Quoi de neuf?

Purpose Long-term outcomes of work rehabilitation for individuals on extended sick leave due to common mental disorders or chronic musculoskeletal pain remain insufficiently studied. This randomized controlled trial evaluated the long-term effects on work disability and cost-effectiveness over eight years, and health outcomes over ten years, comparing (1) unimodal Acceptance and Commitment Therapy (ACT) and (2) multidisciplinary assessment and treatment program including ACT (TEAM) with standard care (Control). Methods Work disability days were analysed using ordered beta regression, and health outcomes were assessed using mixed models for repeated measures. Results are presented as estimated marginal means. Results Both intervention groups demonstrated lower model-predicted median work disability days at all time points compared to Control, but the differences were only statistically significant for the TEAM group at years four, seven, and eight. Both ACT and TEAM interventions showed superior effects on psychiatric symptom reduction relative to Control at one- and two-years follow-up. Conclusion The findings highlight the importance of extended follow-up to fully capture the effects of rehabilitation efforts. The results support the consideration of both rehabilitation models for women with prolonged work disability, with the choice between them potentially guided by available resources, individual patient complexity, and a stepwise approach to care.

© Finnes A; Johansson M; Helgesson M; Andersen A; Berglund E; Anderzen I. BMC Public Health. 26(1), 2026 May 06.
 

Purpose There is a lack of knowledge about reemployment for long-term sick-listed employees when returning to a previous job is not feasible. This study aims to understand the mechanisms and contextual factors that facilitate or hinder return to work with a new employer (RTW-NE) for sick-listed employees. Methods We conducted a realist review of peer-reviewed studies and gray literature from six databases. Data were extracted and synthesized to identify factors and to create context-mechanism-outcome (CMO) configurations to develop an explanatory framework, based on the Integrated Behavior Model and Stages of Change. Results 1,584 records were identified, 28 records met the inclusion criteria and methodological rigor. 12 CMO configurations were divided into seven themes explaining the RTW-NE trajectory and are presented in an integrated model explaining the RTW-NE trajectory. Conclusion An RTW-NE trajectory seems to take more time than a regular RTW trajectory due to various contextual factors such as concurrent life events and false RTW expectations. The motivation for deciding to take the RTW-NE trajectory requires acceptance: closing one door and opening another. The employee's self-efficacy, mental preparation, practical preparation and skill development seem interdependent and thus increasing self-efficacy and skills seems a continuous cyclic process.

© Klerkx ML; van Hees S; Hutting N; de Rijk A; Oomens S. Disability & Rehabilitation. 1-17, 2026 May 04.
 

Purpose Employers can have an important role in optimizing return-to-work (RTW) support during long-term sick leave. The scarce research shows that especially small and medium-sized enterprise (SME) employers experience this as complex and demanding. In the Netherlands, RTW support is even mandatory by law. This study aims to explore the experiences and needs of Dutch SME employers during long-term sick leave and RTW. Methods Semi-structured interviews were conducted with employers in executive positions at SMEs (<= 250 employees) who had supervised at least one long-term (> 6 weeks) sick-listed employee in the past year. Interviews were transcribed and thematically analysed. Results Twenty participants (55% male, mean age: 48) from micro (n = 2), small (n = 8), and medium-sized (n = 10) enterprises across different sectors participated. Employers regarded supporting sick-listed employees as one of their many responsibilities, yet burdensome. This perception of their role was either more intrinsically motivated (e.g., taking care of employees as a core value) or more extrinsically motivated (e.g., concern over financial consequences). Their motivation was shaped by factors such as employee attributes (e.g., reason for sick leave) and organization characteristics (e.g., enterprise size). Interviewees expressed a need for relatedness and autonomy in managing sick leave, but felt restricted by rigid and unclear regulations. They acknowledged lack of competence in providing sick-leave and RTW support. Conclusion In order to support their sick-listed employees, SME employers' needs for autonomy, competence and relatedness need to addressed while taking into account their role perception and contextual factors of SMEs.

© Beerda DCE; Greidanus MA; Schaafsma FG; van Doeveren EEM; de Wind A; de Rijk A; Tamminga SJ. Journal of Occupational Rehabilitation.  2026 May 11.
 

Purpose Sworn and civilian members of any police service are exposed to incidents that increase their risk for mental and/or physical injuries, which may require leave from work. Any leave requires reintegration back into their work environment and occupational responsibilities, yet the literature on the return-to-work (RTW) process is sparse, particularly in policing, revealing a pressing need to identify how RTW can be done successfully. Methods Thus, using semi-structured interviews, we explored the RTW experiences, thoughts, and recommendations of 128 sworn and civilian police members. Coded data were analyzed to focus on common as well as root causes of contradictory experiences and interpretations, all emergent from the data. Results Findings revealed how most participants who took a leave of absence were off for an extended period and had a negative experience due to a lack of organizational support, stigma, and poor communication. Those on leave for a shorter time had more positive experiences due to feelings of organizational support, including incorporating a gradual and task-modified return. Participants felt their leave and RTW processes could be improved with a reintegration strategy that included organizational support, effective communication, and modified duties. Conclusion We suggest processes for re-entry should be individual-specific, meaningful, and flexible, including check-ins and accommodations upon their return.

© Ricciardelli R; Stretton SM. Journal of Occupational Rehabilitation. 2026 May 09.
 

Purpose Employment, while being a marker of economic growth and productivity, is also a wider determinant of health. Disadvantaged groups have higher rates of work-limiting conditions which is compounded by poorer access to health and care interventions. Maintaining an inclusive and diverse workforce is not only important for addressing health disparities, but also for improving economic outcomes. Return to work (RTW) interventions seek to address long-term work or sickness absence. Here we review the policy-focused evidence to understand what works to support disadvantaged groups back to work. Results Generally, effective RTW interventions were multicomponent, multidisciplinary, and had early workplace involvement. To optimise RTW for disadvantaged groups, programmes likely should:  Be holistic and adapted using a tailored biopsychosocial approach which is culturally sensitive; Have two or more intervention components with collaboration between health services and the workplace, advocacy for reasonable adjustments, and work-focused psychological therapies; Include roles, such as RTW coordinators, and partner with non-healthcare services, such as supported employment. Conclusions Research on RTW specifically in disadvantaged groups is sparse despite known inequalities. For equitable RTW, practitioners and policy makers must prioritise those most affected by work-limiting conditions, ensuring RTW support reaches those who need it most.

© Harasgama S, Lamb D, Kuhn I, Gkiouleka A, Ling Wong Y, Gajria C, Loftus L, Dehn Lunn A, Blythe J, Ghanchi A, Ford J. Public Health in Practice, 19 May 2026: https://doi.org/10.1016/j.puhip.2026.100809

Purpose To co-develop the Stay-At-Work (SAW) intervention, a person-centred, interdisciplinary, cross-sectoral vocational rehabilitation (VR) programme for individuals on, or at risk of, sick leave due to chronic low back pain (CLBP) and to advance methodological understanding of how evidence, qualitative insights, stakeholder input and programme theory can be systematically integrated and operationalised into concrete intervention components. Methods Design: A three-stage intervention development study, guided by the Medical Research Council framework for complex interventions, involving evidence review and stakeholder consultation (previously reported); multistakeholder co-design; and prototyping in clinical settings. Setting: The intervention was developed within a Danish public healthcare and welfare context, involving a secondary care spinal service, municipal employment services (n=3), municipal rehabilitation services (n=3) and general practice. Participants: Stage 1: 17 individuals on long-term sick leave due to CLBP participated in interviews and focus groups. Stages 2 and 3: The co-design group included individuals living with CLBP (n=2); clinicians from a secondary care spine service (n=2) and municipal rehabilitation services (n=6); general practitioners (n=2); municipal employment service professionals (n=3) and local managers (n=3); and employer and employee representatives (n=2). Participants were purposively recruited based on their roles and experience in VR and return-to-work processes and contributed across different stages of intervention development. Results The SAW intervention consists of eight structured activities, developed through multistakeholder co-design and underpinned by a programme theory with four core mechanisms: (1) strengthened interprofessional and cross-sectoral understanding and collaboration; (2) stronger alignment around functional capacity and work ability; (3) addressing psychological vulnerability through systematic screening and support; and (4) enhanced coordination of care and rehabilitation efforts across services. Stakeholder input from the co-design group informed the intervention's content and procedures, thereby improving alignment with local contexts and strengthening cross-sector collaboration. Some proposals were excluded due to inconsistency with clinical guidelines. Conclusion This study demonstrates how a structured, theory-informed co-development process can be used to integrate evidence, stakeholder input and programme theory into a coherent, cross-sectoral VR intervention. The approach enhanced transparency, supported alignment with real-world practice, and provides methodological insight to strengthen the reproducibility and transferability of complex interventions.

© Frydenlund G; Mortensen OS; O'Neill S; Sondergaard J; Hansen A. BMJ Open. 16(5):e116084, 2026 May 08.

Purpose Chronic pain impairs work participation. Psychological interventions can support people with chronic pain to work, yet little is known about which components are most effective. A systematic review and meta-analysis assessed the effectiveness of interventions targeting sick leave, return to work, work ability and work-related self-efficacy in chronic pain populations. Intervention content was analysed to identify effective components. Methods A search strategy was developed and applied to six databases from inception until 2nd March 2023, being updated in December 2024: PsychInFO, Medline, Cinahl, Web of Science, Cochrane Library and Embase. Intervention descriptions were coded for intervention functions, theoretical domains and behaviour change techniques. Risk of bias was assessed using the ROB-2 tool. Results 51 randomized controlled trials were identified. Study quality was poor overall. Meta-analysis showed that psychological interventions were complex, that is, contained multiple components delivered alongside other interventions, which together were associated with reduced sick leave (SMD -.41, 95% CI: -.64 to -.18) and a small increase in those working at long-term follow-up (>12 months) (RR 1.03, 95% CI: 1.01-1.06; I2 = 0%) but not work ability/capacity (SMD -.02, 95% CI: -.12-.08, I2 = 0%) or return to work (RR .98, 95% CI: .91-1.05, I2 = 0%). No intervention components appeared most effective, but five common components were identified: education, skills/training, social support, emotional regulation, and confidence building. Conclusion Complex psychological interventions can positively influence work outcomes for people with chronic pain. Future research should prioritize high-quality studies and incorporate the five components to enhance work-focussed support.

© McParland J; Booth L; Dibben G; Abaraogu U; Wainwright E; Demou E; Williams L; Flowers P; Kidd L; Daniels J; Patwa H; Wegrzynek P; Audsley S; O'Kane R; Parchment A; Ranaldi H; Walker-Bone K.  British Journal of Health Psychology. 31(2):e70077, 2026 May.

Purpose This study set out to explore the experiences of adults receiving treatment in outpatient hand therapy and physiotherapy services in the United Kingdom (UK), specifically in relation to remaining in or returning to work. Motivation for the study included the 2022 UK legislative change that enabled occupational therapists and physiotherapists to issue formal sickness certification (Fit Notes). Methods Semi-structured 1:1 qualitative interviews were completed between 2022-2023 at two public hospitals with local ethics approval. Questions examined the impact of the injury/condition on work participation, advice received, and recommendations for supporting future patients. Interview transcripts were analysed using reflective thematic analysis. Results Twenty-three interviews were conducted (12 male, age range 24-72 years). Four themes were developed in relation to remaining in or returning to work: (1) individual experience; (2) workplace support; (3) healthcare support; and (4) provision of return-to-work advice and Fit Notes. Themes captured variation in needs depending on condition, employment type, and workplace support. There were strong expectations for therapists to provide work-related guidance. Conclusions Being in employment was highly valued by participants for purpose and well-being. Participants placed high trust in therapists' expertise and considered them well suited to provide return-to-work advice and Fit Notes. Clear, written, condition-specific guidance with realistic timeframes was strongly desired to aid communication with employers. Meeting these needs may improve patient confidence and facilitate sustained work participation.

© O'Donnell K; Lai TY; Smith L; Kaufmann K; Bamford E; Newington L. Hand Therapy. 17589983261444956, 2026 May 05.

Purpose To determine the effect of implementing a care pathway on return-to-work (RTW) levels and identify prognostic factors among workers filing their first shoulder injury claim. Methods This retrospective cohort study included 5075 workers with a first claim for shoulder injury: 2593 workers (2004-2008) received standard of care consultations, while 2482 workers (2014-2018) underwent specialized shoulder assessments through a care pathway that also included collaborative planning for RTW. Multinomial logistic regression determined the effect of implementing a care pathway on RTW levels and identified demographics, injury, occupational and program factors associated with RTW. Results The most common injuries were traumatic (92.4%) and sprains/strains (64%). Median claim duration was 114 days (IQR = 140), with 80.6% receiving wage replacement benefits. The care pathway cohort was younger with shorter claim duration than the pre-care pathway cohort. They had 1.8 times (95% confidence interval (CI) 1.4; 2.3) greater risk of returning to modified duties than the pre-care pathway cohort. Days receiving wage replacement benefits 12-month post-claim closure were similar between cohorts (p = 0.8). RTW outcomes were impacted by demographics, injury, occupational, and program factors, with interpreter use, prolonged claims, poor compliance, and delayed treatment most strongly associated with failure to RTW at pre-accident levels. Conclusions The findings demonstrate that the care pathway cohort was associated with quicker return to modified duties without compromising long-term RTW outcome. This underscores the importance of proactive intervention strategies like care pathways in optimizing workplace rehabilitation outcomes and minimizing long-term disability.

© Silveira A; Beaupre LA; Voaklander D; Niemelainen R; Jones CA. Journal of Occupational Rehabilitation. 2026 May 08.

Purpose Musculoskeletal disorders (MSDs) are a leading cause of sickness absence from work and early retirement. While structured workplace dialogues about musculoskeletal pain are recommended, their implementation remains challenging. This study explored the implementation of the ‘Talk About Pain—Take Action Together’’ toolbox in two Danish public workplaces. Methods Qualitative observational implementation study informed by reflexive thematic analysis was conducted. Two workplaces with physically demanding roles were included: one with researcher-initiated implementation during the study period and one with internally initiated implementation prior to the study. Data were collected through observations, memos, emails, and four focus group interviews with 10 participants including employees, managers, and occupational safety and health consultants. Results Workplace 1 (WP1) implemented the toolbox, employing seven strategies: identifying and preparing champions, conducting a local needs assessment, distributing educational materials, reminding clinicians, tailoring strategies, organising implementation team meetings, and creating learning collaboratives. Key enablers included management engagement, ongoing exposure, and creating a safe environment, whereas lack of time was identified as a barrier. At workplace 2 (WP2), three strategies were employed: identifying and preparing champions, distributing educational materials, and conducting educational meetings. However, the toolbox was never fully implemented, hindered by time-related barriers, organisational restructuring, and unclear roles and responsibilities. Conclusions Effective implementation of workplace MSD interventions requires management engagement, time allocation, and clear roles.

© Rossen, C. B., Jannsen, B. E., Stochkendahl, M. J., Christiansen, D. H. et Hubeishy, M. H. Journal of Occupational Rehabilitation. https://doi.org/10.1007/s10926-026-10413-8

Purpose People with common mental disorders (CMDs) such as depression and burnout have a high recurrence rate of sickness absence (SA). Few studies have investigated the determinants of sustainable return to work (SRTW) after a CMD. The objective of this study was to identify determinants of SRTW, operationalized as recurrent SA and work ability after the return. Methods Participants were 148 employees that returned to work from April 2022 to January 2024 after CMD-related SA. In this prospective longitudinal cohort study, participants were followed up for one year after their return to work (RTW) by means of five questionnaires. Survival analysis and linear regression were carried out for recurrent SA and work ability outcomes, respectively. Results By twelve months after initial RTW, 27.9% of patients experience recurrent SA, as estimated by the Kaplan-Meier method. Cox proportional hazards regression reveals that patients having a higher symptom severity of anxiety and depression at time of RTW have a significantly higher risk of recurrent SA (HR = 1.176, 95% CI [1.027-1.346], p = 0.019). At time of RTW, better work ability is linked to being married, higher self-efficacy, and greater controllability, while fixed shifts and higher depressive symptoms predict poorer work ability. Three months after RTW, resilience emerges as a positive predictor, whereas at six and nine months, depressive symptoms and controllability remain significant predictors, respectively. Conclusion Symptoms of depression and anxiety at the start of RTW influence recurrent SA and work ability thereafter for people suffering from a CMD.

© Anke D; Isabelle B; Sofie V; Lode G. Journal of Occupational Rehabilitation.  2026 May 13.

Purpose Mental health-related disorders are prevalent among the working population and account for a large proportion of sickness absence. Occupational health professionals (OHPs) play a key role in supporting employee recovery and reintegration, yet little is known about the extent to which individual OHPs affect return-to-work outcomes. Previous studies suggest that OHPs might influence absence duration, but comprehensive quantitative analyses examining variation between OHPs are lacking. In this study, we determine the variation in sickness absence duration attributable to OHPs in mental health-related cases. Methods We analyze a large dataset of more than 30,000 sickness absence cases involving employees diagnosed with mental health-related disorders across multiple sectors. A cross-classified multilevel model was applied to estimate variance attributable to OHPs while controlling for other sources of variation. Results Our results show substantial variation in mental health-related sickness absence duration between OHPs. This corresponds to marked differences in return-to-work outcomes: for high-performing OHPs, the median absence duration is 18 weeks or less, whereas for low-performing OHPs, the median duration is 28 weeks or more. Individual, organizational, and sectoral factors also contribute considerably to differences in sickness absence duration. Including OHP- and organization-level random effects reduced the estimated individual-level variance by about 50%, indicating that differences across providers and employers are relevant in reducing sickness absence duration. Conclusion Based on this, we argue that OHPs and organizations should work in concert to reduce sickness absence durations. Future research should identify which specific OHP characteristics and practices are most helpful in accomplishing this.

© Timp S; van Foreest N; van Rhenen W. PLoS ONE. 21(5):e0348115, 2026.

Purpose Sick leave with stress-related disorders has increased substantially in Sweden and other OECD countries, posing a significant challenge to public health and workforce participation. Whilst employer support has been shown to contribute to return to work (RTW), there is limited evidence regarding which specific workplace adjustments facilitate this process. This study aims to investigate the types of workplace adjustments individuals with stress-related disorders receive to facilitate RTW and whether such adjustments are associated with a reduced number of sick leave days. Methods This study combined data from a national survey of 1,412 individuals on long-term sick leave due to stress-related disorders (ICD-10 F43 codes) with register data on sick leave from the Swedish Social Insurance Agency. Workplace adjustments were self-reported via a multiple-choice questionnaire. Sick leave outcomes were measured as gross and net sick leave days at 6 and 18 months. Multivariable quantile regression was used to examine associations between reported adjustments and the distribution of sick leave days, adjusting for age, sex, and education. Results Eighty per cent of participants reported having received at least one workplace adjustment, with changes in work tasks being most common. Quantile regression analyses revealed that workplace adjustments were associated with fewer net sick leave days, particularly among individuals with longer durations of sick leave. At 18 months, individuals who had received workplace adjustments had significantly fewer net sick leave days across the 40th to 90th percentiles, with the largest difference at the 90th percentile (153 fewer net sick leave days; p < 0.001). Conclusions Workplace adjustments were associated with shorter durations of sick leave among individuals with stress-related disorders, particularly among those with prolonged sick leave. These findings highlight the potential relevance of individualised workplace adjustments in the rehabilitation process.

© Beno A; Hensing G; Jonsdottir IH. Journal of Occupational Rehabilitation. 2026 May 20.

Purpose Long covid affects a significant proportion of people following SARS-CoV-2 infection and is associated with persistent symptoms such as fatigue, cognitive dysfunction and breathlessness which can negatively impact a person's ability to return to and remain in work. Although tiered vocational rehabilitation (VR) models have been proposed, these are often generic, lack empirical validation and may not address the complex, fluctuating needs of this population. Objectives: To co-design a VR intervention (the COVID-19-VR intervention) to support return to work (RTW) for people with long covid (pwLC). Methods Setting: Primary and secondary care. Design: Mixed-methods target population-centred, person-based approach in three stages: Stage 1: interviews (n=21) with pwLC to identify issues and challenges faced in working with long covid. Stage 2: three co-design workshops with pwLC and service providers to (a) generate guiding principles, (b) identify key intervention features to address work needs, (c) create a logic model to illustrate how the intervention could work and (d) develop a treatment plan and resources. Stage 3: feasibility and acceptability testing in six cases (three critical care admissions, three primary care referrals). Results PwLC described work-related problems relating to: fluctuating symptoms (cognition, fatigue and breathlessness), employer, coworker and family's understanding of long covid and workplace adjustments. We developed a 6-session, 12-week individually tailored, remotely delivered intervention that included vocational goal setting, RTW planning, fatigue/symptom management, financial advice, and where permitted, education for family/employers, employer engagement and negotiation of a phased RTW. Following feasibility testing, changes included accommodating the long-term nature of long covid, addressing unmet psychological needs, and adding content on adjustment, processing traumatic experience and performance/symptom anxiety, with extended delivery including monitoring, review and case coordination. Conclusions PwLC may need specialist help to RTW. Our COVID-19-VR appears feasible and acceptable and warrants further evaluation using a staged approach, prior to any definitive effectiveness trial.

© Boutry C; Phillips J; Knight C; Holmes J; Patel P; Morriss R; das Nair R; Douglas E; Bolton CE; Guo B; Radford K. BMJ Open.16(5):e109740, 2026 May 15.

Purpose Post-COVID is associated with prolonged impairments in work ability and return-to-work (RTW). The heterogeneity and complexity of post-COVID symptoms present major obstacles to a sustainable RTW. This systematic review aims to identify facilitators and obstacles affecting work ability and RTW. Methods Eligible studies examined factors affecting work ability or RTW in post-COVID patients. Systematic search of literature was performed up to March 2025 using MEDLINE, CENTRAL, PsycINFO, Scopus, and Web of Science. Study selection followed the Preferred Reporting Items for Systematic Review and Meta-analysis Statement. Risk of bias was evaluated with the "Joanna Briggs Institute Critical Appraisal Tools". Results 31 studies published between 2021 and 2025 were included in the analysis. Most originated from Europe and North America with sample sizes reaching from small qualitative studies to large registry-based cohort studies. The identified factors (N = 59; facilitators: n = 25, obstacles: n = 34) could be grouped into four domains: Disease-related factors associated with SARS-CoV-2 infection (n = 8), Individual biopsychosocial factors (n = 35), Contextual workplace factors (n = 10), Healthcare system and service-related factors (n = 6). The most frequently reported obstacles were fatigue and neurocognitive impairments, stigmatization, lack of managerial support, and rigid RTW policies. Adequate workplace adjustments, interprofessional therapeutic interventions, and self-management strategies facilitate work ability and RTW. Conclusions Work ability and RTW with post-COVID is determined by complex multilevel interactions of biopsychosocial, workplace-related, and systemic factors. Findings suggest that coordinated care and workplace adaptations may help to bridge the gap between medical recovery and occupational participation. Future research should aim to better understand how multiple factors interact in individual cases to develop targeted, evidence-based interventions and policy frameworks.

© Ottiger M; Poppele I; Seefen Soliman AS; Schlesinger T; Muller K. BMC Public Health. 26(1), 2026 May 21.