ReWORK

This research track aims to involve stakeholders within vocational/work rehabilitation in improving work-oriented rehabilitation outcomes and facilitating return to work (RTW) while situating and developing knowledge about work as occupation.

The primary stakeholder in this context is the person with disability, illness, or other condition that results in a need for RTW. Other stakeholders include employers, healthcare professionals, the Swedish Social Insurance Agency (SSIA), the Swedish Public Employment Service (Arbetsförmedlingen), and relatives. Most studies in the group are grounded in neurological rehabilitation with a focus on persons with stroke and spinal cord injury. Other projects within this track involve persons with and without disabilities, which contribute to knowledge about RTW as well as conceptual development of work as occupation.

One of the most important rehabilitation goals for people of working age with neurologically related disability, i.e., after a stroke or spinal cord injury, is return-to-work. Despite this, more than a third of those who have had a stroke do not return to work, and half of those who have a spinal cord injury do not work after the injury. For people with disability after e.g., a stroke or spinal cord injury, work-oriented rehabilitation means finding a "match" between the person's abilities / limitations, work requirements, work environment, as well as repertoire of occupations and everyday life. The intervention projects within ReWork generate new knowledge by people with disability, relatives, representatives of healthcare, employers, Swedish Public Employment Service, and SSIA participating in the design and evaluation of rehabilitation interventions for return to work.

Design

The intervention projects build on the Medical Research Council (MRC) guidance framework for developing and evaluating complex interventions. The coordinator-led interventions ReWork-Stroke and ReWork-SCI have been developed, and pilot-tested for feasibility in case studies. Generic components of these interventions will be identified and presented for further evaluation in the target groups as well as in groups of people with multiple symptoms after other injuries/illnesses. Methods such as qualitative inquiry including visual methods, interviewing, and secondary analyses are utilized in conceptual development as well as identifying questions of relevance in designing and implementing interventions.

Principal Investigators

Eric Asaba (PI – ReWORK-SCI)

Gunilla Eriksson (PI – ReWORK-Stroke)

Collaborating researchers

Lisa Holmlund, Therese Hellman, Susanne Guidetti, Lisette Farias, Ulla Johansson

Network

Annika Öst Nilsson, Birgitta Bernspång, Elin Ekbladh, Åke Seiger, Claes Hultling

Previous financial support

  • Doctoral School in Health Care Sciences at Karolinska Institutet (x 2 projects)
  • Norrbacka-Eugenia Foundation
  • Neuro Sweden
  • Uppsala County Council
  • Gävleborg County Council
  • KI Funds at Karolinska Institutet
  • The Regional Agreement on Medical Training and Clinical Research Between Uppsala County Council and the Uppsala University Hospital (ALF)
  • The Uppsala-Örebro Regional Research Council
  • Promobilia Foundation
  • Praktikertjänst Inc.
  • Swedish Stroke Association
  • Swedish Association of Occupational Therapists

Publications

  • Asaba, E., Aldrich, B., Gabrielsson, H., Ekstam, L., & Farias, L. (2021). Challenging conceptualisations of work: Revisiting contemporary experiences of return to work and unemployment. Journal of Occupational Science. 28:1, 81-94, DOI: 10.1080/14427591.2020.1820896
  • Ekstam, L., Pálsdóttir, A. M., & Asaba, E. (2021). Migrants’ experiences of a nature-based vocational rehabilitation programme in relation to place, occupation, health, and everyday life. Journal of Occupational Science. 28:1, 144-158, DOI: 10.1080/14427591.2021.1880964
  • Johansson U, Öst Nilsson A, Hansen Falkdal A, von Koch L, Hellman T, Eriksson G. (2021). The delivery of the ReWork-Stroke program – A process evaluation. WORK: A Journal of Prevention, Assessment, and Rehabilitation.
  • Johansson U, Hellman T, Öst Nilsson A, Eriksson G. (2021). Using the TIDieR checklist as a tool for describing the ReWork-Stroke rehabilitation programme. Scandinavian Journal of Occupational Therapy, 28:5, 375–383. DOI: 10.1080/11038128.2020.1790654. 
  • Öst Nilsson A, Johansson U, Ekbladh E, Bernspång B, Hellman T, Eriksson G. (2020). Work Potential and Work Performance during the First Try-Out of the Person-Centred Return to Work Rehabilitation Programme ReWork-Stroke: A Case Study. Healthcare, 8, 454; DOI:10.3390/healthcare8040454.
  • Berger, M., Asaba, E., Fallahpour, M., & Farias, L. (2020). The sociocultural shaping of mothers’ doing, being, becoming and belonging after returning to work. Journal of Occupational Science. DOI: 10.1080/14427591.2020.1845226
  • Holmlund, L., Hellman,T., Engblom, M., Kwak, L., Sandman, L., Törnkvist. L., & Björk Brämberg, E. (2020) Coordination of return-to-work for employees on sick leave due to common mental disorders: facilitators and barriers, Disability and Rehabilitation, DOI: 10.1080/09638288.2020.1855263
  • Öst-Nilsson, A., Eriksson, G., Asaba, E., Johansson, U., & Hellman, T. (2020). Being a co-worker or a manager of a colleague returning to work after stroke: A challenge facilitated by cooperation and flexibility. Scandinavian Journal of Occupational Therapy, 27:3, 213–222.
  • Holmlund, L., Guidetti, S., Hultling, C., Seiger, Å., Eriksson, G., & Asaba, E. (2020). Evaluating the feasibility of ReWork – a person-centred intervention for return to work after spinal cord injury. BMJ Open;10:e036000. DOI:10.1136/bmjopen-2019-036000
  • Holmlund, L., Hultling, C., & Asaba, E. (2018). Mapping out one’s own paths towards work - Focus on experiences of return to work after spinal cord injury. Qualitative Health Research. 28(13), 2020–2032.
  • Öst-Nilsson A, Eriksson G, Johansson U, Hellman T. (2017). Experiences of the return-to-work process after stroke while participating in a person-centred rehabilitation programme. Scandinavian Journal of Occupational Therapy; 24:5, 349–356.
  • Holmlund, L. (f.d. Bergmark), Guidetti, S., Eriksson, G., & Asaba, E. (2017). Return to work in the context of everyday life 7–11 years after spinal cord injury – a follow-up study. Disability & Rehabilitation. 1-9.
  • Hellman, T., Bergström, A., Eriksson, G., Hansen Falkdal, A. & Johansson, U. (2016). Return to work after stroke – important factors shared and contrasted by five stakeholder groups. Work 901–911
  • Asaba, E. & Jackson, J. (2011).  Social ideologies embedded in everyday life: A narrative analysis about disability, identities, and occupation.  Journal of Occupational Science, 18(2), 139-152.
  • Bergmark, L., Westgren, N., & Asaba, E. (2011). Returning to work after spinal cord injury: Exploring young adults' early expectations and experience. Disability & Rehabilitation. 33(25–26), 2553-2558.