratory diseases, obesity or a history of depression, and compared it with that of HCWs without comorbidities. Methods We conducted a cross-sectional study in Quebec, Canada. We compared self-reported long COVID cases to COVID-19-infected controls without long COVID on work ability, work functioning, health-related absenteeism, dyspnoea-associated impairment and psychological distress among HCWs (a) with at least one of the four comorbidities, (b) with each of the four comorbidities and (c) without comorbidities. We used inverse probability of exposure and robust Poisson regressions to estimate adjusted prevalence differences (aPD) and prevalence ratios. Comorbidity data were obtained from the Quebec integrated chronic disease surveillance system. Results A total of 3754 and 8439 HCWs with and without comorbidities, respectively, were included. Among HCWs with at least one of the four comorbidities, long COVID was associated with higher prevalence of low work ability (aPD=15%, 95% CI: 12% to 18%), low work functioning (aPD=27%, 95% CI: 22% to 31%), health-related long-term absenteeism (aPD=8%, 95% CI: 5% to 11%), dyspnoea-associated impairment (aPD=23%, 95% CI: 19% to 26%) and psychological distress (aPD=24%, 95% CI: 20% to 28%). aPDs were greater among HCWs with comorbidities than among those without for low work ability (p=0.013 for interaction), for low work functioning (p=0.034) and for dyspnoea-associated impairment (p<0.001). Conclusion Long COVID is associated with significant functional impairment among HCWs with pre-existing chronic conditions. HCWs with at least one of the four comorbidities experience lower work ability, lower work functioning and more dyspnoea-associated impairment compared with those without comorbidities.

© Isangwe S, Talbot D, Coutu MF, Canitrot E, Décary S, Falcone EL, Ouakki M, Latouche P, Piché A, Simard M, Balem M, De Serres G, Carazo S. BMJ Public Health 2026;4:e004108. doi:10.1136/bmjph-2025-004108é.