{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T01:27:46Z","timestamp":1769563666919,"version":"3.49.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-traumatic stress-related illnesses are associated with considerable functional impairment and costs for both individuals and societies. In Sweden, the national diagnose Exhaustion disorder (ED) is one of the most frequently diagnosed disorders in this category. Despite the major negative consequences of illnesses such as ED, there is no clear evidence on successful treatments or effective interventions to enhance return to work outcomes for this population. Therefore, the aim of this study was to explore how individuals who had returned to work after sick leave due to ED experienced the process of returning to work, including facilitating factors, significant challenges and needs of further support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were recruited from three clinics in Stockholm specialized in rehabilitation for Exhaustion Disorder. Semi-structured interviews were conducted with 15 participants and the transcribed interviews were analyzed using qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results yielded three themes \u2013 Struggling to adapt sustainably to change, Being supported or hindered by the context and Being part of a larger societal system. The first theme revolves around individual processes of change, such as gaining insight in one\u2019s own behavior, and rethinking one\u2019s perceived identity. The second theme focuses on how practical and emotional support, or lack thereof, affect the experience of returning to work. The third theme addresses hindering or facilitating factors on a more societal level, such as social norms or conditions of the social welfare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results indicate the relevance of further and prolonged support for individuals returning to work after sick leave due to ED. The workplace and overall organization plays an important role in providing this support. In a clinical individual context, the support given may include programs designed to facilitate behavioral maintenance, sustainable psychological flexibility and renegotiation of values. However, further research is needed on how such programs should be best designed and delivered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40359-025-03873-9","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T14:24:21Z","timestamp":1766240661000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of returning to work after sick leave due to exhaustion disorder: a qualitative content analysis"],"prefix":"10.1186","volume":"14","author":[{"given":"Sanna","family":"Forslund","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Jovicic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"N\u00e4slund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Habte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Clason van de Leur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Buhrman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Rozental","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"3873_CR1","volume-title":"Burnout in the workplace: A review of data and policy responses in the EU","author":"Eurofound","year":"2018","unstructured":"Eurofound. Burnout in the workplace: a review of data and policy responses in the EU [Internet]. Luxemburg: Publications Office of the European Union; 2018. 1\u201341 p. Available from: http:\/\/eurofound.link\/ef18047."},{"key":"3873_CR2","doi-asserted-by":"crossref","unstructured":"Nagarajan R, Ramachandran P, Dilipkumar R, Kaur P. Global estimate of burnout among the public health workforce: a systematic review and meta-analysis. Hum Resour Health. 2024;22(1):30.","DOI":"10.1186\/s12960-024-00917-w"},{"key":"3873_CR3","doi-asserted-by":"crossref","unstructured":"Wallensten J, \u00c5sberg M, Wiklander M, Nager A. Role of rehabilitation in chronic stress-induced exhaustion disorder: a narrative review. J Rehabil Med. 2019;51(5):331\u2009\u2212\u200942.","DOI":"10.2340\/16501977-2545"},{"key":"3873_CR4","unstructured":"European Agency for Safety and Health at Work. Calculating the costs of work-related stress and psychosocial risks \u2013 A literature review [Internet]. Luxembourg: Publications Office of the European Union; 2014 [cited 2025 Jun 15]. Available from: https:\/\/publications.europa.eu\/resource\/cellar\/c8328fa1-519b-4f29-aa7b-fd80cffc18cb.0001.01\/DOC_"},{"key":"3873_CR5","doi-asserted-by":"crossref","unstructured":"Wolvetang S, van Dongen JM, Spekl\u00e9 E, Coenen P, Schaafsma F. Sick leave due to stress, what are the costs for Dutch employers? J Occup Rehabil. 2022;32(4):764\u2009\u2212\u200972.","DOI":"10.1007\/s10926-022-10042-x"},{"key":"3873_CR6","doi-asserted-by":"crossref","unstructured":"Hassard J, Teoh KR, Visockaite G, Dewe P, Cox T. The cost of work-related stress to society: A systematic review. J Occup Health Psychol. 2018;23(1):1.","DOI":"10.1037\/ocp0000069"},{"key":"3873_CR7","unstructured":"F\u00f6rs\u00e4kringskassan. [Swedish Social Insurance Agency]. Korta analyser 2016:2 [Short analyses 2016:2]. Stockholm (SE): F\u00f6rs\u00e4kringskassan, Department for Analysis and Forecast; 2016."},{"key":"3873_CR8","doi-asserted-by":"crossref","unstructured":"Grossi G, Perski A, Osika W, Savic I. Stress-related exhaustion disorder\u2013clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro\u2010biological and physiological changes in clinical burnout. Scandinavian J Psychol. 2015;56(6):626\u2009\u2212\u200936.","DOI":"10.1111\/sjop.12251"},{"key":"3873_CR9","doi-asserted-by":"crossref","unstructured":"Hasselberg K, Jonsdottir IH, Ellbin S, Skagert K. Self-reported stressors among patients with exhaustion disorder: an exploratory study of patient records. BMC psychiatry. 2014;14(1):1\u201310.","DOI":"10.1186\/1471-244X-14-66"},{"issue":"5","key":"3873_CR10","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1159\/000490742","volume":"87","author":"E Linds\u00e4ter","year":"2018","unstructured":"Linds\u00e4ter E, Axelsson E, Salomonsson S, Santoft F, Ejeby K, Ljotsson B, et al. Internet-based cognitive behavioral therapy for chronic stress: a randomized controlled trial. Psychother Psychosom. 2018;87(5):296\u2013305.","journal-title":"Psychother Psychosom"},{"issue":"12","key":"3873_CR11","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1136\/oemed-2017-104342","volume":"74","author":"S Salomonsson","year":"2017","unstructured":"Salomonsson S, Santoft F, Linds\u00e4ter E, Ejeby K, Lj\u00f3tsson B, \u00d6st L-G, et al. Cognitive\u2013behavioural therapy and return-to-work intervention for patients on sick leave due to common mental disorders: a randomised controlled trial. Occup Environ Med. 2017;74(12):905\u201312.","journal-title":"Occup Environ Med"},{"issue":"1","key":"3873_CR12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12888-020-02907-3","volume":"20","author":"JC van de Leur","year":"2020","unstructured":"van de Leur JC, Buhrman M, \u00c5hs F, Rozental A, Jansen GB. Standardized multimodal intervention for stress-induced exhaustion disorder: an open trial in a clinical setting. BMC Psychiatry. 2020;20(1):1\u201314.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"3873_CR13","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1037\/ocp0000097","volume":"24","author":"A Finnes","year":"2019","unstructured":"Finnes A, Ghaderi A, Dahl J, Nager A, Enebrink P. Randomized controlled trial of acceptance and commitment therapy and a workplace intervention for sickness absence due to mental disorders. J Occup Health Psychol. 2019;24(1):198.","journal-title":"J Occup Health Psychol"},{"issue":"8","key":"3873_CR14","doi-asserted-by":"publisher","first-page":"684","DOI":"10.2340\/16501977-1003","volume":"44","author":"T Stenlund","year":"2012","unstructured":"Stenlund T, Nordin M, J\u00e4rvholm LS. Effects of rehabilitation programmes for patients on long-term sick leave for burnout: a 3-year follow-up of the REST study. J Rehabil Med. 2012;44(8):684\u201390.","journal-title":"J Rehabil Med"},{"key":"3873_CR15","doi-asserted-by":"crossref","unstructured":"Linds\u00e4ter E, Sv\u00e4rdman F, Wallert J, Ivanova E, S\u00f6derholm A, Fondberg R, et al. Exhaustion disorder: scoping review of research on a recently introduced stress-related diagnosis. BJPsych Open. 2022;8(5):e159.","DOI":"10.1192\/bjo.2022.559"},{"issue":"1","key":"3873_CR16","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2025.2516915","volume":"20","author":"H Tuvesson","year":"2025","unstructured":"Tuvesson H, Gunnarsson AB, Sj\u00f6sten M, Carlsson V, Holmberg S, Wagman P, et al. What people with stress-related disorders experience as being supportive for recovery\u2013a systematic review and meta-synthesis of qualitative studies. Int J Qual Stud Health Well-being. 2025;20(1):2516915.","journal-title":"Int J Qual Stud Health Well-being"},{"issue":"1","key":"3873_CR17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-821","volume":"14","author":"B Karlson","year":"2014","unstructured":"Karlson B, J\u00f6nsson P, \u00d6sterberg K. Long-term stability of return to work after a workplace-oriented intervention for patients on sick leave for burnout. BMC Public Health. 2014;14(1):821.","journal-title":"BMC Public Health"},{"issue":"9","key":"3873_CR18","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1136\/oemed-2023-108867","volume":"80","author":"C Lambreghts","year":"2023","unstructured":"Lambreghts C, Vandenbroeck S, Goorts K, Godderis L. Return-to-work interventions for sick-listed employees with burnout: a systematic review. Occup Environ Med. 2023;80(9):538\u201344.","journal-title":"Occup Environ Med"},{"key":"3873_CR19","doi-asserted-by":"crossref","unstructured":"Karlsson I, Frantz A, Ax\u00e9n I, Bergstr\u00f6m G, B\u00fcltmann U, Finnes A, et al. Is a Problem-Solving Intervention with Workplace Involvement for Employees on Sickness Absence Due to Common Mental Disorders More Effective, than Care as Usual, in Reducing Sickness Absence Days? Results of a Cluster-Randomised Controlled Trial in Primary Health Care. J Occup Rehabil. 2025;35(3):615\u201324.","DOI":"10.1007\/s10926-024-10229-4"},{"key":"3873_CR20","doi-asserted-by":"crossref","unstructured":"Hoff A, Bojesen AB, Eplov LF. The Danish Ibbis Trials for Sickness Absentees with Common Mental Disorders: A Phase 4 Prospective Study Comparing Randomized Trial and Real-World Data. Int J Integrated Care. 2024;24(3):10.","DOI":"10.5334\/ijic.7562"},{"key":"3873_CR21","doi-asserted-by":"crossref","unstructured":"Hoff A, Fisker J, Poulsen RM, Hjorth\u00f8j C, Rosenberg NK, Nordentoft M, et al. Integrating vocational rehabilitation and mental healthcare to improve the return-to-work process for people on sick leave with stress-related disorders: results from a randomized trial. Scand J Work Environ Health. 2022;48(5):361\u2013371.","DOI":"10.5271\/sjweh.4021"},{"issue":"6","key":"3873_CR22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-074137","volume":"13","author":"C Bj\u00f6rkelund","year":"2023","unstructured":"Bj\u00f6rkelund C, Saxvik A, Svenningsson I, Petersson E-L, Wiegner L, Larsson M, et al. Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability\u2013a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project. BMJ Open. 2023;13(6):e074137.","journal-title":"BMJ Open"},{"key":"3873_CR23","doi-asserted-by":"crossref","unstructured":"Eklund A, Karlsson I, Bergstr\u00f6m G, Holmlund L, Bj\u00f6rk Br\u00e4mberg E. The effectiveness of a problem-solving intervention with workplace involvement on self-reported sick leave, psychological symptoms and work ability: a cluster randomised clinical trial. BMC Public Health. 2024;24(1):3052.","DOI":"10.1186\/s12889-024-20564-z"},{"key":"3873_CR24","doi-asserted-by":"crossref","unstructured":"Br\u00e4mberg E, \u00c5hsberg E, Fahlstr\u00f6m G, Furberg E, Gornitzki C, Ringborg A, et al. Effects of work-directed interventions on return-to-work in people on sick-leave for to common mental disorders\u2014a systematic review. Int Arch Occup Environ Health. 2024;97(6):597\u2013619.","DOI":"10.1007\/s00420-024-02068-w"},{"key":"3873_CR25","doi-asserted-by":"crossref","unstructured":"Andersen M, Nielsen K, Brinkmann S. Meta-synthesis of qualitative research on return to work among employees with common mental disorders. Scand J Work Environ Health. 2011;38:93\u2013104.","DOI":"10.5271\/sjweh.3257"},{"key":"3873_CR26","doi-asserted-by":"crossref","unstructured":"Glise K, Wiegner L, Jonsdottir IH. Long-term follow-up of residual symptoms in patients treated for stress-related exhaustion. BMC psychology. 2020;8(1):1\u20139.","DOI":"10.1186\/s40359-020-0395-8"},{"key":"3873_CR27","doi-asserted-by":"crossref","unstructured":"Jonsdottir IH, Nordlund A, Ellbin S, Ljung T, Glise K, W\u00e4hrborg P, et al. Working memory and attention are still impaired after three years in patients with stress-related exhaustion. Scand J Psychol. 2017;58(6):504-9.","DOI":"10.1111\/sjop.12394"},{"issue":"4","key":"3873_CR28","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1111\/sjop.12722","volume":"62","author":"S Ellbin","year":"2021","unstructured":"Ellbin S, Jonsdottir IH, Eckerstr\u00f6m C, Eckerstr\u00f6m M. Self-reported cognitive impairment and daily life functioning 7\u201312 years after seeking care for stress\u2010related exhaustion. Scand J Psychol. 2021;62(4):484\u201392.","journal-title":"Scand J Psychol"},{"key":"3873_CR29","unstructured":"F\u00f6rs\u00e4kringskassan. [Swedish Social Insurance Agency]. Korta analyser 2017:1 [Short analyses 2017:1] F\u00f6rs\u00e4kringskassan, Department for Analysis and Forecast; 2017."},{"issue":"2","key":"3873_CR30","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1007\/s10926-012-9396-7","volume":"23","author":"S Norlund","year":"2012","unstructured":"Norlund S, Fjellman-Wiklund A, Nordin M, Stenlund T, Ahlgren C. Personal resources and support when regaining the ability to work: an interview study with exhaustion disorder patients. J Occup Rehabil. 2012;23(2):270\u20139.","journal-title":"J Occup Rehabil"},{"key":"3873_CR31","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1080\/09638280310001644898","volume":"26","author":"K Holmgren","year":"2004","unstructured":"Holmgren K, Dahlin-Ivanoff S. Women on sickness absence - views of possibilities and obstacles for returning to work. A focus group study. Disabil Rehabil. 2004;26:213\u201322.","journal-title":"Disabil Rehabil"},{"issue":"7","key":"3873_CR32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234897","volume":"15","author":"M Str\u00f6mb\u00e4ck","year":"2020","unstructured":"Str\u00f6mb\u00e4ck M, Fjellman-Wiklund A, Keisu S, Sturesson M, Eskilsson T. Restoring confidence in return to work: a qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention. PLoS One. 2020;15(7):e0234897.","journal-title":"PLoS One"},{"issue":"3","key":"3873_CR33","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1108\/QRJ-08-2020-0101","volume":"21","author":"A Lawani","year":"2021","unstructured":"Lawani A. Critical realism: what you should know and how to apply it. Qual Res J. 2021;21(3):320\u201333.","journal-title":"Qual Res J"},{"issue":"6","key":"3873_CR34","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care"},{"key":"3873_CR35","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523","volume":"292","author":"M Hennink","year":"2022","unstructured":"Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 2022;292:114523.","journal-title":"Soc Sci Med"},{"issue":"9","key":"3873_CR36","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","volume":"15","author":"H-F Hsieh","year":"2005","unstructured":"Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277\u201388.","journal-title":"Qual Health Res"},{"issue":"2","key":"3873_CR37","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","volume":"24","author":"UH Graneheim","year":"2004","unstructured":"Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105\u201312.","journal-title":"Nurse Educ Today"},{"key":"3873_CR38","doi-asserted-by":"crossref","unstructured":"Elo S, K\u00e4\u00e4ri\u00e4nen M, Kanste O, P\u00f6lkki T, Utriainen K, Kyng\u00e4s H. Qualitative content analysis: A focus on trustworthiness. SAGE open. 2014;4(1):2158244014522633.","DOI":"10.1177\/2158244014522633"},{"issue":"1","key":"3873_CR39","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-024-01756-z","volume":"12","author":"I Aronsson","year":"2024","unstructured":"Aronsson I, Neely AS, Boraxbekk C-J, Eskilsson T, Gavelin HM. Recovery activities are needed every step of the way\u201d\u2014exploring the process of long-term recovery in people previously diagnosed with exhaustion disorder. BMC Psychol. 2024;12(1):248.","journal-title":"BMC Psychol"},{"key":"3873_CR40","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.752707","volume":"12","author":"S Ellbin","year":"2021","unstructured":"Ellbin S, Jonsdottir IH, B\u00e5\u00e5the F. Who I am now, is more me.\u201d An interview study of patients\u2019 reflections 10 years after exhaustion disorder. Front Psychol. 2021;12:752707.","journal-title":"Front Psychol"},{"issue":"2","key":"3873_CR41","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.beth.2009.08.002","volume":"44","author":"SC Hayes","year":"2013","unstructured":"Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther. 2013;44(2):180\u201398.","journal-title":"Behav Ther"},{"key":"3873_CR42","doi-asserted-by":"crossref","unstructured":"Samuelsson C, Gunnarsson L, Sv\u00e4rdman F, R\u00fcck C, Linds\u00e4ter E. Physicians\u2019 experiences of assessing and supporting fatigued patients in primary Care: A focus group study. BMC Primary Care. 2025;26(1):197.","DOI":"10.1186\/s12875-025-02891-1"},{"key":"3873_CR43","doi-asserted-by":"crossref","unstructured":"Joosen MC, Lugtenberg M, Arends I, van Gestel HJ, Schaapveld B, Terluin B, et al. Barriers and facilitators for return to work from the perspective of workers with common mental disorders with short, medium and long-term sickness absence: a longitudinal qualitative study. J Occup Rehabil. 2022;32(2):272\u2009\u2212\u200983.","DOI":"10.1007\/s10926-021-10004-9"},{"issue":"6","key":"3873_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10061247","volume":"10","author":"GM Liedberg","year":"2021","unstructured":"Liedberg GM, Bj\u00f6rk M, Dragioti E, Turesson C. Qualitative evidence from studies of interventions aimed at return to work and staying at work for persons with chronic musculoskeletal pain. J Clin Med. 2021;10(6):1247.","journal-title":"J Clin Med"},{"issue":"1","key":"3873_CR45","doi-asserted-by":"publisher","DOI":"10.1080\/17482631.2020.1754087","volume":"15","author":"U H\u00f6rberg","year":"2020","unstructured":"H\u00f6rberg U, Wagman P, Gunnarsson AB. Women\u2019s lived experience of well-being in everyday life when living with a stress-related illness. Int J Qual Stud Health Well-being. 2020;15(1):1754087.","journal-title":"Int J Qual Stud Health Well-being"},{"issue":"3","key":"3873_CR46","doi-asserted-by":"publisher","first-page":"214","DOI":"10.5014\/ajot.45.3.214","volume":"45","author":"L Krefting","year":"1991","unstructured":"Krefting L. Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991;45(3):214\u201322.","journal-title":"Am J Occup Ther"},{"key":"3873_CR47","unstructured":"F\u00f6rs\u00e4kringskassan [Swedish Social Insurance Agency]. F\u00f6rs\u00e4kringskassans l\u00e4gesrapport 2024:1. [Swedish Social Insurance Agencys Status Report 2024:1]. Stockholm (SE): F\u00f6rs\u00e4kringskassan; 2024."},{"key":"3873_CR48","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.nedt.2017.06.002","volume":"56","author":"UH Graneheim","year":"2017","unstructured":"Graneheim UH, Lindgren B-M, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29\u201334.","journal-title":"Nurse Educ Today"},{"issue":"3","key":"3873_CR49","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1177\/0170840621994507","volume":"43","author":"M Alvesson","year":"2022","unstructured":"Alvesson M, Sandberg J. Pre-understanding: an interpretation-enhancer and horizon-expander in research. Organ Stud. 2022;43(3):395\u2013412.","journal-title":"Organ Stud"}],"container-title":["BMC Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40359-025-03873-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03873-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40359-025-03873-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:25:54Z","timestamp":1769516754000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40359-025-03873-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,20]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3873"],"URL":"https:\/\/doi.org\/10.1186\/s40359-025-03873-9","relation":{},"ISSN":["2050-7283"],"issn-type":[{"value":"2050-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,20]]},"assertion":[{"value":"26 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Swedish Ethical Review Authority (Diary number: 2022-00892-01, and was carried out in accordance with the ethical principles of the Declaration of Helsinki. All participants received both written and verbal information about the study and had the opportunity to ask questions before agreeing to participate. The participants were informed about how the data would be handled, stored and presented. Written informed consent was provided by all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"117"}}