Background: To achieve adequate return to work (RTW) after sickness absence, Dutch legislation prescribes cooperation between absent employees and employers. Yet, we lack insight into how employees with low levels of education exercise influence over (i.e. self-direct) RTW.
Objective: This study aimed to enhance our understanding of: (A) the role that employers play in the self-direction of employees with low levels of education over their RTW; (B) how employers perceive these employees' efforts (or lack thereof) to self-direct their own RTW; and (C) how employers understand and interpret the behaviours of these employees. Social cognitive theory served as a framework.
Methods: A qualitative study was conducted with 13 employer representatives using semi-structured interviews. Data were analysed in NVivo12 using a template approach.
Results: Employers tend to play a guiding, directive role in employees' RTW. According to employers, employees generally comply with the employers' decisions and suggestions, whether or not they have tried to realise their own preferences regarding mode and timing of RTW. Employers interpret such employee behaviours from the perspective of environmental (e.g. financial pressures to RTW) and person-related factors (e.g. sickness and RTW perceptions).
Conclusions: Employers, rather than employees direct the employees' RTW. Employers should give voice to employees and enable them to have more control over their RTW. Future research should acquire more insight in the employees' perspective.
Keywords: Return to work; employees with low levels of education; employers; self-direction; sick leave; sickness absence.