Top

Published in:

01-06-2013

Obstacles to and Facilitators of Return to Work After Work-Disabling Back Pain: The Workers’ Perspective

Authors: Clermont E. Dionne, Renée Bourbonnais, Pierre Frémont, Michel Rossignol, Susan R. Stock, Ève Laperrière

Published in: Journal of Occupational Rehabilitation | Issue 2/2013

Abstract

Introduction Back pain entails considerable costs, particularly because many injured workers are absent from work for long periods. Factors that influence return to work among workers with back pain are still, however, not well understood. This qualitative study aimed at documenting affected workers’ perspective on the: 1—difficulties caused by back pain, and 2—most important obstacles to and facilitators of return to work. Methods Two focus groups composed of workers having suffered from work-disabling back pain were held: a group of participants who had returned to work (n = 9) and a group of participants who had not returned or had recently returned to work (n = 10). The verbatim accounts of the discussions were transcribed and a content analysis was carried out that included a ranking of items. Results Difficulties caused by back pain were related to: (1) personal, (2) family, (3) social, (4) occupational, and (5) financial factors, and (6) health services. Obstacles to and facilitators of return to work were of 4 different types: (1) occupational factors, (2) factors associated with the utilization of health services, (3) clinical, and (4) personal factors. Persistent pain, lack of access to information or support groups, and lack of collaboration and understanding from employer were the most important obstacles identified, whereas knowledge of one’s limits and physical training were perceived to be the most important facilitators of return to work, ahead of work-related factors. Differences between groups’ perceptions were attributed mainly to control beliefs. Conclusions Personal, clinical, occupational and health services factors are perceived by workers with back pain to play a crucial role in determining whether they return to work or not.

Available only for authorised users

Dionne CE. Low back pain. In: Crombie IK, editor. Epidemiology of pain. Seattle: IASP Press; 1999. p. 283–97.

CSST. Statistiques sur les affections vertébrales 2004–2007 [report] DC: 300-274-2; 2008. p. 28.

van Velzen JM, van Bennekom CA, van Dormolen M, Sluiter JK, Frings-Dresen MH. Factors influencing return to work experienced by people with acquired brain injury: a qualitative research study. Disabil Rehabil. 2011;33(23–24):2237–46.PubMedCrossRef

Mackey SP, Diba R, McKeown D, Wallace C, Booth S, Gilbert PM, et al. Return to work after burns: a qualitative research study. Burns. 2009;35(3):338–42.PubMedCrossRef

Tamminga SJ, de Boer AG, Verbeek JH, Frings-Dresen MHW. Breast cancer survivors’ views of factors that influence the return-to-work process—a qualitative study. Scand J Work Environ Health. 2012;38(2):144–54.PubMedCrossRef

Main DS, Nowels CT, Cavender TA, Etschmaier M, Steiner JF. A qualitative study of work and work return in cancer survivors. Psychooncology. 2005;14(11):992–1004.PubMedCrossRef

Keus F, de Vries J, Gooszen HG, van Laarhoven CJ. Assessing factors influencing return back to work after cholecystectomy: a qualitative research. BMC Gastroenterol. 2010;10:12.PubMedCrossRef

Cabral LH, Sampaio RF, Figueiredo IM, Mancini MC. Factors associated with return to work following a hand injury: a qualitative/quantitative approach. Rev Bras Fisioter 2010;14(2):149–57.

Muijzer A, Brouwer S, Geertzen JH, Groothoff JW. Exploring factors relevant in the assessment of the return-to-work process of employees on long-term sickness absence due to a depressive disorder: a focus group study. BMC Public Health. 2012;12:103.PubMedCrossRef

10.

Friis L, Carter N, Edling C. Self-reported health problems among Swedish miners one year after unemployment. Occup Med (Lond). 1998;48(5):297–301.CrossRef

11.

Blitz CL, Mechanic D. Facilitators and barriers to employment among individuals with psychiatric disabilities: a job coach perspective. Work. 2006;26(4):407–19.PubMed

12.

Hartke RJ, Trierweiler R, Bode R. Critical factors related to return to work after stroke: a qualitative study. Top Stroke Rehabil 2011;18(4):341–51.

13.

Alaszewski A, Alaszewski H, Potter J, Penhale B. Working after a stroke: survivors’ experiences and perceptions of barriers to and facilitators of the return to paid employment. Disabil Rehabil. 2007;29(24):1858–69.PubMedCrossRef

14.

Jongbloed L, Backman C, Forwell SJ, Carpenter C. Employment after spinal cord injury: the impact of government policies in Canada. Work. 2007;29(2):145–54.PubMed

15.

MacEachen E, Kosny A, Ferrier S. Unexpected barriers in return to work: lessons learned from injured worker peer support groups. Work. 2007;29(2):155–64.PubMed

16.

Dekkers-Sanchez PM, Wind H, Sluiter JK, Frings-Dresen MH. A qualitative study of perpetuating factors for long term sick leave and promoting factors for return to work: chronic work disabled patients in their own words. J Rehabil Med. 2010;42(6):544–52.PubMedCrossRef

17.

Young AE. Employment maintenance and the factors that impact it after vocational rehabilitation and return to work. Disabil Rehabil. 2010;32(20):1621–32.PubMedCrossRef

18.

Gard G, Derberg S. How can a work rehabilitation process be improved—perspective of social insurance officers. Disabil Rehabil. 2004;26(5):299–305.PubMedCrossRef

19.

Côté P, Clarke J, Deguire S, Frank JW, Yassi A. Chiropractors and return-to-work: the experiences of three Canadian focus groups. J Manipul Physiol Ther. 2001;24(5):309–16.CrossRef

20.

Larsson A, Gard G. How can the rehabilitation planning process at the workplace be improved? A qualitative study from employers’ perspective. J Occup Rehabil. 2003;13(3):169–81.PubMedCrossRef

21.

Costa-Black KM, Durand MJ, Imbeau D, Baril R, Loisel P. Interdisciplinary team discussion on work environment issues related to low back disability: a multiple case study. Work. 2007;28:249–65.PubMed

22.

Baril R, Clark J, Friesen M, Stock S, Cole D, Bombardier C, et al. Management of return-to-work programs for workers with musculoskeletal disorders: a qualitative study in three Canadian provinces. Soc Sci Med. 2003;57:2101–14.PubMedCrossRef

23.

Friesen MN, Yassi A, Cooper J. Return-to-work: the importance of human interactions and organizational structures. Work. 2001;17:11–22.PubMed

24.

Muijzer A, Geertzen JH, de Boer WE, Groothoff JW, Brouwer S. Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study. BMC Public Health. 2012;12(1):77.PubMedCrossRef

25.

Lærum E, Indahl A, Skouen J. What is “the good back-consultation”? A combined qualitative and quantitative study of chronic low back pain patients’ interaction with and perceptions of consultations with specialists. J Rehabil Med. 2006;38:255–62.PubMedCrossRef

26.

Borkan J, Reis S, Hermoni D, Biderman A. Talking about the pain: a patient-centered study of low back pain in primary care. Soc Sci Med. 1995;40(7):977–88.PubMedCrossRef

27.

Tarasuk V, Eakin JM. Back problems are for life: perceived vulnerability and its implications for chronic disability. J Occup Rehabil. 1994;4(1):55–64.CrossRef

28.

Soeker M, Wegner L, Blanche P. I’m going back to work: back injured clients’ perceptions and experiences of their worker roles. Work. 2008;30:161–70.PubMed

29.

Magnussen L, Nilsen S, Raheim M. Barriers against returning to work—as perceived by disability pensioners with back pain: a focus group based qualitative study. Disabil Rehabil. 2007;29(3):191–7.PubMedCrossRef

30.

Raak R, Wahren LK. Health experiences and employment status in subjects with chronic back pain: a long-term perspective. Pain Manag Nurs. 2007;7(2):64–70.CrossRef

31.

Hansson M, Bostrom C, Harms-Ringdahl K. Sickness absence and sickness attendance-what people with neck or back pain think. Soc Sci Med. 2006;62:2183–95.PubMedCrossRef

32.

Shaw W, Huang Y. Concerns and expectations about returning to work with low back pain: identifying themes from focus groups and semi-structured interviews. Disabil Rehabil. 2005;27(21):1269–81.PubMedCrossRef

33.

Lindell O, Johansson SE, Strender LE. Predictors of stable return-to-work in non-acute, non-specific spinal pain: low total prior sick-listing, high self prediction and young age. A two-year prospective cohort study. BMC Fam Pract. 2010;11:53.PubMedCrossRef

34.

De Vries HJ, Brouwer S, Groothoff JW, Geertzen JHB, Reneman MF. Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers’ experiences. BMC Musculoskelet Disord. 2011;12:126.

35.

Lydell M, Hildingh C, Mansson J, Marklund B, Grahn B. Thoughts and feelings of future working life as a predictor of return to work: a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders. Disabil Rehabil. 2011;33(13–14):1262–71.PubMedCrossRef

36.

Denzin N, Lincoln Y. Handbook of qualitative research. 2nd ed. Thousands Oaks, California: Sage; 2000.

37.

Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Larocque I. A clinical return-to-work rule for patients with back pain. CMAJ. 2005;172(12):1559–67.PubMed

38.

Onwuegbuzie AJ, Leech NL, Collins KMT. Innovative data collection strategies in qualitative research. Qual Rep. 2010;15(3):696–726.

39.

Cieza A, Stucki G, Weigl M, Disler P, Jackel W, van der Linden S et al. ICF core sets for low back pain. J Rehabil Med Jul 2004;(44 Suppl):69–74.

40.

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):349–57.PubMedCrossRef

41.

World Health Organization (WHO). International classification of functioning, disability and health (ICF). Geneva: WHO; 2010.

42.

May S. Patients’ attitudes and beliefs about back pain and its management after physiotherapy for low back pain. Physiother Res Int. 2007;12(3):126–35.PubMedCrossRef

43.

Snelgrove S, Liossi C. An interpretative phenomenological analysis of living with chronic low back pain. Br J Health Psychol. 2009;14(Pt 4):735–49.PubMedCrossRef

44.

De Souza LH, Frank AO. Experiences of living with chronic back pain: the physical disabilities. Disabil Rehabil. 2007;29(7):587–96.PubMedCrossRef

45.

Abyholm AS, Hjortdahl P. The pain takes hold of life. A qualitative study of how patients with chronic back pain experience and cope with their life situation. Tidsskr Nor Laegeforen. 1999;119(11):1624–9.PubMed

46.

Mitchelmore M. The psychosocial implications of back injury at work. Nurs Stand. 1996;10(38):33–8.PubMed

47.

Walker J, Holloway I, Sofaer B. In the system: the lived experience of chronic back pain from the perspectives of those seeking help from pain clinics. Pain. 1999;80(3):621–8.PubMedCrossRef

48.

Schlesinger L. Chronic pain, intimacy and sexuality: a qualitative study of women who live with pain. J Sex Res. 1996;33(3):249–56.CrossRef

49.

Strunin L, Boden LI. Family consequences of chronic back pain. Soc Sci Med. 2004;58:1385–93.PubMedCrossRef

50.

Corbett M, Foster NE, Ong BN. Living with low back pain-stories of hope and despair. Soc Sci Med. 2007;65:1584–94.PubMedCrossRef

51.

Walker J, Sofaer B, Holloway I. The experience of chronic back pain: accounts of loss in those seeking help from pain clinics. Eur J Pain. 2006;10:199–207.PubMedCrossRef

52.

Osborn M, Smith JA. Living with a body separate from the self. The experience of the body in chronic benign low back pain: an interpretative phenomenological analysis. Scand J Caring Sci. 2006;20(2):216–22.PubMedCrossRef

53.

Crowe M, Whitehead L, Gagan MJ, Baxter GD, Pankhurst A, Valledor V. Listening to the body and talking to myself—the impact of chronic lower back pain: a qualitative study. Int J Nurs Stud. 2010;47(5):586–92.PubMedCrossRef

54.

Patel S, Greasley K, Watson PJ. Barriers to rehabilitation and return to work for unemployed chronic pain patients: a qualitative study. Eur J Pain. 2007;11(8):831–40.PubMedCrossRef

55.

Richard S, Dionne CE, Nouwen A. Self-efficacy and health locus of control: relationship to occupational disability among workers with back pain. J Occup Rehabil. 2011;21(3):421–30.PubMedCrossRef

56.

Wallston KA, Wallston BS, DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) scales. Health Educ Monogr. 1978;6(2):160–70.PubMedCrossRef

57.

Kübler-Ross E, Kessler D. On grief and grieving: finding the meaning of grief through the five stages of loss. New-York: Simon & Schuster Ltd; 2005.

58.

Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Nouwen A, et al. Determinants of “return to work in good health” among workers with back pain who consult in primary care settings: a 2-year prospective study. Eur Spine J. 2007;16(5):641–55.PubMedCrossRef

Title: Obstacles to and Facilitators of Return to Work After Work-Disabling Back Pain: The Workers’ Perspective
Authors: Clermont E. Dionne
Renée Bourbonnais
Pierre Frémont
Michel Rossignol
Susan R. Stock
Ève Laperrière
Publication date: 01-06-2013
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 2/2013
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-012-9399-4

At a glance: The STEP trials

Springer Medicine

Obstacles to and Facilitators of Return to Work After Work-Disabling Back Pain: The Workers’ Perspective

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2013

Onset of Work Restriction in Employed Adults with Lower Limb Joint Pain: Individual Factors and Area-Level Socioeconomic Conditions

The Influence of Perceived Health on Labour Participation Among Long Term Unemployed

Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study

Personal Resources and Support When Regaining the Ability to Work: An Interview Study with Exhaustion Disorder Patients

A Test of the Occupational Matching Hypothesis for Rehabilitation Clients with Severe Mental Illness

The Clinical Utility of the Multidimensional Pain Inventory (MPI) in Characterizing Chronic Disabling Occupational Musculoskeletal Disorders