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People Factors
What motivates people to return to work?

At a glance:
Many factors are important for motivating someone to return to work. When people felt they could do a good job and help others they were more motivated to return to work. Good relationships in and out of the workplace also helped motivation.
Perspectives:
Employee
The people in this study say relationships with colleagues, how they feel about their work and how they are generally coping with their health influences whether they return to work.

Pain prevents people returning to work, but when the right motivation is present people can return to work despite their pain. Work then becomes therapy in which pain management is learnt, a return to normal activities is achieved and over time health improves.

It has been said that habits take one month to establish. Once a habit is established it is difficult to change even if you are keen to alter the situation. When people are out of work for a month, not working becomes their habit and a return to work becomes more difficult. As these interviews show, there are other influences such as the job, the manager and relationships with work colleagues that can positively influence and support your return to work.

This article encourages you to look at the overall situation and think about what can be done to help return to work. Think about would increase the positive aspects of work and then talk to others about your ideas.
Employer
Most people can identify factors that motivate and demotivate them. Return to work is often centred on the medical condition. However many studies have shown return to work is heavily influenced by workplace relations including how the person feels about the job, whether they make a useful contribution and whether they feel they belong and are needed in the workplace.

Employers can make a big difference.

How does your company operate in this regard? Do you look at motivating factors? If a return to work is not progressing smoothly do you ask the individual what might make a difference? Alternatively, what can you do to assist them to improve their pain management? Engage them in the job? Give them meaningful work? What could be done to influence their co-workers or managers to acknowledge the employees value, so the person will be more motivated to return to work and pre-injury tasks?
Treater
As a treating practitioner
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 the focus is usually medical, how to treat and improve the condition. Return to work management can be difficult, particularly when subtle workplace influences are negatively impacting a return to work.

People can often identify factors that are motivating or demotivating. It is worth exploring these issues if return to work doesn't seem to be going smoothly.

Ask the patient about workplace relations, how they feel about their job? Having an interested employer makes identifying positive solutions easier. However if the employer is unlikely to change practices the person themselves can often think of solutions, when they have identified important factors that are interfering with their return to work.

As other studies on this site show, people who remain off work have poorer health outcomes. Many people eventually lose their jobs, isolation and depression
depression
A symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection. Major depression is likely to interfere significantly with everyday activity, with symptoms including insomnia, irritability, weight loss, and a lack of interest in outside events. The disorder may last several months or longer and may recur, but it is generally reversible in the short run.
 are common, and there are negative financial consequences for most people. Return to work is important and more likely to be successful if we can openly discuss the barriers that obstruct it.
Insurer
People become demotivated. We all become demotivated in various situations. Getting motivated and getting back on track can be quite difficult. Have you wanted to improve your level of fitness by starting to exercise, or improve your health by changing your diet? How easy was it to get into a routine? How did you motivate yourself to do this?

When someone has been off work for a few months the habit of their lives includes not working, then it is normal that the motivation to return to work is diminished. What can the employer, or you, do to assist them? Are they frustrated and demotivated because of the medical condition? Do they feel they are contributing at work, do they feel productive? What factors can influence them, and what contribution can you make to improve their level of motivation?
Original Article, Authors & Publication Details:
G. Gard1 and A. C, Sandberg2 (1998).

Motivating factors for return to work. Physiotherapy Research International; 3(2):100-108

1Department of Physical Therapy, Lund University Sweden.
2Department of Physical Therapy, Karolinska Institute, Stockholm, Sweden
Background, Study Objectives, How It Was Done:
This study examined patients who participated in an active 12-week 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.
 program in Sweden. The program consisted of three days at work and two days of rehabilitation a week. Past research has shown that pain prevents people from being motivated to return to work, and that motivation increases when functional coping strategies are identified and learnt. Therefore, the rehabilitation component of the program focused on reducing pain (by physical therapy and psychological
psychological
Refers to a person's perceptions, thought processes, emotions, personality and behaviour. Psychologists can treat mental health problems.
 treatment) and helping patients to cope with their pain by finding ways to accommodate their injury at work and home. Patients were also taught to care for themselves by increasing their physical fitness and strength whilst learning good techniques at work.

The idea that motivation can change the experience of pain was introduced in 1965. Increased concentration and motivation reduce the level of suffering as a consequence of pain.

The factors that will motivate a person to return to work depend on the individual's needs, personality and background. Personal, work-related and social factors will affect a person's motivation to return to work.

The aim of this study was to identify factors that patients found motivated or de-motivated them to return to work.

Patients participated in the rehabilitation program if they had musculoskeletal
musculoskeletal
Involving the muscles and the skeleton. This term includes the limbs, neck, shoulders and back. 'Musculoskeletal problem' refers to many different conditions that can affect the tendons, muscles and related structures.
 (back, shoulder or neck) pain for at least a year and had taken at least four weeks of sick leave from the pain.

Ten patients on the waiting list for the program were randomly selected to be part of the study. Nine women and one man were selected, aged 30-34. Half the participants had shoulder or neck pain and the other half had low back pain. They had experienced pain for 3-15 years. All participants had jobs in the health care or service industries, where they had worked for 5-17 years.

The participants were interviewed one month after the rehabilitation program and were asked questions aimed at identifying motivating and de-motivating factors. They were asked about their general work and home situation and their ideal situation and asked to evaluate the success of the rehabilitation program.
Study Findings:
Many factors were found to influence the patients' motivation to return to work.

Categories of motivating and de-motivating factors for return to work were identified by patient interviews. These included:

1. Work systems. People felt more motivated to return to work if they felt that they could do as much work and as good a job as their workmates. Communication with supervisors and control over work tasks was also important for motivation.

2. Work content. All of the study participants worked in the health care or service professions. They were more motivated to return to work if they felt their job was meaningful and helped others.

3. Relationships. The study participants said that relationships with workmates most affected their motivation to return to work. Satisfaction with the work environment, including a feeling of belonging and being appreciated, was a strong reason for wanting to return to work. Patients said that a bad relationship with their supervisor, with little communication and support, was a de-motivating factor for returning to work. Support outside of work also motivated people to return to work.

4. Health. Physical symptoms of pain discouraged people from working if it interfered with a patients' functioning at work. Being able to manage their symptoms motivated patients to return to work.

5. Self-confidence. If the study participants felt that they could do their job satisfactorily, as well as their workmates could, and that their job was helping others they were much more motivated to return to work. Positive feedback was listed as important for self-confidence.
Conclusions:
Many factors are important for motivating someone to return to work. If people felt they could do good job and help others they were more motivated to return to work. If people felt their symptoms were interfering with their functioning at work they lost motivation, so being taught to cope with painful symptoms helped people to remain motivated to work. Good relationships with workmates and friends/relatives outside of work helped motivate people to return to work, while a poor relationship with a supervisor could hinder motivation.
References:
PubMed Abstract
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