Seminar Presentation 4-4

4-4 (Presentation within Topical Seminar 4):
What do people take into consideration when they answer questions about their return-to-work expectations?

Presented by: Amanda Ellen Young

Seminar Details

Part of Topical Seminar 4: Psychosocial Factors Involved in the RTW Process
Tuesday September 30


Young A1, Choi Y1, Woiszwillo MJ1

  1. Center for Disability Research, Liberty Mutual Research Institute for Safety, USA



Workers’ own expectations for return to work (RTW) have been found to be one of the best predictors of future work status, but there is a limited understanding of why people expect what they do. Using a qualitative methodology (focus groups), this study specifically asked what people take into consideration when forming expectations for return to work.


34 people (8 women, 26 men) currently off work due to a musculoskeletal condition were recruited to participate in one of 14 two-hour focus groups conducted at our research facility between February and August 2013. At the start of each focus group, each participant completed an individual questionnaire about 1) whether they expect to return to work, 2) the approximate time frame for when they expect to do so, and 3) the factors they considered in forming those expectations. Next, each participant briefly introduced themselves and presented their responses. After that, the influences participants listed were discussed and reflected upon by the group. Focus group audio recordings were fully transcribed and subject to content analysis, which was assisted with the use of NVivo 10.


Participants were 25 to 65 years old (M=45, SD=12.6) and had been out of work for 3 months or less due to their injury. At the time of participating in the focus group all reported expecting to return to work, with the most commonly expected time to RTW being approximately weeks (M = 47 days, Range = 1 day-6 months). When asked to list the things they took into consideration when formulating their answer, most participants listed 4 or 5 factors (Range = 2-14). Generally, participants listed factors such as physical health (e.g., recovery, healing) and financial concerns (e.g., bills to pay) on the questionnaires, but the group discussions revealed a far richer picture. Analysis of the group discussions indicated that many more factors were considered. Findings suggest that when formulating RTW expectations, workers reference components of themselves, as well as elements of their disability management, work, social, economic, and physical contexts. Analysis also indicated that interactions with elements influenced expectations. More specifically, thoughts about, desire and need for, feelings towards, access to, and behavioral exchanges were often spoken about when explaining RTW predictions. It was also found that some elements can influence expectations in contrasting ways. For example, peers were said to exert both positive and negative influence (i.e., “you should be working” vs. “milk the system”).


Indications are that many of the variables that people spoke about were amenable to intervention, suggesting that more can be done to assist workers progress more quickly and confidently through the process of returning to work.