2.1 Changes in Well-being of Injured Workers Post-Return-to-Work

Work is not merely a means of subsistence. Rather, it holds at least two significant meanings. First, work functions as a critical link between the individual and society. According to Hegel (2003), work is mediating activity between individual subjectivity and the institutional life of society, wherein individuals realize their freedom and gain recognition (Fayard, 2021). This perspective positions work as a critical mechanism for integration into the social world. Building on this foundation, Budd (2019) emphasized that work is not only an economic activity to fulfill material needs but also a socially constructed role that enables individuals to internalize institutional norms and expectations, and reinforces their sense of belonging. In this regard, work functions as a central site for meaning-making, identity formation, and social embeddedness.

Second, work enables individuals to cultivate a sense of agency and autonomy, allowing them to exercise control over their lives and make meaningful contributions. Human beings have a fundamental need to perceive themselves as self-determining, capable of exercising free choice, and effectively managing their own activities or environments (Baumeister, 1998; Rosso et al., 2010). Thus, the workplace serves as a central arena in which this sense of agency is continually enacted and reinforced through daily routines, responsibilities, and goal-directed actions.

However, occupational injuries can severely disrupt the foundations of a person’s working life. The disruption of work following an injury not only ruptures individuals’ connections to their occupational roles but also undermines the structured context through which they experience autonomy, competence, and purpose. Such accidents occur unexpectedly and, regardless of the individual’s intentions, force a temporary or permanent separation from their occupational roles that anchor them to broader social and institutional networks. As injured workers lose access to this meaningful framework, their perceived capacity to act as autonomous agents may be substantially weakened. Empirical evidence supports the disruptive effects of work interruption due to occupational injuries. Involuntary work disruption following such injuries is associated with heightened psychological distress, including increased symptoms of depression and anxiety among affected workers (Granger and Turner, 2025; Carnide et al., 2016; Gerasimaviciute et al., 2020). Drawing upon COR theory, we propose that returning to work after occupational injury represents progressive resource restoration that enhances injured workers’ self-efficacy over time. COR theory posits that individuals are motivated to obtain, retain, and protect resources that they value (Hobfoll, 1989; Hobfoll et al., 2018). These resources may include objects, conditions, or energies that are either directly valued or serve as means to obtain other valued resources (Halbesleben et al., 2014). According to COR theory, psychological stress arises not only from the actual loss of these resources but also from the threat of loss or a failure to regain previously lost resources.

Occupational injuries typically create resource loss spirals, simultaneously depleting multiple valued resources, including one's work identity, income stability, social ties, and sense of efficacy (Hobfoll et al., 2018). However, returning to work provides a meaningful opportunity for comprehensive resource restoration. Through re-engagement with work, injured workers can rebuild their sense of control, competence, and autonomy, while reconnecting with the deeper structures of meaning, identity, and continuity that work embeds in everyday life. As this restoration process unfolds, critical psychological resources such as self-efficacy could be progressively strengthened. Empirical studies also support that returning to work significantly increases psychological well-being (Boštjančič and Galič, 2020; Figueredo et al., 2020; Noh et al., 2019).

Hypothesis 1-1: Self-efficacy of injured workers returning to work increases over time.

Building on this, we extend our theoretical framework to examine broader well-being outcomes. While self-efficacy represents a vital internal resource that helps workers regain control over their work-related functioning, life satisfaction represents a broader evaluative judgment of one’s overall quality of life (Diener et al., 1985). From a COR perspective, returning to work initiates a positive gain cycle in which the recovery of multiple psychological and social resources collectively contributes to enhanced well-being (Hobfoll, 2001). Specifically, the return to work provides a renewed sense of purpose, financial stability, and social connectedness, all of which are critical determinants of subjective well-being (Diener et al., 2003). As this resource rebuilding process continues, injured workers are likely to experience gradual improvements in their life satisfaction throughout the reintegration process.

Hypothesis 1-2: Life satisfaction of injured workers returning to work increases over time.

We further suggest the positive relationship between self-efficacy and life satisfaction during the return-to-work process. From a COR perspective, self-efficacy functions as a resource caravan passageway (Hobfoll et al., 2018). It means that its restoration does not operate in isolation but instead unlocks pathways through which additional valued resources are subsequently acquired. As injured workers regain self-efficacy through returning to work, this restored psychological resource activates a cascading process of resource accumulation—enabling access to career advancement opportunity, social recognition, and financial stability—all of which are central determinants of life satisfaction (Diener and Fujita, 1995). This resource accumulation operates partly through a positive spillover effect, wherein gains in work-related efficacy permeate into non-work domains, strengthening their sense of purpose, competence, and social connectedness. Empirically, Kim (2024) found a significant positive relationship between self-efficacy and life satisfaction among injured workers in return-to-work contexts. This finding suggests that workers’ enhanced efficacy contributes to their overall life satisfaction during the reintegration process.

Hypothesis 2: Increases in self-efficacy of injured workers returning to work are positively related to increases in their life satisfaction.

2.2 Gender Divergent Trajectories in Well-Being Post-Return-to-Work

We propose that gender creates different trajectories in resource restoration during return-to-work processes, with female injured workers experiencing systematically slower recovery of self-efficacy compared to their male counterparts. This disparity stems from deeply embedded structural inequalities that privilege masculine norms and expectations in both workplace cultures and recovery frameworks. Despite progress in labor market participation, occupational gender imbalance continues to disadvantage women (Levanon and Grusky, 2016), who remain overrepresented in lower-paying service, care, and administrative roles while men dominate higher-paying, male-coded sectors such as construction, manufacturing, and engineering (Folbre et al., 2023; Goldin, 2014; Ngai and Petrongolo, 2017). These disparities not only mirror existing societal norms but also reinforce a hierarchy of occupational value that places female-dominated work at a disadvantage (England, 2010).

Two complementary theoretical frameworks explain how gender systematically undermines women’s self-efficacy recovery. First, status characteristics theory (Berger et al., 1972; Correll and Ridgeway, 2003) demonstrates that individuals are assigned differing levels of social status and presumed competence based on gender, race, and socioeconomic backgrounds. Among various individual characteristics, gender is uniquely visible and influential in shaping expectations within mixed-sex groups (Chen et al., 2023). For instance, women may be regarded as less competent or unsuitable for high-status roles solely because of their gender, regardless of actual performance (Eagly and Karau, 2002). This perception becomes more pronounced in male-dominated work environments, where gender becomes not only visible but also structurally consequential. It reinforces gender hierarchies and leads to tangible disadvantages for women in occupational settings.

In the context of returning to work following occupational injury, these status-based expectations shape how others perceive and interact with female injured workers. As a result, female workers returning to work after injury may receive reduced support, be held to lower expectations, and encounter fewer chances to reaffirm their competence. This lack of opportunity to demonstrate capability can hinder the reinforcement of a positive self-concept (Bandura, 1997). Simultaneously, others’ low expectations may be internalized, shaping female workers’ self-evaluations in ways that make it more difficult to rebuild self-efficacy during the recovery process.

Second, we draw on the notion of “masculine defaults” (Cheryan and Markus, 2020) to examine how recovery norms reflect gendered expectations. In particular, such norms are often structured around masculine ideals of speed, independence, and emotional control (Eagly and Steffen, 1984; Hentschel et al., 2019). While injured men also face pressure to recover quickly and suppress vulnerability, the critical distinction lies how these norms intersect with gender identity. For male workers, masculine defaults align with their gender identity, making successful compliance an efficacy-affirming experience. For female workers, however, these same norms create a double bind: conforming to masculine recovery standards risks being judged as inauthentic, while failing to conform may be perceived as dependency or incompetence.

Empirical research supports our argument by revealing how gendered assumptions are embedded within institutional structures that govern post-injury recovery. These masculine defaults extend beyond workplace expectations into formal support systems, where industrial accident compensation remains primarily designed for male-dominated “core industries” while systematically excluding female-concentrated sectors such as domestic and caregiving work (Ferguson, 2013; Lee, 2019). For instance, in 2022, the occupational injury recognition rate in Korea starkly differed between male (81%) and female (19%) workers (Public Data Portal, 2024).

This structural exclusion is compounded by the sectoral characteristics of female-dominated work. Service and care occupations—where women are disproportionately concentrated—tend to offer limited organizational support, lower job security, and reduced access to formal legal or administrative resources. From the perspective of COR theory (Hobfoll, 1989), this creates a resource loss spiral: when institutional channels for injury recognition are inaccessible or systematically biased, injured female workers are unable to replenish the material and social resources lost at the point of injury. The resulting resource deficit not only prolongs physical and economic hardship but also impairs the accumulation of mastery experiences and social support—two primary mechanisms through which self-efficacy is built (Bandura, 1997). Critically, the low injury recognition rate for women does not reflect safer working conditions but rather a cultural tendency to attribute women's musculoskeletal and mental health conditions to domestic labor or personal factors rather than occupational causes (Messing, 1998; Park, 2020), further eroding the institutional legitimacy that injured female workers need to rebuild their sense of competence and agency.

Critically, occupational injury amplifies these structural disadvantages. The injury event creates precisely such a state of acute resource depletion (Hobfoll et al., 2018), stripping away the buffer resources that ordinarily allow workers to navigate structural inequalities. For women, whose buffer resources are already more constrained due to lower occupational status and gender-based competence expectations, this depletion is particularly consequential: without resources to counteract status-based biases, the structural disadvantages that were manageable pre-injury become disproportionately burdensome during the vulnerable recovery period. It is the interaction between pre-existing structural disadvantage and acute resource depletion that creates a distinctive post-injury gender trajectory. Therefore, we propose the following hypothesis:

Hypothesis 3-1. Injured workers’ gender (female) is negatively related to increases in self-efficacy.

These gendered barriers create an indirect pathway whereby female workers experience diminished life satisfaction through impaired self-efficacy. As women face systematic disadvantages in rebuilding this essential psychological resource, their diminished self-efficacy subsequently undermines broader well-being outcomes, particularly life satisfaction.

Hypothesis 3-2. Gender is indirectly negatively related to increases in life satisfaction through increases in self-efficacy.

3.1 Measures

Unless otherwise noted, all survey items were rated using a 5-point Likert scale (1=strongly disagree to 5=strongly agree).

3.2 Data Analysis

To explore the trajectories of self-efficacy and life satisfaction, we utilized latent growth modeling with Mplus 8.4. This advanced methodology allows for the estimation of latent factors, initial values (intercept), and growth trajectories (slopes) based on observed indicators collected longitudinally. Through this approach, we are equipped to analyze baseline trends and the interrelations among them comprehensively. For handling missing data, we applied the full-information maximum likelihood estimation technique (Arbuckle, 1996).

5.1 Limitations and Future Research

This study has several limitations. First, while our sample comprised workers who maintained employment during all five waves of data collection, this design choice may have introduced a potential selection bias. Specifically, a healthy worker survivor bias (Buckley et al., 2015) may exist, as individuals with more severe injuries or lower self-efficacy who left employment earlier were not captured in the sample. Given our theoretical argument that women face systematic disadvantages in resource recovery, female injured workers may be disproportionately represented among those who exited employment and were thus excluded from the sample. If so, the gender gap in self-efficacy and life satisfaction trajectories observed in our study may be conservative, understanding the full extent of gendered disparities in post-injury psychological recovery. Additionally, the negative covariance between initial levels and growth rates in our models indicates workers who started higher showed slower gains–a ceiling effect that may further attenuate the observed trajectories and gender differences. Accordingly, the reported growth rates and gender gaps may underestimate the magnitude of these differences. Also, workers with significant recovery challenges or barriers to reintegration were excluded from our analysis. We invite future researchers to utilize more inclusive sampling that follows injured workers regardless of their employment status, enabling comparisons between those who successfully maintain employment and those who exit the labor force.

Second, the use of self-reported data by injured workers may be vulnerable to social desirability bias and common method variance (Podsakoff et al., 2003). In particular, life satisfaction was measured using a single item, which may raise concerns regarding measurement reliability. Although single-item life satisfaction measures have demonstrated reliability in prior research (e.g., Lucas and Donnellan, 2012), future research should consider adopting multi-item scales such as the Satisfaction with Life Scale (SWLS; Diener et al., 1985). Also, future researchers could collect data from multiple sources (e.g., objective indicators such as advancement rates and supervisor or peer evaluations). Additionally, employing ecological momentary assessment (e.g., experience sampling method) may offer valuable insights into the temporal fluctuations of self-efficacy and life satisfaction throughout the return-to-work process, thereby deepening our understanding of these developmental trajectories.

Third, the unique socio-cultural characteristics of South Korea, in which our data were collected, may constrain the generalizability of our findings. Considering that South Korea has the huge gender wage gap among OECD countries (OECD, 2023), the structural challenges faced by female workers in the Korean labor market could be particularly pronounced.

These contextual elements may interact with the recuperation experiences associated with occupational injuries, showing different patterns observed in more gender-equal societies. Lastly, while we theorize that workplace reintegration is the primary driver of the observed self-efficacy and life satisfaction trajectories, the current research design cannot fully disentangle return-to-work specific effects from natural recovery processes, emotional adjustment, or the simple passage of time since injury. The absence of a comparison group of injured workers who did not return to work during the same period limits causal attribution.

Thus, we suggest directions for future research. First, the present study was conducted within a single cultural context, which may limit the generalizability of the findings. Future research would benefit from cross-cultural comparative studies that examine how varying degrees of (objective and subjective) gender equality and cultural norms shape the return-to-work experiences of injured workers. Second, future research should employ quasi-experimental designs such as propensity score matching between returning and non-returning injured workers or experience sampling methods capturing day-to-day fluctuations in psychological states to better isolate the return-to-work specific effect on psychological resource trajectories.

5.2 Conclusion

Our findings highlight the need for gender-sensitive return-to-work programs that address the slower self-efficacy recovery among female workers. Organizations could implement mentoring programs pairing female injured workers with successful female role models who have navigated similar challenges. More specifically, organizations should consider three type of gender-sensitive interventions. First, phased job reassignment programs can provide female injured workers with modified roles upon initial return that offer early, visible opportunities to demonstrate competence which directly supplies the enactive mastery experiences (Bandura, 1997) that accelerate self-efficacy restoration. Second, flexible work arrangements — including phased return schedules, reduced-hour options, and remote work — can mitigate the competing caregiving demands that disproportionately burden female workers during recovery, reducing the role conflict that otherwise impedes sustained workplace reintegration. Third, gender-sensitive mentoring programs that connect female injured workers with experienced female colleagues who have successfully navigated similar recovery processes can provide vicarious efficacy experiences and counter the low-competence expectations they may encounter up on return.

Additionally, policy reforms should address inequalities impeding women's psychological recovery following occupational injuries. Recent research suggests that individual-level coping strategies alone may be insufficient to address burnout, highlighting the need for structural and organizational interventions (e.g., Mihai et al., 2025). Gender-sensitive monitoring systems can track intervention effectiveness over time, while comprehensive follow-up systems should monitor both physical recovery and psychological well-being indicators. Through this holistic approach, decision-makers can create more equitable support systems that recognize the gendered nature of post-injury recovery, fostering better outcomes for all injured workers.