Development of the Resilience Capacity Framework (RCF) for Return-to-Work in Individuals with Chronic Illness

Abstract

Background and Objectives: Traditional Return-to-Work (RTW) approaches often treat employment entry as a one-and-done success. In chronic illness cases however, the episodic nature of symptoms may challenge the approach. Without incorporating resilience enhancement strategies, the flare-up symptoms often compromise working productivity and eventually lead to premature retirement. Hence, this study aimed to identify key components associated with resilience in the RTW context and develop a framework to guide in bolstering resilience capacity for individuals with chronic illness. Method: This study was conducted in three phases using a sequential mixed-methods design. Phase I employed a cross-sectional survey (N=400), aimed at identifying predictors associated with resilience through validated questionnaires. Phase II utilised focus group discussions (N=32), aimed to gain insight into factors influencing resilience for RTW process. Finally, Phase III involved framework development, which was guided by the results of Phase I and Phase II and supported by existing literature. Results: Phase 1 identified illness acceptance and self-esteem as key modifiable predictors of resilience (p < 0.05), while Phase II yielded six elements associated with resilience for RTW, which were psychological adaptation, physical activity engagement, interpersonal support, healthcare facilitated empowerment, spiritual coping, and workplace adaptation. These findings resulted in the development of Resilience Capacity Framework (RCF), providing 18 actionable elements to be considered as strategies to bolster resilience for RTW. Conclusion: The RCF provides a detailed insight of the key pillars of resilience relevant for RTW process. The developed framework may serve as a foundation for supporting and advancing occupational rehabilitation