The guidelines published by the International Social Security Association, ISSA Guidelines: Return to Work and Reintegration, provide a policy imperative towards early intervention for people with nonoccupational health conditions at risk of exiting the workforce and moving to disability dependency. Socioeconomic and fiscal imperatives have been demonstrated by the Organisation for Economic Co-operation and Development's (OECD) review on sickness, disability and work (OECD, 2010), and by an accumulating evidence base for effectiveness. This study explored how social protection agencies are responding in terms of employment rehabilitation services for employed people with acquired disabilities. Specifically, this study reviewed job retention and return processes for workers with nonoccupational health conditions from the perspective of the ISSA guidelines in four jurisdictions with differing system frameworks. The methods used included a review of relevant literature and web resources and gathering detailed system descriptions from national respondents. Although the jurisdictions differed in the concepts used, service context, the structure of welfare systems and eligibility criteria, there was evidence of an acknowledgement of the needs of employed people with disabilities. This was not, however, consistently reflected in procedures, processes or outcome measurements. While some promising characteristics were identified, there was substantial room for improvement in the job retention and return to work strategies of the relevant agencies in all four jurisdictions. It was concluded that the deployment of the ISSA Guidelines: Return to Work and Reintegration, published in 2013, had yet to make a substantial impact on services and approaches in the domain of nonoccupational health conditions in these jurisdictions.

Despite the high prevalence of withdrawal from employment gained post-traumatic spinal cord injury (tSCI), relatively few studies have examined the factors that precipitate job withdrawal. Within the context of general systems theory, the aim of the present study was to identify and classify the factors that led to job withdrawal post-tSCI. Using purposive sampling and a structured proforma, 30 participants completed an in-depth telephone interview. Job withdrawal was precipitated more frequently by micro-system (person-centred) factors or meso-system (job-related) factors than macro-system (socio-economic) factors. Micro-system factors fell into five groups (SCI-related, psychological/psychosocial, mobility, general health and knowledge/skills/abilities) as did meso-system factors (job design, psychosocial climate, ergonomics, human resources and work cycles). Two groups of macro-system factors were identified (proximal and distal). Classifying job withdrawal factors within the context of general systems theory provides an integrated framework for intervention development and furnishes decision-makers with guidance as to whether a top-down or bottom-up approach would be more feasible/beneficial to address preventable job withdrawal post-tSCI.

Objective. The study examined the evidence for the influence of chronic pain on proximal work participation behaviours important for job retention such as presenteeism, absenteeism and job satisfaction.

Method. A comprehensive literature search was undertaken using various databases including PsycINFO, Medline, Scopus and other sources which resulted in the identification of 353 articles of which 15 articles were chosen for analysis and inclusion. Eligibility was based on a mixed methodological framework using the Consolidated Standards of Reporting Trials (CONSORT) checklist.

Results. There is evidence to suggest that chronic pain influences work participation qualities including absenteeism, presenteeism and job satisfaction. Personality and work content factors mediate the relationship between chronic pain and the proximal work participation variables.

Conclusion. Interventions targeting proximal work context behaviours appear to hold promise for long-term work participation by people with chronic pain. Rehabilitation interventions for job retention with chronic pain will likely be successful with attention to ongoing, changeable work participation behaviours that predict job retention.