Return to work model after injury or illness: A Scoping Review Protocol

Abstract

After injury or illness, return to work (RTW) is important for previously-employed patients, and is positively associated with functional recovery and economic status.1-5 Failure to return to work (RTW) following illness or injury is often, both theoretically and operationally, equated with work disability.6 In the past three decades, biomedical, social construction, and biopsychosocial models have proposed to describe the process and potential factors that influence human responses to work and the development of work disability. 7 Within the biomedical perspective, disability is produced by a medical condition, which deviates individuals from normal biomedical function or structure. 6 8 Factors such as context and environment are not considered. However, in the social construction paradigm, disability is viewed as a combination of activities, relationships, individual attributes, and conditions arising mainly from the social environment.8 Thus, disability depends on a societal response in a given context. The biopsychosocial models approach disability from both the social and the biomedical paradigms, which provide the most comprehensive view to discuss work disability. From the biopsychosocial point of view, multiple factors potentially affect RTW. The occupational disability model, which includes medical status (such as neurologic, cardiovascular), physical capability (physical status, work tolerance), work demands (biomechanical, psychological), and psychological/behavioral resources (workers traits, psychological readiness), is an example of an early biopsychosocial approach.9 Many other models have been proposed to understand RTW from the biopsychosocial approach, such as the Institute of Medicine model of disability,10 the International Classification of Functioning, Disability, and Health (ICF)/the expanded ICF model,11 the cancer and work model,12 as well as the readiness for return to work model. The scoping review aims to 1) identify existing RTW models using biopsychosocial approach, 2) compare and contract these models, and 3) synthesis these models and proposed a comprehensive model.

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