Return to work after long-term sick leave for common mental disorders : Women’s beliefs, intentions, health and psychological well-being

Sammanfattning: Background: Long-term sick leaves due to common mental disorders (CMDs)are common in Sweden today, especially among women. Return-to-work (RTW) support usually includes work-related factors and treatment for the CMD. Despite this, the way back to work is often long with an increased risk of relapse into sick leave afterwards. The overall aim of this thesis was to generate knowledge about women’s RTW after long-term sick leave for CMDs by investigating their beliefs, intentions, perceived health and psychological wellbeing.Methods: Study I reported on the development and psychometric evaluation of the RTW Beliefs Questionnaire based on the Theory of Planned Behaviour (TPB). It contain items about attitude towards, social pressure to, perceived behavioural control over, and intentions to RTW. Study II was a cross-sectional study investigating determinants (RTW beliefs and perceived health) of RTW intentions. Study III was a 1-year follow-up investigating predictors of RTW and psychological well-being. Study IV was a qualitative study describing women’s health and psychological well-being in the RTW process from women’s and first-line managers’ perspectives.Results: Beliefs about RTW mainly concerned health, psychological well-being, the work situation and relations in private life. The RTW Beliefs Questionnaire showed varied psychometric qualities and a distinct division between work and private life. Women with a more positive attitude, stronger social pressure and higher perceived behavioural control had stronger RTW intentions. The follow-up showed that the only predictor of having RTW one year later was stronger RTW intentions at baseline. However, these intentions were not associated with higher psychological well-being. In the qualitative study, women’s health and psychological well-being were described to be dependent on the individual characteristics of the women themselves, their private life, work and RTW stakeholders.Conclusions: Women’s RTW after long-term sick leave for CMDs concerned three core aspects: Private-, personal- and work-related. It is important that RTW is compatible with good health and high psychological well-being and that health promotion continue after the end of sick leave. Future studies in the area should consider private life aspects in addition to personal- and work-related aspects.