Ethical aspects of the coordination of return-to-work among employees on sick leave due to common mental disorders: a qualitative study

Figures & data

Figure 1. Procedure for the recruitment (n = 46). PCCs: Primary care centres; OHS: Occupational Health Services; SSIA: Swedish social insurance agency. ¹Number of contacts, persons who after information from a third party or announcement had agreed to contact the researchers/number of included participants. ²Process leaders are providing operational support to coordinators in their daily work.

The figure illustrates a flow chart of the researchers’ recruitment. The researchers contacted management and process leaders at the primary care centres, Swedish Social Insurance offices, associations of occupational health service and occupational health services, placed an ad in a newspaper and shared information via a homepage and a newsletter to recruit participants for the study. In total 86 individuals were contacted personally and 46 agreed to participate in the study.

Table 1. Professional stakeholders (n = 37), characteristics and type of interview.

Participant number^a	Formal education	Gender	Position	Work sector	Professional experience (years)	Type of interview
C01	HR	Female	Coordinator	Regional	10–20	Telephone
C02	Single-subject courses	Female	Coordinator	Regional	Missing	Telephone
C03	Nurse	Female	Coordinator	Regional	10–20	In-person
C04	OT	Female	Coordinator	Regional	20–30	In-person
C05	Single-subject courses	Female	Coordinator	Regional	<5	In-person
C06	PT	Female	Coordinator	Regional	10–20	In-person
C07	Single-subject courses	Female	Coordinator	Regional	Missing	In-person
C08	PT	Female	Coordinator	Regional	<5	In-person
C09	Nurse	Female	Coordinator	Regional	Missing	In-person
C10	PT	Female	Coordinator	Regional	20–30	In-person
C11	Social worker	Female	Coordinator	Regional	10–20	In-person
C12	OT	Female	Coordinator	Regional	10–20	In-person
C13	OT	Female	Coordinator	Regional	20–30	In-person
C14	Nurse	Female	Coordinator	Regional	5–10	In-person
C15	Social Worker	Female	Coordinator	Regional	Missing	Telephone
C16	PT	Female	Coordinator	Regional	20–30	In-person
C17	PT	Female	Coordinator	Regional	<5	In-person
C18	Social worker	Female	Coordinator	Regional	20–30	In-person
P01	Physician	Male	GP	Regional	20–30	FG^b
P02	Physician	Male	GP	Regional	20–30	FG^b
P03	Physician	Female	ST	Regional	5–10	FG^b
P04	Physician	Female	ST	Regional	<5	FG^b
P05	Physician	Male	GP	Regional	5–10	FG^b
SSIA01	Missing	Male	CW	Governmental	5–10	Telephone
SSIA02	None	Male	CW	Governmental	<5	In-person
SSIA03	Missing	Female	CW	Governmental	Missing	In-person
SSIA04	Missing	Female	CW	Governmental	<5	In-person
OHS01	OT	Female	Coordinator	Regional in-house	10–20	In-person
OHS02	Nurse	Female	Coordinator	Private, external	10–20	Telephone
OHS03	Nurse	Female	OHS nurse	Private, external	>30	In-person
OHS04	Nurse	Female	OHS nurse	Private, external	<5	In-person
M01	HR	Female	HR	Municipal	5–10	Telephone
M02	Nurse	Female	CEO	Regional	5–10	Telephone
M03	Social worker	Female	CEO	Municipal	>30	Telephone
M04	None	Male	HR	Private	5–10	Telephone
M05	Behavioural Science Degree	Male	HR	Municipal	<5	Telephone
M06	OT	Female	HR	Municipal	<5	Telephone

CEO: Chief executive officer; CW: Case Worker; GP: General Practitioner; HR: Human resource specialist; FG: Focus group interview; OT: Occupational Therapist; PT: Physio Therapist; ST: Specialist training to become a General Practitioner.

^aParticipant number: C: Coordinator; P: Physician; SSIA: Swedish Social Insurance Agency; OHS: Occupational health services; M: Managerial position.

^bThe focus group interview was carried out as an in-person interview.

Table 2. Employees on sick leave due to common mental disorders (CMDs) (n = 9), characteristics and type of interview.

Employee number^a	Age (years)	Gender	Work Sector (private/municipal)	Professional experience (years in current profession)	Sick leave (part-time/full-time)	Type of interview
ES01	34	Female	Private	<5	Part-time	Telephone
ES02	Missing	Female	Municipal	<5	Full-time	In-person
ES03	61	Female	Municipal	5–10	Part-time	Telephone
ES04	46	Female	Private	<5	Part-time	Telephone
ES05	31	Female	Municipal	5–10	Part-time	Telephone
ES06	43	Female	Private	<5	Part-time	Telephone
ES07	25	Female	Private	5–10	Part-time	Telephone
ES08	33	Female	Private	5–10	Part-time	In-person
ES09	61	Male	Private	10–20	Full-time	Telephone

^aEmployee on sick leave due to CMDs.

Table 3. Overview of themes.

Themes	Ethical aspects represented in the themes^a
1. Autonomous decision-making versus the risk of taking over	Compatibility with ethical norms (autonomy and privacy)
2. Employee’s rights versus restrictions to self-determination
3. Respect for the employee’s privacy versus stakeholders’ interests
4. Risk of unequal inclusion due to insufficient organizational structure and resources	Structural factors with implications for equality (resources and organization, professional values)
5. Risk of unequal support due to unclear professional roles and responsibilities

^a*Heintz E, Lintamo L, Hultcrantz M, et al. Framework for systematic identification of ethical aspects of healthcare technologies: the sbu approach. Int J Technol Assess Health Care 2015;31(3):124–130.

Data availability statement

Data is available upon reasonable request.