Reïntegratie bij langer durend ziekteverzuim : een longitudinaal onderzoek naar (inter)acties van werknemer, leidinggevende en bedrijfsarts

Abstract

The reason behind this study concerns amendments to Dutch legislation in the period 1990-2005, which were aimed at stimulating active reintegration behaviour in employers and employees. These have far-reaching consequences for what is expected from those directly involved in sick-leave situations. The main focus is on the reintegration behaviour of the sick employee, of the manager who is responsible for the guidance process and of the occupational physician supporting them: In situations of long-term sick leave, to what extent does the reintegration behaviour of a sick employee, the direct manager and the occupational physician involved in the micro situation correspond to the behaviour that is intended by legislation and regulations and what are the key factors and mechanisms that play a role in the differences that occur? In a multiple-case study with a longitudinal setup and a grounded approach, reintegration development is analysed in eleven cases from two healthcare institutions. On the basis of the analyses of the differences in reintegration behaviour the following conclusions have been drawn. In a literal sense, the reintegration behaviour meets the requirements of the legislation in most cases. Seen from the perspective of the intentions of the legislation, the majority of the cases show considerable discrepancies between the behaviour observed and the behaviour intended by the legislator. According to the logic of legislation, the employee and manager – supported by the occupational physician – must actively and mutually cooperate in a structured process in order to establish a return to the labour process that is as swift as possible. The norm ‘work to your capacity’ implies that adequate behaviour means that labour possibilities are optimally used. The macro objective of increasing labour participation implies that the legislator finds a sustainable return to the labour process important. Behaviour that is labelled as anticipating corresponds the most to what the legislator intended with the amended legislation. Differences in reintegration behaviour are related to the various normative role orientations and cognitive action orientations of employee and manager. Furthermore, there is a connection to the differences in using resources: · An active interpretation of the own role by the employee and manager coincides with the expectation that the other will take part actively as well and with the idea of placing reintegration into the perspective of future employability. This interpretation and vision are linked to an active use of resources, e.g. medical knowledge, knowledge of legislation and regulations, previous experiences with reintegration and expert advice. · A less active interpretation of the own role by the employee and manager, in which they expect that the other or the occupational physician will take the lead, coincides with a vision in which the medical aspects of sick leave are emphasized and in which priority is given to terminating the sick leave. In this interpretation and vision, less use is made of the available resources. In both cases the mechanisms of adjustment of the employee’s and manager’s behaviour to that of the other and of the intensification of this in the interaction process occur.