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Workplace Factors
The social side of returning to work is important

At a glance:
Helping people return to work involves a range of interpersonal interactions. Outcomes are improved when these interactions are positive.

Supervisors need adequate support to manage productivity, provide restricted duties and encourage good communication.
Co-workers need advice about how to deal with the person returning to work.
People returning to work do better when they communicate their issues in a clear and assertive manner, rather than avoiding communication, which can turn small issues into large problems.
Perspectives:
Employee
Returning to work after injury or illness usually goes smoothly. However, in some situations it is challenging. For return to work to be successful in a challenging situation it is important to establish positive relations in the workplace. You can assist by communicating any concerns or issues you have to your supervisor or employer. Sometimes people feel they should not complain, and therefore avoid reporting problems or difficulties. Small problems can then worsen, and interfere with the person's return to work.

When people feel uncomfortable about communicating or voicing a problem, they will often do it in a negative way (complain rather than explain) and therefore get an unhelpful response. Try to work out how to communicate any concerns or problems in a clear and non-confrontational fashion. Some things that may help when setting up a meeting with your supervisor include:

Set up the meeting in a quiet room
Request time to discuss your concerns
Bring a list of concerns to the discussion
Provide positive options
Work out ways to improve your situation that will also assist the supervisor
Tell your supervisor about what you can and can't do
Tell your supervisor how long you will need to be off work, or on modified duties
Employer
Interpersonal relations strongly affect whether a person will return to work successfully after sickness absence. Interactions in the workplace are important to both supervisors and employees returning to work.

Supervisors are in a difficult situation during the return to work process. They are responsible for productivity while also needing to provide restricted duties and special attention to people returning to work. Support your supervisors by giving them appropriate training and support tools. Reduce their productivity requirements while they are supporting an employee's return to work.

Supervisors can also help by setting up good communication channels. When people are returning to work it can be difficult for them to talk about any problems or issues. Getting people to address concerns and giving them advice about how to present issues in a positive and constructive way (explain rather than complain) can assist the return to work process.
Treater
Returning to work can be challenging, particularly for people with a long-term condition. People can become frustrated which can be disruptive to the workplace. Encouraging positive communication makes a difference. It helps not only the well-being of people involved, but also enables the injured employee to return to work successfully.

People returning to work should be encouraged to communicate their concerns with their workplace clearly and constructively. When people voice their concerns in a negative way, the response is less likely to be helpful. Treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
  should help employees who are returning to work to think about ways they can be positive and productive in the workplace. This helps their well-being, gives them the sense that they can contribute, and improves outcomes.
Insurer
Encourage employers to think broadly about return to work issues. Communication, positive relations, and supporting supervisors are important ways of improving return to work outcomes.
Original Article, Authors & Publication Details:
Lauren BG.1

Workplace Accommodation as a Social Process. Journal of Occupational Rehabilitation 2000;10(1):85.

1Workplace Center, Columbia University School of Social Work, New York, New York.
Background, Study Objectives, How It Was Done:
Helping people with a medical condition to remain in the workforce, or return to work involves accommodating them at the workplace. The authors note that current approaches to accommodate injury are often unsuccessful.

Accommodating people who are not fully fit requires that the needs of the individual are balanced with workplace policies and procedures, the needs of supervisors, co-workers and productivity.

The traditional approach to job modification is to implement technical changes in the workplace such as changes to job tasks, routines, ergonomics, and hours. A key component of returning to work is the social accommodation of the person in the workplace. The injured worker's interactions with other staff on their return to work influences whether they will remain at work. Having somebody in the workplace that is not fully fit also affects supervisors, co-workers and human resources staff.

The aim of the paper is to examine the social issues of workplace accommodation, in order to improve return to work outcomes. The author:

1. Reviewed the research relevant to this area
2. Reported on a project to assist people with a mental health
mental health
Emotional wellbeing. Ability to cope with difficulty and enjoy life. THe absence of a mental health problem.
 disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 back to the workforce

Relevant findings from other research studies include:

A person's return to work is affected by how well the workplace responds to their needs.
The company's organisational structure, including its culture and management practices, influences return to work outcomes.
If an employee feels their employer does not care whether they return to work they are less likely to do so.
Compensation claims are higher in companies with poor working conditions and poor labour relations.
People who require workplace accommodation often feel they are treated negatively by their company.
Lack of training and information for supervisors influences the organisation's culture and responsiveness to people who are returning to work.
Attitudes of supervisors affect whether a person returns to work.
Communication between the supervisor and worker about the person's capacity improves outcomes.
When the supervisor encourages the employee to protest if work is too difficult and to participate in choosing modified duties return to work is improved.
Support offered by supervisors improves outcomes. Perceptions of support have been shown to reduce feelings of work related stress and increase a sense of well-being.

The author started a project to help people with mental health problems return to work. This project:

1. Trained supervisors in good return to work practices, including the psychological
psychological
Refers to a person's perceptions, thought processes, emotions, personality and behaviour. Psychologists can treat mental health problems.
 and interpersonal aspects of return to work
2. Interviewed the people returning to work
3. Interviewed the supervisors responsible for return to work
4. Assessed the return to work results from the case records

Social factors important for return to work were identified in the interviews with workers and supervisors, and grouped into the four categories discussed below.
Study Findings:
Job accommodation is different than the ordinary work routine and affects for both the supervisor and the worker.

For job accommodation to be effective in helping a person to return to work both parties need to communicate about what is working and was is not. The following features are important to supervisors and employees:

1. Communication skills to describe problems and find solutions

It is important that the employee requests assistance if necessary. Otherwise employees may say nothing until the situation deteriorates and there is a major problem. Alternatively, if the employee asks for assistance in a negative or confused way, the supervisor may be frustrated and react negatively.

Clear and assertive communication by both the supervisor and the worker make return to work more likely to be successful.

2. Recognising relationship components in each job modification

The interaction between the person returning to work and their co-workers can influence outcomes. Sometimes the work group can be overprotective, slowing rehabilitation.
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 Workers can feel scrutinised, or the group can be insensitive or intolerant.

Co-workers may try to interact with humour. Employees returning to work may be sensitive, intended jokes might create tension.

Supervisors described their frustrations at trying to deal with the difficulties of return to work and job accommodations. This may be compounded if they have multiple staff requiring job restrictions. Relationship issues have been identified as the greatest barrier to return to work, with social accommodation in the workplace being the hardest to establish. Training supervisors in how to effectively deal with these situations assists them and the people returning to work.

3. Psychoeducation should be provided.

Psychoeducation is teaching supervisors and workers about the psychological or psychosocial
psychosocial
Refers to psychological and social factors. Examples of psychosocial factors that affect return to work area include: a person's beliefs about how they will cope with their condition, the attitude of the inured worker's family to their condition and return to work, the employer's return to work policy and the influence of the WorkCover system on a person.
 aspects of a return to work.

4. Supervisors are the key to successful return to work.

Without the support of the supervisor, a return to work program is unlikely to be successful.

Supervisors need resources to help them understand job modifications
Supervisors are responsible for productivity. The person returning to work may be less than fully productive, especially if they are on modified duties. This can increase the workload and stress levels of the supervisor. Teaching supervisors how to effectively communicate these issues to managers and other staff can help them to manage return to work.
Supervisors who are able to manage people returning to work well reduce distress
distress
Severe suffering, pain, anxiety or sorrow
 and improve outcomes.
Conclusions:
Helping people return to work often means job hours or job tasks need to be modified.

The author of this paper suggests that job modification that focuses only on tasks, hours and technical aspects of the role is unlikely to help people to return to work successfully. Understanding interpersonal dynamics, and supporting the employee, supervisor, and co-workers is important. Helping each party understand the needs of the others and to have positive relations improves outcomes.
References:
No PubMed Abstract
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