Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2011

Open Access 01-12-2011 | Research article

Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences

Authors: Haitze J de Vries, Sandra Brouwer, Johan W Groothoff, Jan HB Geertzen, Michiel F Reneman

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

Login to get access

Abstract

Background

Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors).

Methods

A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?"

Results

A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs.

Conclusions

Personal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at work are needed to obtain further evidence.
Appendix
Available only for authorised users
Literature
1.
Andersson GBJ: Epidemiological features of chronic low-back pain. Lancet. 1999, 354: 581-585. 10.1016/S0140-6736(99)01312-4.CrossRefPubMed
2.
Bloch FS, Prins R: Social security, work incapacity, and reintegration. Who returns to work and why. A six country study on work incapacity & reintegration. Edited by: Bloch FS, Prins R. 2000, New Brunswick: Transaction Publishers, 5: 9-25.
3.
Picavet HS, Schouten JS: Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. 2003, 102: 167-178. 10.1016/s0304-3959(02)00372-x.CrossRefPubMed
4.
Blyth FM, March LM, Nicholas MK, Cousins MJ: Chronic pain, work performance and litigation. Pain. 2003, 103: 41-47. 10.1016/S0304-3959(02)00380-9.CrossRefPubMed
5.
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D: Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006, 10: 287-333. 10.1016/j.ejpain.2005.06.009.CrossRefPubMed
6.
IJzelenberg W, Burdorf A: Patterns of care for low back pain in a working population. Spine (Phila Pa 1976). 2004, 29: 1362-1368. 10.1097/01.BRS.0000127188.58944.1E.CrossRef
7.
Backman CL: Employment and work disability in rheumatoid arthritis. Curr Opin Rheumatol. 2004, 16: 148-152. 10.1097/00002281-200403000-00014.CrossRefPubMed
8.
Varekamp I, Verbeek JH, van Dijk FJ: How can we help employees with chronic diseases to stay at work? A review of interventions aimed at job retention and based on an empowerment perspective. Int Arch Occup Environ Health. 2006, 80: 87-97. 10.1007/s00420-006-0112-9.CrossRefPubMed
9.
Liedberg GM, Henriksson CM: Factors of importance for work disability in women with fibromyalgia: an interview study. Arthritis Rheum. 2002, 47: 266-274. 10.1002/art.10454.CrossRefPubMed
10.
Lofgren M, Ekholm J, Ohman A: 'A constant struggle': successful strategies of women in work despite fibromyalgia. Disabil Rehabil. 2006, 28: 447-455. 10.1080/09638280500197891.CrossRefPubMed
11.
Engstrom LG, Janson S: Predictors of work presence--sickness absence in a salutogenic perspective. Work. 2009, 33: 287-295.PubMed
12.
Turk DC, Okifuji A: Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol. 2002, 70: 678-690.CrossRefPubMed
13.
Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358: 483-488. 10.1016/S0140-6736(01)05627-6.CrossRefPubMed
14.
Braun V, Clarke V: Using thematic analysis in psychology. Qualitative Research in Psychology. 2006, 3: 77-101.CrossRef
15.
16.
Central Statistics office: Sickness absence stabilizing last years. 2010, Dutch: Centraal Bureau voor Statistiek. Ziekteverzuim laatste jaren stabiel. CBS-publications
17.
18.
Engers AJ, Koke A, Torenbeek M: Nederlandse Dataset Pijnrevalidatie. 2007, Hoensbroek: Stichting Revalidatie Limburg
19.
Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA: Studies with Pain Rating-Scales. Ann Rheum Dis. 1978, 37: 378-381. 10.1136/ard.37.4.378.CrossRefPubMedPubMedCentral
20.
Jensen MP, Karoly P, Braver S: The Measurement of Clinical Pain Intensity - a Comparison of 6 Methods. Pain. 1986, 27: 117-126. 10.1016/0304-3959(86)90228-9.CrossRefPubMed
21.
Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole RM: Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001, 94: 149-158. 10.1016/S0304-3959(01)00349-9.CrossRefPubMed
22.
Childs JD, Piva SR, Fritz JM: Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005, 30: 1331-1334. 10.1097/01.brs.0000164099.92112.29.CrossRef
23.
Pollard CA: Preliminary validity study of Pain Disability Index. Percept Mot Skills. 1984, 59: 974-CrossRefPubMed
24.
Tait RC, Chibnall JT, Krause S: The Pain Disability Index: psychometric properties. Pain. 1990, 40: 171-182. 10.1016/0304-3959(90)90068-O.CrossRefPubMed
25.
Antonovsky A: Health, Stress, and Coping: new perspectives on mental and physical health. 1979, San Francisco: Jossey-Bass
26.
Aronsson G, Gustafsson K: Sickness presenteeism: prevalence, attendance-pressure factors, and an outline of a model for research. J Occup Environ Med. 2005, 47: 958-966. 10.1097/01.jom.0000177219.75677.17.CrossRefPubMed
27.
Berglind H, Gerner U: Motivation and return to work among the long-term sicklisted: an action theory perspective. Disabil Rehabil. 2002, 24: 719-726. 10.1080/09638280210124301.CrossRefPubMed
28.
Karasek RA: Job Demands, Job Decision Latitude, and Mental Strain - Implications for Job Redesign. Adm Sci Q. 1979, 24: 285-308. 10.2307/2392498.CrossRef
29.
Nicholson N: Absence Behaviour and Attendance Motivation: a Conceptual Synthesis. JMS. 1977, 14: 231-252.
30.
Rosse JG, Miller HE: Relationship between absenteeism and other employee behaviors. New approaches to understanding, measuring, and managing employee absence. Edited by: Goodman, P.S. and Atkin, R.S. 1984, San Francisco: Jossey-Bass, 194-228.
31.
van Dijk FJH, Dormolen M, Kompier MAJ, Meijman TF: Re-evaluation of the model work demands-capacity (in Dutch). Tijdschrift voor Sociale Gezondheidszorg. 1990, 68: 3-10.
32.
Loisel P, Durand MJ, Berthelette D, Vezina N, Baril R, Gagnon D, Lariviere C, Tremblay C: Disability prevention - New paradigm for the management of occupational back pain. Disease Management & Health Outcomes. 2001, 9: 351-360. 10.2165/00115677-200109070-00001.CrossRef
33.
Giacomini MK, Cook DJ: Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 2000, 284: 357-362. 10.1001/jama.284.3.357.CrossRefPubMed
34.
Kuper A, Reeves S, Levinson W: An introduction to reading and appraising qualitative research. BMJ. 2008, 337: a288-10.1136/bmj.a288.CrossRefPubMed
35.
Hooftman WE, Westerman MJ, van dB, Bongers PM, van Mechelen W: What makes men and women with musculoskeletal complaints decide they are too sick to work?. Scand J Work Environ Health. 2008, 34: 107-112.CrossRefPubMed
36.
Hansson M, Bostrom C, Harms-Ringdahl K: Sickness absence and sickness attendance--what people with neck or back pain think. Soc Sci Med. 2006, 62: 2183-2195. 10.1016/j.socscimed.2005.10.002.CrossRefPubMed
37.
Linton SJ, Buer N: Working despite pain: Factors associated with work attendance versus dysfunction. Int J Behav Med. 1995, 2: 252-262. 10.1207/s15327558ijbm0203_4.CrossRefPubMed
38.
Turk DC, Rudy TE: Toward an empirically derived taxonomy of chronic pain patients: integration of psychological assessment data. J Consult Clin Psychol. 1988, 56: 233-238.CrossRefPubMed
39.
Kerns RD, Turk DC, Rudy TE: The West Haven Yale Multidimensional Pain Inventory (Whympi). Pain. 1985, 23: 345-356. 10.1016/0304-3959(85)90004-1.CrossRefPubMed
40.
Boot CR, van Exel NJ, van der Gulden JW: "My lung disease won't go away, it's there to stay": profiles of adaptation to functional limitations in workers with asthma and COPD. J Occup Rehabil. 2009, 19: 284-292. 10.1007/s10926-009-9185-0.CrossRefPubMedPubMedCentral
41.
Shaw WS, Linton SJ, Pransky G: Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?. J Occup Rehabil. 2006, 16: 591-605. 10.1007/s10926-006-9061-0.CrossRefPubMed
42.
Johansson G, Lundberg I: Adjustment latitude and attendance requirements as determinants of sickness absence or attendance. Empirical tests of the illness flexibility model. Soc Sci Med. 2004, 58: 1857-1868. 10.1016/S0277-9536(03)00407-6.CrossRefPubMed
43.
Hultin H, Hallqvist J, Alexanderson K, Johansson G, Lindholm C, Lundberg I, Moller J: Low level of adjustment latitude--a risk factor for sickness absence. Eur J Public Health. 2010, 20: 682-688. 10.1093/eurpub/ckp240.CrossRefPubMed
44.
Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ: Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001, 40: 464-484. 10.1002/ajim.1116.CrossRefPubMed
45.
Nordqvist C, Holmqvist C, Alexanderson K: Views of laypersons on the role employers play in return to work when sick-listed. J Occup Rehabil. 2003, 13: 11-20. 10.1023/A:1021841722613.CrossRefPubMed
46.
Pransky G, Shaw W, Franche RL, Clarke A: Disability prevention and communication among workers, physicians, employers, and insurers--current models and opportunities for improvement. Disabil Rehabil. 2004, 26: 625-634. 10.1080/09638280410001672517.CrossRefPubMed
47.
Hayes SC, Strosahl KD, Kelly GW: Acceptance and Comitment Therapy: An Experimental Approach to behavior change. 1999, New York: The Guilford Press
48.
Vowles KE, McCracken LM: Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process. J Consult Clin Psychol. 2008, 76: 397-407.CrossRefPubMed
49.
Coutu MF, Baril R, Durand MJ, Cote D, Rouleau A, Cadieux G: Transforming the meaning of pain: an important step for the return to work. Work. 2010, 35: 209-219.PubMed
50.
Rhodes S, Steers R: A systematic approach to diagnosing employee absenteeism. Employee Relations. 1993, 3: 17-22.CrossRef
51.
52.
French JR, Caplan RD: Organizational stress and individual strain. The failure of success. Edited by: Marrow AJ. 1972, New York: Amacon, 31-66.
53.
World Health Organization: ICF, International Classification of Functioning, Disability and Health. 2001, Geneva
54.
Anema JR, Schellart AJ, Cassidy JD, Loisel P, Veerman TJ, van der Beek AJ: Can cross country differences in return-to-work after chronic occupational back pain be explained? An exploratory analysis on disability policies in a six country cohort study. J Occup Rehabil. 2009, 19: 419-426. 10.1007/s10926-009-9202-3.CrossRefPubMedPubMedCentral
55.
Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M, Webster B: Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil. 2005, 15: 507-524. 10.1007/s10926-005-8031-2.CrossRefPubMed
56.
Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J: Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil. 2010, 32: 607-621. 10.3109/09638280903186301.CrossRefPubMed
57.
58.
Broersen JP, de Zwart BC, van Dijk FJ, Meijman TF, van Veldhoven M: Health complaints and working conditions experienced in relation to work and age. Occup Environ Med. 1996, 53: 51-57. 10.1136/oem.53.1.51.CrossRefPubMedPubMedCentral
Metadata
Title
Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences
Authors
Haitze J de Vries
Sandra Brouwer
Johan W Groothoff
Jan HB Geertzen
Michiel F Reneman
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-12-126

Other articles of this Issue 1/2011

BMC Musculoskeletal Disorders 1/2011 Go to the issue

Study protocol

Cost-effectiveness of exercise therapy versus general practitioner care for osteoarthritis of the hip: design of a randomised clinical trial

Study protocol

Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

Research article

Microstructure and biomechanical characteristics of bone substitutes for trauma and orthopaedic surgery

Research article

Subgroup analyses on return to work in sick-listed employees with low back pain in a randomised trial comparing brief and multidisciplinary intervention

Technical advance

Septic arthritis of the knee: Presentation of a novel irrigation-suction system tested in a cadaver study

Research article

Night-time splinting after fasciectomy or dermo-fasciectomy for Dupuytren's contracture: a pragmatic, multi-centre, randomised controlled trial