title: A qualitative study of perpetuating factors for long term sick leave and promoting factors for return to work: chronic work disabled patients in their own words.
abstract: OBJECTIVE
  Chronic work disability generates high financial costs for society and causes personal suffering to patients and their families; however, crucial knowledge about the factors associated with long-term sick leave is still missing. This study provides insight, from the perspective of chronic work disabled patients, into the perpetuating factors for long-term sick leave and promoting factors for return to work.
  
  
  METHODS
  Five focus group interviews were conducted with 27 patients with different disorders who had been on long-term sickness absence (18 months or more). Qualitative data analysis was performed using a conceptual framework to identify barriers and enablers for return to work.
  
  
  RESULTS
  Four main themes of important perpetuating factors for long-term sick leave were identified: health-related obstacles, personal obstacles, social obstacles, and work-related obstacles. Four main themes of important promoting factors for return to work were identified: favourable working conditions, positive personal characteristics of the employee, the influence of the social environment, and the influence of the personal economic situation.
  
  
  CONCLUSIONS
  Besides sickness, several non-medical factors are recognized barriers for return to work. Factors such as illness perceptions and self-efficacy expectations are reported to be promoting factors for return to work.
authors.affiliation: Academic Medical Center, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands. p.m.dekkers@amc.uva.nl
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dekkers-Sánchez
authors.forename: Haije
authors.initials: H
authors.lastname: Wind
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D000041:Absenteeism; D000223:Adaptation, Psychological; D000328:Adult; D017281:Cost of Illness; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012050:Rehabilitation, Vocational; D020377:Self Efficacy; D018582:Sick Leave / Q000191:economics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014938:Work Capacity Evaluation; D016526:Workload