Breast cancer in women of productive age is a huge problem of the current population. Approximately 52% of women, which were diagnosed with breast cancer in 2013, were aged 20-64. The aim of this thesis is to discover the influence of surgical solution of breast cancer on women return to their original profession. There were 68 suitable participants, who received surgical treatment, were aged 20-64, with finished treatment and who went back to their original employment. The results show that amongst manually working women, 60,9% return to their original employment, in administrative 78% return, which, in acceptance region of 0,05 (p = 0,142), is not a statisticaly significant difference. Furthermore, it was not found that age and lenght of treatment are connected (p=0,040). It appears that the time it takes to return to employment is significantly connected to the type of operation (acceptance region 0,05, p=0,046). This research shows how important it is for women after breast cancer treatment to receive timely rehabilitational intervention and to return to employment and how this affects their quality of life. Key words: Breast cancer, occupational therapy, return to work, cancer survivors, quality of life, quantitative research

En stor del av den arbetsföra befolkningen drabbas någon gång under sitt arbetsliv av hälsobesvär. För att möjliggöra ett hållbart arbetsliv finns det lagstadgade krav på arbetsgivaren att genomföra arbetsanpassningar, för att motverka hälsobesvär och för att sjukskrivna medarbetare ska kunna återgå i arbetet. Dock omfattar forskningen sällan HR-funktionen och därför har vi valt att undersöka hur individer i en HR-funktion upplever sin roll vid arbetsanpassning för sjukrivna medarbetare. Studien är avgränsad till att endast omfatta arbetsanpassning vid återgång i arbete. Med en kvalitativ metod har åtta intervjuer genomförts med informanter i en HR-funktion. Resultatet i studien visar att individer i HR-funktionen är en högst delaktig och viktig aktör med en samordnande funktion. / A large part of the workforce suffers from health issues at some point during their work life. As a result, there are statutory requirements for the employer to carry out work adjustments, partly to counteract health problems and so that employees on sick leave can return to work. However, research rarely covers the HR-function and therefore we have chosen to investigate how individuals in the HR-function perceives its role when work is modified for employees on sick leave. This study is limited to modified work when an employee on sick leave will return to work. Through a qualitative method were eight interviews conducted with informants in an HR-function. The results of the study show that individuals in an HR-function is a highly involved and important actor with a coordinated function.

I Sverige är det lagstadgat att arbetsgivaren skall upprätta en plan tillsammans med en sjukskriven arbetstagare om hur denne skall återgå till arbetsplatsen på bästa sätt. Trots att tillstånden mellan en föräldraledig och sjukskriven inte kan sättas i paritet med varandra gårdet att dra en parallell då de båda tillstånden innebär längre frånvaro från arbetsplatsen. Syftet med denna studie är att undersöka mödrars upplevelse av återgång till yrkesarbetet efter en tid av föräldraledighet samt vilket stöd de får under denna process. Studien riktar sig mot mödrar av den anledning att kvinnor är föräldralediga i långt större utsträckning än män. Även om vi går mot en jämnare fördelning av föräldraledigheten mellan könen är det fortsatt mödrarna som är föräldralediga under en längre period. Denna studie har genomförts med kvalitativa semistrukturerade intervjuer där sju mödrar deltagit. Samtliga kvinnor som deltog i studien har varit föräldralediga de senaste fem åren och har sedan återgått till samma arbetsplats. Studiens resultat visar att det finns en splittrad upplevelse av återgången till arbetsplatsen efter föräldraledighet. Vidare visar resultatet att aktiviteter i en re-onboarding bestående av handledning, utbildning samt samtal mellan arbetstagare och arbetsgivare är betydelsefulla vid återgången tillbaka till arbetsplatsen. Stödet från kollegor och chefer är också av betydande vikt för kvinnors upplevelse av återgången tillbaka till yrkesarbetet efter föräldraledighet. / In Sweden, it is stated by law that the employer has to establish a plan with an employee currently on sick leave on how to integrate the employee as optimally as possible back into the workplace. Even though a sick leave and paternal leave cannot be put into parity, there are parallels since both results in a prolonged workplace absence. The purpose of this study is to look into the reintegration of mothers into the workplace, their experience regarding this, and what support they receive from their employers during this process. The study is aimed at mothers because they are on maternal leave a far longer period of time than fathers onparental leave. However, the gap between maternal and paternal leave is shrinking, but mothers are still absent from work for a longer period. This study has been made with qualitative semi-structured interviews with participation from seven mothers. All seven women who participated had been on maternal leave sometime during the last five years and then returned to the same workplace. The study shows that there are mixed experiences related to workplace reintegration. Furthermore, the result also shows that re-onboarding activities such as tutorials, training and an employer-employee dialogue are significant during reintegration. The support of colleagues and superiors was also of noticeable importance during this process.

<p><strong>Purpose:</strong></p> <p>The purpose of this study was to determine what cut-off of the Orebro Musculoskeletal Pain Screening Questionnaire score will best differentiate workers with acute musculoskeletal injuries at-risk for delayed return to work (greater than 3 months), in a population of workers of less than 3 weeks injury duration.</p> <p><strong>Study Design:</strong></p> <p>Retrospective cohort design, using a sample of convenience.</p> <p><strong>Methods:</strong></p> <p>A sample of 259 consecutive WCB patients seeking assessment and treatment at a multidisciplinary rehabilitation facility were reviewed, with 152 meeting the inclusion criteria of having sustained a soft tissue injury within 3 weeks of initial assessment. Descriptive statistics, tests of difference between Time 1 and Time 2 OMPSQ scores and Receiver Operator Characteristic curves were generated. The method of determining predictive ability of the OMPSQ at two points in time was by means of ROC analysis.</p> <p><strong>Results:</strong></p> <p>This study determined that the OMPSQ is moderately predictive of failure to achieve timely return to work (RTW) in a population of injured workers with acute musculoskeletal soft tissue injuries, when assessed two-weeks after treatment is initiated, and less predictive at the initial intake into treatment. Delayed RTW was defined as those workers who had not returned to their pre-injury job full time by 90 days, due to reduced functional ability as it related to their pre-injury occupation.</p> <p><strong>Conclusions:</strong></p> <p>This study demonstrates that there is variability in cut-off scores across studies. Future research should attempt to define cut-off scores as they relate to the population , outcome, condition and time-frame of interest . <strong></strong></p> / Master of Science Rehabilitation Science (MSc)

Problem: Mental health issues are rising, driven by stress leading to significant sick leave and reduced work capacity. Prolonged sick leave has detrimental effects on individuals and society, emphasizing the need to support return to work (RTW) efforts. Flexible work options like remote work could aid this transition by providing greater autonomy and adaptability. However, further research investigating how remote work flexibility supports RTW after mental health-related absences is crucial. Aim/purpose: To investigate and describe how employees experience remote work when returning to work after sick leave due to stress-related mental health issues. Method: A qualitative method with an inductive approach was applied. Empirical data was collected through semi-structured interviews and the data was analyzed using qualitative content analysis. Results: The study found that remote work during RTW was mostly positive. Participants appreciated the ability to adapt work and hours to their needs. However, they noted negative aspects like altered demands and lack of social interaction and support. The extent of remote work was particularly significant later in the RTW process. Conclusion: The study's results showed that remote work can have a double-edged effect, although the positive experiences outweighed the negative. The results indicate that remote work can be a work adaptation that could promote RTW

Auf der Suche nach Determinanten der erfolgreichen beruflichen Integration in den allgemeinen Arbeitsmarkt wurden Teilnehmer einer Integrationsmaßnahme für psychisch beeinträchtigte Menschen bei der REHAaktiv darr GmbH sowohl qualitativ als auch quantitativ untersucht. Es handelt sich um eine prospektive Längsschnitt- bzw. Kohortenstudie. Der umfangreichere Quantitative Teil der Arbeit beinhaltet die Auswertung erhobener demographischer, psychodiagnostischer und persönlicher (Freizeit, finanzielle Situation) Daten von n=206 Maßnahmeteilnehmern bezüglich der Zielvariablen erfolgreiche berufliche Integration direkt nach der Maßnahme, nach einem halben Jahr sowie nach einem Jahr und Abbruch der Maßnahme aus gesundheitlichen Gründen sowie Anzahl krankheitsbedingter Fehlzeiten während der Maßnahmedauer. Als Prädiktoren der erfolgreichen beruflichen Integration konnten ein hohes Intelligenzniveau, ein guter Schulabschluss, das Vorhandensein eines Partners, ein mittleres bis hohes Engagement, gute Kontrollstrategien innerhalb der Stressbewältigung sowie ein höheres Einkommen zu Maßnahmebeginn gefunden werden. Die Einnahme von Medikamenten, ein höheres Alter, eine vorhandene Berufsunfähigkeit sowie eine subjektiv höhere Einschätzung der psychosomatischen Beschwerden wurden als Prädiktoren des Maßnahmeabbruchs aus gesundheitlichen Gründen identifiziert. Die Anzahl krankheitsbedingter Fehlzeiten wurde durch die beiden Prädiktoren psychosomatische Beschwerden sowie das Fehlen der Diagnose Schizophrenie, vorher gesagt. Im zweiten Teil der Arbeit erfolgte die Auswertung der qualitativen Interviews von jeweils sechs erfolgreich integrierten und sechs nicht integrierten Maßnahmeteilnehmern. Als Ergebnis konnten die generellen Bedeutungsschwerpunkte Empfundene Unterstützung durch die Mitarbeiter, fehlende berufliche Orientierung sowie die große Bedeutung der Praktika und der Seminargruppe herausgestellt werden. Individuelle Unterschiede in Bezug auf den Integrationserfolg zeigten sich bezüglich der Bedeutung der Arbeit, der Fähigkeit zur Stressbewältigung, der Selbsteinschätzung und der Einstellung zur Maßnahme. / Searching for determinants for the successful integration into the general job market, participants in a rehabilitation program for the mental handicapped carried out by REHAaktiv darr GmbH were studied qualitatively und quantitatively. This was a prospective longitudinal or cohort study. The more extensive, quantitative part of the study consists of an analysis of the demographic, psychodiagnostic and personal (leisure time, financial situation) data ascertained from n=206 participants with regard to the variable objectives of the successful integration immediately after completion of the scheme, after six months and one year as well as after dropping out of the scheme for health reasons as well as the number of days absent for health reasons during the scheme. Predictors of a successful integration are high intelligence, high school graduation, the presence of a partner, a mid to high level of commitment, good strategies of control as soon as a higher income in the beginning of the program. Medication, advanced age, vocational disability and subjectively higher assessment of the psychosomatic troubles were identified as predictors for dropping out of the scheme for health reasons. The number of absences due to illness was predicted by the predictors psychosomatic disorders as well as the absence of a diagnosis schizophrenia. The second part of the study consisted of the assessment of the qualitative interviews with six participants who were successfully integrated and six who were not. The result that emerged emphasized the amount of support from the REHAaktiv personnel “felt” by the participants, a lack of career orientation on their part as well as the great importance of the practical training and the seminar group. Individual differences with respect to the success of the integration could be attributed to the importance of work, the ability to deal with stress and mental attitude to the scheme.

Introdução: Câncer de mama é o mais comum em mulheres. Embora sua incidência ainda esteja em ascensão, as taxas de recorrência e mortalidade têm diminuído, em especial nos países desenvolvidos. Assim o câncer pode ser considerado um choque transitório que não impede que os sobreviventes retomem a normalidade em suas vidas, incluindo atividades laborais. Na América do Norte e Europa, as taxas de RT entre as pacientes com câncer de mama variam de 24-66% após 6 meses e 53-82% após 36 meses de diagnóstico. Os fatores mais associados ao RT são: idade, quimioterapia, sequelas da terapia do câncer e apoio do empregador e colegas de trabalho. Esses achados, no entanto, variam sugerindo que outros fatores e até aspectos de diferentes legislações podem interferir no RT. Na América Latina há escassez de dados sobre RT após o diagnóstico de câncer de mama. Objetivos: Avaliar as taxas de retorno ao trabalho nos meses 12 e 24 após o diagnóstico de câncer de mama e verificar a correlação de fatores à retomada ao trabalho aos 24 meses. Métodos: Estudo prospectivo observacional avaliando taxas de RT em mulheres com câncer de mama tratadas no Instituto do Câncer do estado de São Paulo, com idade > 18 e < 57 anos e que trabalhavam de forma remunerada por pelo menos 03 meses ao diagnóstico. Pacientes com doença inoperável ou metastática foram excluídas. Nos meses 06, 12 e 24 do seguimento responderam à questionários do estudo e de qualidade de vida (FACT-B), por telefone. Resultados: Entre julho/2012 e setembro/2014, 125 pacientes assinaram o TCLE. Quatro foram excluídas da análise (02 óbitos e 02 sem contato por telefone). A idade média foi de 45.1 anos (± 8,1). A maioria (94%) gostava do trabalho, 73% receberam apoio do empregador, mas apenas 29% relataram ter recebido oferta de ajuste no trabalho. Metade apresentava doença no estádio II e 93% fizeram quimioterapia como parte de seu tratamento. As taxas de RT foram 21,5%, 30,3% e 60,4% aos 06, 12 e 24 meses, após o diagnóstico de câncer de mama. Na análise multivariada os fatores que afetaram de forma positiva as taxas de RT foram: renda familiar mensal >= 02 salários mínimos (OR 17,76, IC95% 3,33-94,75, p 0,001), cirurgia conservadora da mama (OR 9,77, IC 95% 2,03-47,05, p 0,004) e oferta de ajuste no trabalho pelo empregador (OR 37,62, IC95% 2,03-47,05, p 0,004). Fatores que se associaram de forma negativa ao RT foram: terapia endócrina (OR 0,11, IC95%0,02-0,74, p 0,023) e diagnóstico de depressão após o câncer (OR 0,07, IC95% 0,01-0,63, p 0,017). Conclusões: As taxas de RT aos 12 e 24 meses após diagnóstico de câncer de mama são inferiores a maioria dos estudos conduzidos na América do Norte e Europa. Oferta de ajuste no trabalho, maior renda familiar, cirurgia conservadora da mama, terapia endócrina adjuvante e diagnóstico de depressão após o câncer de mama desempenharam importante papel no RT / Background: Breast cancer is the most common cancer in women. While its incidence has been increasing, recurrence and mortality rates have been decreasing, mainly because of better treatment options. Because of that cancer can be regarded as a transient shock that does not prevent survivors resume normality in their lives including return to their workplace. In North America and Europe return to work (RTW) rates vary among breast cancer patients from 24- 66% after 06 months and 53-82% after 36 months of diagnosis. Factors most associated with the decision to return to work are: age, chemotherapy, sequelae related to cancer therapy and support from the employer and coworkers. However, these findings vary among the different populations evaluated, suggesting that other factors and even variations in countries laws may interfere with the decision to return to work. So far there is a lack of data on RTW after breast cancer diagnosis in Latin America. Endpoints: To evaluate return to work rates on months 12 and 24 after breast cancer diagnosis, and check the correlation of some factors with the decision to return to work at 24 months. Methods: A prospective, observational study evaluating RTW rates in patients with breast cancer diagnosis, > 18 and < 57 years old and a paid work for at least 03 months at the time of dianosis. Patients with inoperable or metastatic disease were excluded. On months 6, 12 and 24 they answered a telephone interview and the quality of life questionnaire (FACT-B). Results: Between july/2012 and september/2014, 125 patients were enrolled. Two of them died and two other could not be reached by telephone, and were excluded from the analysis. Mean age was 45,1 years (± 8,1). Most of them reported that they liked their job (94%) and received support from employer (73%), but only 29,1% reported having been offered work adjustment. Half of patients had stage II disease and 93% received chemotherapy as part of their treatment. Overall, 21,5%, 30,3% and 60,4% of patients returned to work 06, 12 and 24 months after breast cancer diagnosis, respectively. In the multivariate analysis, factors associated with positive RTW outcomes included higher income (OR: 17,76, CI95% 3,33-94,75; p = 0,001), breast conserving surgery (OR: 9,77, CI95% 2,03-47,05; p = 0,004) and work adjustment (OR: 37,62, CI95% 2,03-47,05; p= 0,004). Factors associated with negative RTW outcomes included adjuvant endocrine therapy (OR: 0,11, IC95% 0,02-0,74; p = 0,023) and depression diagnosis after breast cancer diagnosis (OR: 0,07, IC95% 0,01-0,63; p = 0,017). Conclusion: RTW rates after 12 and 24 months of breast cancer diagnosis are lower than reported in North America (with exception for low income americans) and Europe. Workplace adjustments, higher income, breast conserving surgery, endocrine therapy and depression after breast cancer played an important role in the RTW decision

<p>The aim of this study was to examine how individuals with disability pension reason about a return to work. Action theory, as presented by Berglind, was used as theoretical approach. Qualitative interviews were conducted with five individuals who have disability pension due to mental illness. The respondents describe how they weigh benefits and disadvantages against each other. The main reason for a return to work is economical. The greatest disadvan-tage is the risk of losing their right to disability pension, which seems to limit their motivation to return to work. All respondents stress benefits associated with work but they do not all wish to return to work. Work is not described as equal to paid work but as an essential part of life. All respondents’ express a belief in their ability to work but are doubtful concerning their chances of getting employment, which seems to have a negative impact on their motivation as well. Furthermore, the respondents criticize the public authorities in the field of rehabilitation for not contributing to a return to work process. However, they give an example of how a non-governmental organisation has been important for increasing their possibilities of a return to work.</p>

<p>Bakgrund: Sjukfrånvaron i Sverige är hög i jämförelse med andra EU-länder.Långtidssjukskrivning till följd av stressrelaterade sjukdomar domineras av kvinnor.Det finns ett stort behov av en effektivare återgångsprocess till arbetslivet efter ensjukskrivning där olika insatser bör prövas och utvärderas. I vissa fall kan en neutralpart i form av en oberoende samordnare vara till hjälp för den sjukskrivne iåtergångsprocessen. Syfte: Syftet med studien var att beskriva kvinnors erfarenheter avmöten med arbetsgivarringens representant i återgångsprocessen till arbete, efter enstressrelaterad långtidssjukskrivning. Metod: Data insamlades genom kvalitativaintervjuer med tio kvinnor. Inklusionskriterer var att ha varit långtidssjukskriven förstressrelaterade sjukdomar, att ha varit i kontakt med en arbetsgivarring, samt att underåren 2007-2008 återgått till tidigare arbete eller annat lönearbete i en omfattning avminst 25 procent och ha arbetat under minst sex månader. Med arbetsgivarringens hjälpgjordes ett strategiskt urval, där hänsyn togs till ålder, sjukskrivningens längd, yrke ocharbetsplats. Data analyserades med manifest- och latent innehållsanalys. Resultat:Resultatet visar på fyra kategorier som representerar det manifesta innehållet: att blibemött med respekt och engagemang, att arbeta med att finna lösningar, egen utvecklingmed ökat självförtroende, organisatoriska aspekter. Det latenta innehållet beskriverkvinnans utvecklingsprocess, arbetsgivarringens handledningsprocess och det mellanmänskligasamspel som sker mellan dessa parter. Intervjuerna genomsyras av uttryckdär kvinnan beskriver att hon befinner sig i centrum. Allt handlar om henne och det ärarbetsgivarringen som får henne att känna sig betydelsefull. Slutsats: Genom en djupareförståelse för vad som bidrar till återgång till arbetslivet för personer medlångtidssjukskrivning, kan grunden läggas till ökad satsning och adekvata insatser förökad återgång till arbetet för fler personer.Nyckelord: återgång till arbete (RTW), stressrelaterad långtidssjukskrivning</p> / <p>Background: Sickness absenteeism is high in Sweden compared to other countries inthe European Union. Long-term-sick-absenteeism which depends on stress-relatedsickness is dominated by women. There is a great need to make the return-to-work(RTW) process more effective after an absenteeism where different contributions mustbe tested and evaluated. In some cases may neutral parties in form of an independentRTW-coordinator support sick-listed persons in their RTW-process. Purpose: Thepurpose of the study was to describe women’s experiences of meetings with a personfrom an “arbetsgivarring” in the RTW-process, after a period of stress-related sickness.Methods: Data was collected by qualitative interviews with ten women. Criteria thatincluded participation: to have been long-term-sick-listed because of stress-relatedsickness,to have been in touch with an “arbetsgivarring”, and during 2007-2008returned to earlier occupation or other form of paid work in an extend of 25 percent andhave been working for at least six month. Data was analysed using both manifest andlatent content analysis. Results: The result shows four categories representing themanifest content: to be treated with respect and engagement, to work with findingsolutions, own development with increased self-confidence, organisational aspects. Thelatent content describes the development process of the woman, the guidance process ofthe “arbetsgivarring” and the inter-mediate humanity that occurs between these twoparts in the meeting. All narratives are permeated by expressions where the womandescribes herself being in the centre of attention. Everything is about her and the“arbetsgivarring” makes her feel important. Conclusions: Through deeperunderstanding regarding what promotes RTW for persons on long-term-sick-list thebasis for an increased investment and adequate contributions to reach an improvingRTW can be laid for numerous persons.</p>

The primary aim of this investigation was to evaluate a seven-week multidisciplinary rehabilitation programme, with emphasis on musculoskeletal disorders, for working-age people, by assessments at the start and end of the rehabilitation programme, and at follow-up examinations 6, 12 and 24 months after completion of the programme. A further aim was to explore the experiences of people not returning to work during a period of six years after participation in an extensive multidisciplinary rehabilitation programme. Sixty participants, 40 women and 20 men (mean age 46.8 ± SD 7.9), with musculoskeletal disorders, mainly neck and back pain, participated in a 7- week rehabilitation programme which was based on a combination of theoretical and practical education, physical activities, relaxation and individual guidance. Before and after the programme and at the follow-up occasions all participants were evaluated with the Global Self-Efficacy Index (GSI), Hospital Anxiety and Depression Scale (HAD), and Stress test (Study I). A group of participants who were still full-time sick-listed (Group I) at the end of the study period were compared with participants who were part-time or not sick-listed (Group II) at the end of the study period (II, III, IV). They were evaluated with the Disability Rating Index (DRI), with the Pain Intensity Rating Index on a visual analogue scale (VAS) (II, III)), mobility tests (III), GSI (III), HAD, and a stress test (IV). Seven women (median age 48 years) and three men (53 years) (Group I) were interviewed and the interviews were analysed by manifest content analysis (V). At the 2-year follow-up full-time sick leave, anxiety, depression and selfexperienced stress had decreased in both sexes. They also showed increased quality of life (QoL) (I). In participants with full-time sick leave (Group I), self-experienced physical disability and pain ratings were high and showed no decrease up until the 2-year follow-up. In participants with part-time or no sick leave (Group II), physical disability and pain ratings decreased gradually throughout the 2-year follow-up period (II). Cervical and thoracolumbar spine range of motion (ROM) was lower in Group I than in Group II from the start of rehabilitation to a 2-year follow-up. Only Group II showed a temporal improvement in ROM. No changes in DRI, VAS or GSI were found in parallel with corresponding temporal changes in any of the ROM (III). Group I experienced no change in anxiety or depression during the study period, in contrast to Group II, in which this decreased. Decreased stress was found in both groups (IV). Group I described perceived barriers to and possibilities of returning to work, and also gave information on what strategies they used, to cope with everyday life (V). The majority of the participants improved and they continued to be physically active, their QoL improved, and most participants returned to work. Ten of the participants, however, were on full-time sick leave throughout the whole study period, with high self-experienced physical disability, high pain rating and no improvement in anxiety and depression. They experienced barriers to re-entering the labour market as consequences of physical symptoms and fatigue. But they also believed in possibilities of returning to work if they could get a modified job adapted to their own capacity. Thus, persons with severe disability and pain did not improve by rehabilitation in this project. New methods of treatment have to be developed for improvement of symptoms resulting in reduction of functional impairment and a consequent need for sick leave. / Huvudsyftet med undersökningen var att utvärdera ett 7-veckors multidisciplinärt rehabiliteringsprogram inriktat på muskuloskeletala besvär, för arbetsföra kvinnor och män, vid start och efter rehabiliteringsprogrammets slut samt vid 6, 12 och 24 månader. Vidare var syftet att undersöka deltagares upplevelse av att inte återgå i någon form av arbete sex år efter deltagande i rehabiliteringsprogrammet. Sextio deltagare, 40 kvinnor och 20 män (medelålder 46.8 ±7.9), med muskuloskeletala besvär, framför allt nack- och ryggbesvär, deltog i ett 7- veckors rehabiliteringsprogram som innehöll en kombination av teoretisk och praktisk undervisning, fysisk aktivitet, avslappning och individuell vägledning. Deltagarna testades före och efter rehabiliteringsprogrammet samt vid uppföljningstillfällena med Globalt Självskattnings Index (GSI), Hospital Anxitey and Depression Scale (HAD) och stress test (Studie I). En grupp deltagare som fortfarande var helt sjukskriven (Grupp I) i slutet av studieperioden, jämfördes med deltagare som var delvis eller inte alls sjukskriven (Grupp II) vid studieperiodens slut (II, III, IV). De utvärderades med Disability Rating Index (DRI), smärtskattning med visuell analog skala (VAS) (II,III), rörlighetsmätning (III), GSI (III), HAD, och stress test (IV). Sju kvinnor (median ålder 48 år) och tre män (53 år) (Grupp I) intervjuades och intervjuerna analyserades med manifest innehållsanalys (V). Vid två års uppföljning hade heltidssjukskrivning, ångest/oro, depression och självupplevd stress minskat hos båda könen. De visade också ökad livskvalitet (I). Deltagarna som var helt sjukskrivna (Grupp I) hade hög självskattad funktionsnedsättning samt smärtskattning och visade ingen förändring vid två års uppföljning. Deltagarna som var delvis eller inte alls sjukskrivna (Grupp II) visade en gradvis förbättring av fysisk funktion och smärtskattning under studieperioden (II). Cervical och thoracolumbar rörlighet var mindre i Grupp I jämfört med i Grupp II från start till två års uppföljning. Endast Grupp II visade en temporär förbättring av den aktiva rörligheten. DRI, VAS och GSI förändrades inte parallellt med förändringarna i den aktiva rörligheten (III). Grupp I upplevde ingen förändring i ångest/oro eller depression under studie perioden jämfört med Grupp II, som minskade ångest/oro och depression. Båda grupperna skattade mindre stress (IV). I studie V beskrevs deltagarnas upplevelser av hinder och möjligheter för att återgå i arbete. De beskrev vidare vilka strategier som användes för att hantera vardagslivet. Majoriteten av deltagarna förbättrades och de fortsatte att vara fysiskt aktiva, livskvaliteten förbättrades och de flesta deltagarna återgick i arbete. Tio av deltagarna var helt sjukskrivna under hela studieperioden, med hög självskattad fysisk funktionsnedsättning, hög smärtskattning och ingen förbättring i ångest/oro eller depression. De upplevde hinder för återgång i arbete, en konsekvens av de fysiska symtomen och trötthet. De trodde också på möjlighet till återgång i arbete om de kunde få ett arbete anpassat till deras egen arbetsförmåga. Alltså, personer med stor funktionsnedsättning och hög smärta förbättrades inte av rehabilitering i det här projektet. Nya metoder av behandling behöver utvecklas för att förbättra symtomen och därmed minska funktionell försämring och behovet av sjukskrivning.