%0 Journal Article
%T Professionals' experiences of what affects health outcomes in the sick leave and rehabilitation process-A qualitative study from primary care level.
%A Löfgren M
%A Törnbom K
%A Gyllenhammar D
%A Nordeman L
%A Rembeck G
%A Björkelund C
%A Svenningsson I
%A Hange D
%J PLoS One
%V 19
%N 7
%D 2024
%M 39074087
%F 3.752
%R 10.1371/journal.pone.0306126
%X <B>OBJECTIVE: </B>To explore frontline employees' experiences of how to create a purposeful sick leave and rehabilitation process (SRP) with the best interest of patients' long-term health in focus.<BR><B>METHODS: </B>Qualitative design based on focus group interviews in a primary care context in Region Västra Götaland, Sweden. Strategically selected professionals from different SRP organizations discussed sick leave outcomes and the rehabilitation process. Analysis was performed with Systematic text condensation.<BR><B>METHODS: </B>General practitioners (n = 6), rehabilitation coordinators and/or healthcare professionals from primary healthcare (n = 13), caseworkers from the Social Insurance Agency, the Employment Agency, and Social Services (n = 12).<BR><B>RESULTS: </B>The outcome of the SRP was described to depend upon the extent to which the process meets patients' bio-psycho-social needs. Aspects considered crucial were: 1) early bio-psycho-social assessments, including medical specialist consultations when needed, 2) long-term realistic planning of sick leave and rehabilitation alongside medical treatment, 3) access to a wide range of early rehabilitative and supportive interventions, including situation-based, non-medical practical problem solving, and 4) trusting relationships over time for all involved professions and roles to maximize process quality and person-centeredness. A gap between the desired scope of the SRP and existing guidelines was identified.<BR><B>CONCLUSIONS: </B>Interviewees perceived that successful outcomes from the sick leave and rehabilitation process in a primary care context depend on consensus, person-centeredness, and relationship continuity for all involved professions. An extended process scope and relationship continuity for all involved professionals were suggested to improve process outcomes.