Variation in Lifestyle and Readiness of Participants of a Return to Work Program According to Depressive State by a Mixed Design Method

Abstract

Background: Mental health problems in the workplace are an important issue globally, and return-to-work (RTW) programs for people on sick leave because of mental health problems are being developed. However, participants' situations and states are various and there are few assessment tools.

Objectives: We aimed to reveal the clinical picture of participants of an RTW program according to depressive state with mixed method research to help occupational therapists plan client-centered rehabilitation programs.

Methods: We used a conversion mixed methods research design. We collected basic information and administered the Beck Depression Inventory (BDI) in the quantitative arm, and used written rehabilitation plans based on interviews conducted in the initial stage assessments of participants in an RTW program as the qualitative arm. Data from the quantitative arm were divided into three groups according to severity of depressive symptoms based on BDI cut-off points. Qualitative data were analyzed by creating codes and categories following the grounded theory approach. Both types of data were merged by calculating the frequencies of occurrence of codes for each depression severity group.

Results: Our results showed that participants' clinical pictures were different depending on their depressive state. Participants with a severe state had difficulty waking up early, disordered eating habits and appetite, and difficulty with selfdisclosure. Participants with a lighter depressive state had a stable lifestyle and were able to perform high-level cognitive activities like studying or exercise.

Conclusions: Our results will help occupational therapists assess participants in the initial stage RTW programs, and contribute to effective interventions.