Quoi de neuf?

Veille scientifique - octobre 2026

Incapacité et retour au travail

Purpose Social insurance systems provide essential financial support to cover living expenses and medical treatment needs during times of work incapacity. However, many ill and injured workers experience the administrative processes involved in accessing these systems as difficult to navigate, which can stifle recovery and slow return to work. The present study centres workers' lived experiences to better understand facilitators and barriers to recovery, and to identify solutions grounded in workers' perspectives. Methods Twenty Australian workers with work-related injuries, health, and mental health conditions completed an online interview between February and August 2024. Thematic analysis was used to interpret and group participant responses. Results Three themes describing recovery experiences emerged, whereby each theme described a facilitator and a barrier subtheme. Additionally, four solution themes emerged, emphasising the importance of shifting systems towards including workers in decision-making steps, increasing transparency and ease of claim processing, and reducing financial strain. Conclusions Findings are discussed in light of Administrative Burden Theory (ABT). ABT introduces concepts of learning, compliance, and psychological costs that ill and injured workers bear while engaging with social insurance systems. ABT proposes that these costs are not equally distributed, often disadvantaging those with fewer resources or support networks. We argue that ABT provides a useful framework through which to understand ill and injured workers' experiences with workers' compensation, and that it provides mechanisms to explain workers' suggested solutions.

Purpose Research on the therapeutic alliance (TA) has largely focused on therapist-patient dyads, overlooking the complexity of multi-actor and intercultural contexts such as work rehabilitation. This study examines how the TA is constructed and negotiated within a multidisciplinary return-to-work program involving immigrant workers in Quebec. Methods Using a qualitative case study design, the study combines participant observation and semi-structured interviews with seven injured immigrant workers. Results Our findings suggest that the therapeutic alliance may be better understood as a stable interpersonal relationship but rather as a dynamic, multi-level process embedded within clinical, institutional, and sociocultural contexts. The bond of trust emerges as a composite construct, including rapport, perceived competence, perceived allegiance, trust in the system, and therapist trust in the patient. While tasks tend to be a site of relative consensus, goals-particularly return to work-are often contested, reflecting divergent expectations between workers and institutions. These tensions are further shaped by intercultural dynamics, migration trajectories, and systemic constraints. Conclusions The study contributes to reconceptualizing the TA as an ecosystemic and negotiated process, extending beyond dyadic models. It highlights the need for reflexive clinical practices, greater transparency regarding institutional mandates, and increased attention to cultural and structural factors in rehabilitation.

Purpose Facilitating a worker's return to work (RTW) following disability helps to prevent prolonged disability. While stakeholder trust is crucial for RTW success, its constituents remain empirically underexplored.This study aims to explore the constituents of trust from RTW coordinators' perspective. Methods We took inspiration from the critical incident technique and conducted exploratory interviews with RTW coordinators from the healthcare, insurance, and workplace sectors with at least three years of experience helping workers RTW following disability due to musculoskeletal or common mental disorders. Interviews were transcribed and underwent theory-informed deductive thematic analysis so inductive insights could emerge. Results Most of the eleven RTWCs interviewed were insurer representatives (n = 4) or workplace representatives (n = 5). Their narratives confirmed previously documented constituents of trust and revealed new subconstituents. Notably, serenity-a trustee characteristic-was determined to be an antecedent of trust alongside several contextual factors. Furthermore, the attribute risk of opportunism was refined to emphasize the trustor's perception of the risk, and willingness to act, previously a consequence of trust, was recategorized as an attribute. These findings suggest there exist other elements that could be leveraged to strengthen trust in RTW practices and highlight relational consequences that may influence organizational culture. Conclusion Since empirical analyses of trust constituents in RTW contexts are, to our knowledge, largely absent from the literature, this study provides an original contribution on this subject. Targeting antecedents of trust could help build trust and collaboration among stakeholders, thereby strategically strengthening these factors.

Purpose Work-related injuries and occupational illnesses constitute a substantial but unevenly recognised burden on workers and health systems. While work can provide income, social protection, and social integration, it can also expose workers to physical, psychosocial, and organisational hazards, and the resulting harm remains unevenly documented within occupational health and safety (OHS) systems. Growing evidence indicates that official statistics and compensation and surveillance systems incompletely capture work-related harm, including among workers in precarious or temporary employment and migrant workers. This scoping review examines how work-related injuries and illnesses become institutionally invisible within systems of reporting, recognition, compensation, and surveillance. Methods Drawing on 59 peer-reviewed publications conducted in or including middle- and high-income settings and published between 2015 and April 2026, the review synthesises evidence on the mechanisms through which occupational harm is underreported, misclassified, suppressed, or excluded from institutional records. The review followed PRISMA-ScR guidelines, with findings synthesised using a thematic, multilevel analytical approach. Results Across the literature, institutional invisibility may emerge through cumulative processes of invisibilisation rather than isolated reporting failures. These mechanisms include constraints on reporting, organisational practices such as claim suppression and incomplete recordkeeping, and institutional filters involving classification, compensation, surveillance, and regulation. They intersect with employment precarity and stratified protection, contributing to uneven institutional visibility among differently positioned groups of workers. Beyond surveillance bias, invisibility may also have downstream clinical and occupational consequences, including delayed access to care, compensation, rehabilitation, and return-to-work support. Conclusions By proposing an integrative framework for understanding how occupational harm becomes institutionally invisible, this review contributes to debates in public health and health systems research on evidence production, risk governance, and health equity. It underscores the importance of incorporating occupational recognition into health equity agendas and addressing the institutional processes that shape whether work-related harm becomes visible and actionable.

Purpose the sick-listing process is often perceived uncertain and unclear by both patients and staff. to improve the process, a framework for structured assessment of rehabilitation and sick-listing (staRs) has been developed in the south-eastern healthcare Region in sweden. staRs consists of seven methodological tools supporting healthcare professionals in sick-listing and rehabilitation. the purpose of this study was to investigate how primary healthcare staff clinically involved in the sick leave process experience working according to staRs. Method We used a qualitative design conducting focus group discussions (n = 7) with healthcare staff (n = 37). eligible participants were physicians, rehabilitation coordinators and other healthcare professionals working clinically with patients. the focus group conversations were analyzed with thematic content analysis according to Braun and clarke. the study was registered in clinicaltrials.gov (number Nct05655962). Result The participants’ experience of working according to staRs were described by the overarching theme ‘staRs as an enabling structure’ formed by three themes and eight subthemes. the themes were ‘clearer roles and responsibilities through the RecO function’, ‘Moving from individual work to teamwork’ and ‘a more active and personalized rehabilitation and sick-listing process’. Conclusion the findings suggest that implementing the staRs framework may provide a supportive structure for a uniform and consistent way of working across primary healthcare centers. By clarifying RecOs’ roles and strengthening interprofessional collaboration, the framework may support a more patient-centered approach across services.

Purpose The aims of this study were to (1) to perform the transcultural adaptation from English to Canadian French of four instruments measuring return to work (RTW) expectations and two on recovery expectations, (2) assess their construct validity, and (3) to test their underlying constructs. Methods The instruments were translated and then adapted through pre-testing. Their construct validity was verified using hypothesis testing. Correlations between RTW and recovery-expectation instruments tested their conceptual overlap. Results The transcultural adaptation step was straightforward. Hypothesis testing supported three RTW-expectations and one recovery expectations' instruments. Their correlations were low, suggesting that RTW expectations and recovery expectations instruments do not measure the same constructs. Conclusions Hypothesis testing allowed rejecting some instruments but supported others. Recovery expectations, referring to health and healing, should be differentiated from RTW-expectations, referring to work participation.

Purpose Work-related injuries pose significant physical, psychological, and economic burdens on workers, their families, and society. Rehabilitation and return-to-work (RTW) programs are essential for recovery and reintegration into the workforce. However, little is known about injured workers' perceptions of and satisfaction with rehabilitation services in Jordan.This study aims to explore and compare the perceptions and satisfaction of injured employees with rehabilitation services offered by the Social Security Corporation (SSC) and evaluate their outcomes of returning to work (RTW). Methods This cross-sectional survey evaluated perceptions and outcomes of return-to-work and satisfaction of a random sample of injured employees in Jordan in 2022. Phone interviews were conducted by trained interviewers using a five-part questionnaire on injury and rehabilitation experiences. Data were analyzed using descriptive statistics and inferential tests, including independent t-tests, ANOVA, Mann-Whitney U tests, Kruskal-Wallis tests, and Spearman's rank correlation coefficient. Results A total of 400 injured workers were surveyed. The mean age of the respondents was 36.1 +/- 10.3 years, with the majority being males (92.5%) and married (70.3%). Less than half (46.8%) received rehabilitative services. The type and cause of injury were strongly correlated with receiving rehabilitation (p < 0.001). The mean perception rating was 3.89 +/- 0.49 (out of 5), and the mean satisfaction rating among those who underwent rehabilitation was 4.52 +/- 0.53. Perception was significantly higher among higher-income workers and workers who had rehabilitation services. There was a positive correlation between perception and satisfaction (r = 0.328, p < 0.001). In general, 87.5% of those who were injured returned to work. Conclusion Most injured workers successfully returned to work and expressed generally positive perceptions of SSC rehabilitation services. Enhancing awareness among employers and employees about the value and benefits of rehabilitation could further improve understanding, engagement, and utilization of these services among injured workers.

Purpose Returning to work after an occupational injury is a complex process that extends beyond physical recovery. While rehabilitation programs focus primarily on medical treatment and functional restoration, psychological and workplace-related factors significantly influence long-term reintegration. In South Korea, despite ongoing efforts to reduce industrial accidents through policies and legislation, over 100,000 workers annually experience occupational injuries, highlighting the need for a more comprehensive approach to post-injury recovery.This study investigates the interplay between self-perception and workplace support in shaping the reintegration outcomes of injured workers. Rather than treating psychological traits as independent predictors, this study explores how workplace relationships and support mechanisms moderate the effects of self-perception on job and life satisfaction. Methods This study analyzes data from 540 workers who returned to their workplaces after an occupational injury. Using structural equation modeling approach (Partial Least Square), the study examines the relationships between self-esteem, self-efficacy, workplace support, and reintegration outcomes. Results The findings reveal that self-esteem positively can help self-efficacy, which in turn enhances job and life satisfaction. Additionally, workers who perceive higher levels of workplace support can exhibit greater psychological resilience, leading to smoother reintegration and reduced job-related stress. Conclusions These results can highlight the importance of workplace culture and structured support programs in fostering successful post-injury reintegration. Employers and policymakers need to develop interventions that enhance workers' confidence, strengthen workplace relationships, and facilitate sustainable career recovery following occupational injuries.

Santé mentale

Purpose In Sweden, rehabilitation coordinators (RCs) have been introduced into healthcare service to offer coordination and support to patients, with the aim of streamlining sick leave and rehabilitation processes and promoting patients' return-to-work (RTW)/entry into work.Before the introduction of RCs, there was no corresponding function with mainly this specific focus and responsibility. The present study explores healthcare professionals' (HCPs') views and experiences of having access to a RC within psychiatric care. Methods This descriptive qualitative study involved individual semi-structured interviews with 12 HCPs in psychiatric care. Data were analysed using inductive thematic analysis. Results Two main themes were identified: "A specific function that improves the ability to focus on and support vocational rehabilitation" and "Uncertainty and confusion regarding roles and contributions within vocational rehabilitation". The introduction of a RC was viewed positively, enhancing the possibilities to focus on and offer patients coordination and vocational rehabilitation (VR) efforts. The HCPs felt they lacked both the time and knowledge to manage these tasks within their current work situation. By sharing knowledge, taking responsibility for, and coordinating the patients' VR process, the RC was seen as a valuable resource that contributed to better working situation for HCPs. However, the introduction of the RC also brought about uncertainty and confusion, particularly linked to the RC function and the role of HCPs within VR. Conclusions The RC's focus and in-depth knowledge of VR addressed a gap within psychiatric healthcare units. This contributed to providing more extensive support in patients' VR processes and improved the working environment for HCPs. To minimise inequalities in patient care and support the implementation of the RC function within psychiatric care, it is essential to clarify the roles and responsibilities of both RCs and HCPs in patients' VR processes. The findings of this study may guide and support the implementation of RCs across various care units, potentially extending beyond psychiatric care.

COVID longue

Purpose To evaluate the association between long Covid and socioeconomic, clinical, healthcare, and functional factors with reduced work performance and difficulty returning to work. Methods A cross-sectional study of individuals in Sao Paulo aged >= 18 years with long Covid (77.8%), with data collected between April 2023 and June 2024. A systematic random sample of severe and mild Covid-19 cases from March 2020 to January 2022. The severity of Covid-19 was classified according to the U.S. Centers for Disease Control and Prevention (CDC) guidelines. Prevalences were assessed, and a Poisson test was performed to examine the association between reduced work performance and difficulty returning to work and sociodemographic, clinical, healthcare-related, and functional factors considered significant (p <= 0.05). Among the participants, 43.9% experienced reduced work performance, and 22.2% had difficulty returning to work. Long Covid is defined as having two or more symptoms that develop and persist for more than four weeks after Covid-19, cannot be explained by an alternative diagnosis, and are assessed using a Likert scale for the intensity of self-reported symptoms (0-10). Participants ' functional status was assessed using scales for basic activities (Katz), instrumental activities (Lawton), functional limitations (WHO-DAS), and sarcopenia (SARC-F). Results Poorer work performance was associated with advanced age (PR = 2.20; 95%CI 1.27-3.80), as well as being the primary provider (PR = 1.55; 95%CI 1.05-2.29), and having moderate (OR = 2.99; 95%CI 1.60-5.58) or severe (OR = 4.88; 95%CI 2.59-9.19) functional impairment. For difficulty returning to work, the main association observed was severe functional impairment (OR = 4.33; 95%CI 1.58-11.80). Conclusion It is noteworthy that advanced age and, particularly, severe functional impairment were significantly associated with poorer performance and difficulty returning to work in the studied population with long Covid.

Quoi de neuf?

Veille scientifique - octobre 2026

From Participant to Passenger: Workers' Experiences of Recovery During a Workers' Compensation Claim.

Beyond the dyad: negociating the working alliance in intercultural return-to-work rehabilitation.

Unravelling the constituents of trust in the context of return to work: An exploratory study from the return-to-work coordinators' perspective.

The hidden injuries of work: Institutional invisibility, precarity, and the recognition of occupational harm. A scoping review.

A structured framework for assessment of rehabilitation and sick-listing (STARS) – experiences among healthcare professionals.

Canadian French adaptation and validation of instruments measuring return-to-work expectations and recovery expectations: Exploring similarities and differences between the two concepts.

Perception and satisfaction of injured workers toward rehabilitation services: A cross-sectional study.

Rebuilding confidence after workplace injuries: The role of self perception and job satisfaction in reintegration.

Exploring healthcare professionals' views and experiences of having access to a rehabilitation coordinator in their work in psychiatric care: a qualitative descriptive study.

Functional impact of long Covid on work performance and return to work: a cross-sectional study.