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Purpose <p>To analyze occupational physicians’ (OPs) interpretations of confidentiality regarding health information in multistakeholder return-to-work (RTW) negotiations, situated at the intersection of healthcare and working life.</p> Material and Methods <p>Reflexive thematic analysis was applied to 14 video-recorded RTW negotiations and 14 interviews with OPs involved in these negotiations.</p> Results <p>Four themes were developed, showing how OPs navigate confidentiality by (i) addressing knowledge asymmetries among participants, (ii) balancing their dual role in fostering trust, (iii) constructing confidentiality as depending on employees’ willingness to disclose health information, and (iv) approaching confidentiality flexibly to find solutions for RTW. Interpretations varied across and within negotiations, depending on specific situations or negotiation objectives.</p> Conclusion <p>Our study reveals that OPs’ aim at restricting discussions on employees’ health and respect their autonomy in disclosing health information in RTW negotiations, yet their approach to confidentiality seems complex and situationally flexible. Confidentiality issues compete with other incentives and complicate the collaboration, thus careful attention, ethical considerations, and clearer guidance from policymakers are required. The demanding nature of planning and leading RTW negotiations calls for systematic education of interaction skills in OPs’ specialist training. Further research is needed to explore the strategies and meaning-making related to confidentiality in multistakeholder RTW collaboration.</p>

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Authorization to Disclose: How Occupational Physicians Interpret Confidentiality in Return-to-Work Negotiations

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月9日

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  • Hanna Keränen,
  • Sanna Pesonen,
  • Sanni Tiitinen,
  • Elina Weiste,
  • Pirjo Juvonen-Posti,
  • Leena Ala-Mursula

摘要

Purpose

To analyze occupational physicians’ (OPs) interpretations of confidentiality regarding health information in multistakeholder return-to-work (RTW) negotiations, situated at the intersection of healthcare and working life.

Material and Methods

Reflexive thematic analysis was applied to 14 video-recorded RTW negotiations and 14 interviews with OPs involved in these negotiations.

Results

Four themes were developed, showing how OPs navigate confidentiality by (i) addressing knowledge asymmetries among participants, (ii) balancing their dual role in fostering trust, (iii) constructing confidentiality as depending on employees’ willingness to disclose health information, and (iv) approaching confidentiality flexibly to find solutions for RTW. Interpretations varied across and within negotiations, depending on specific situations or negotiation objectives.

Conclusion

Our study reveals that OPs’ aim at restricting discussions on employees’ health and respect their autonomy in disclosing health information in RTW negotiations, yet their approach to confidentiality seems complex and situationally flexible. Confidentiality issues compete with other incentives and complicate the collaboration, thus careful attention, ethical considerations, and clearer guidance from policymakers are required. The demanding nature of planning and leading RTW negotiations calls for systematic education of interaction skills in OPs’ specialist training. Further research is needed to explore the strategies and meaning-making related to confidentiality in multistakeholder RTW collaboration.