“Work is a beautiful thing....” Exploring attitudes towards employment in chronic pain (CP) patients attending a pain management programme (PMP)

Abstract

BACKGROUND:

Chronic pain (CP) is detrimental to physical and psychological function frequently resulting in work-absence which in turn is associated with reduced wellbeing. Patients with negative cognitive representations of pain are less likely to engage in re-employment oriented activities.

OBJECTIVE:

To explore patients’ beliefs and attitudes towards return to work (RTW) and understand how these may impact on RTW readiness.

METHODS:

Patients attending a 3-week high intensity pain management rehabilitation programme (PMP) at the Royal National Orthopaedic Hospital were recruited to participate in semi-structured focus group discussions. The sample consisted of 17 patients (M:F 8:9, age range 18–65+ years). Data was digitally recorded and transcribed verbatim to permit a thematic analysis.

RESULTS:

Four superordinate themes emerged from the data: (1) living with CP, (2) the fine balance between CP and RTW, (3) work is a beautiful thing... when you have it and (4) the luck of the draw. The first two imparted patients’ coping strategies towards maintaining employment or RTW. The second two reflected participants’ cognitions on factors that facilitate or obstruct RTW.

CONCLUSIONS:

The need for vocational support in chronic pain rehabilitation programmes was identified. Several recommendations are presented for vocational rehabilitation intervention targets.

Keywords

Chronic pain return to work vocational rehabilitation psychological beliefs qualitative research

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