Work ethics and societal norms influence sick leave and return to work: tales of transformation

Purpose: This study's purpose was to explore how people on sick leave manage societal norms and values related to work, and how these influence their perspectives of themselves throughout the rehabilitation process.

Materials and methods: This was a longitudinal interview study with a narrative approach, comprising 38 interviews with 11 individuals on long-term sick leave. Data collection was conducted in two phases and analysed iteratively through content analysis.

Results: The results suggest that work ethics and societal norms influence individuals' views of themselves and the sick leave and rehabilitation process. Conforming one's personal values to the work norm can create internal conflicts and cause feelings of shame for not being able to live up to the established norm. The strong work norm may create unrealistic expectations, which in some cases may result in constraining the return to work process.

Conclusion: To transform a sick leave narrative into a positive one, societal norms and their influence on identity needs to be recognised. Stakeholders involved in the process can contribute to a positive transformation by not only supporting return to work, but also to acknowledge and help people manage their self-image as having a disability that limits their ability to work.IMPLICATIONS FOR REHABILITATIONStakeholders involved in the sick leave and rehabilitation process need to support sick listed individuals by acknowledging and helping people manage their self-image.Full RTW is not always the best option from a quality of life and wellbeing perspective.Treatment and support from stakeholders should be viewed as meaningful and legitimate, even if it does not lead to RTW.