Exploring stakeholder perspectives on contemporary return-to work strategies and practices for chronic pain sufferers

Wegrzynek, P (2021) Exploring stakeholder perspectives on contemporary return-to work strategies and practices for chronic pain sufferers. PhD thesis, Bath Spa University.

Abstract

Psychologically and physically safe work is good for the health and well-being of most people including those living with pain. Chronic pain remains the second biggest reason for work absence, and is economically and psychologically costly to employees, employers, and governments. This thesis investigates the most effective strategies in promoting return to work (RTW) among employees with ongoing pain. Two reviews (one systematic, one narrative) found no conclusive evidence to support any treatment approach, although stratified, multidisciplinary interventions with workplace­oriented elements are optimal. Semi-structured interviews with employees with chronic pain (study one), occupational health physicians (study two), occupational therapists and occupational health nurses (study three) were analysed using thematic analysis. In study one, employees with chronic pain felt motivated towards RTW and adopted an 'active' role in the process. Social support played a pivotal role, although workers felt pressured to be '100% fit' upon returning. Employees felt expert in their pain experience, entitled to ownership of their care decision-making, and acted as knowledge conduits between stakeholders. In study two, occupational health physicians were frustrated with current RTW processes, perceived overworked GPs as unwitting saboteurs of RTW processes, and blamed systemic issues within the NHS and reduced resources for the lack of access to multidisciplinary interventions. Study three revealed that medicalisation of chronic pain hinders RTW, and primary RTW outcomes should be driven by workers' meaningful activity. Health professionals in study three adopt a protective role with pain clients, similar to the mentoring role suggested in study two. The thesis' theoretical framework, revised in the light of the empirical analyses, retains the biopsychosocial model of pain and the Job Demands-Resources model, and suggests that a successful RTW strategy for workers with chronic pain should be multidisciplinary, consider patients' active roles, their need for support, and adopt a flexible approach to compensation. Implications for practice include extending who does sick-listing and examining volunteering as an occupational outcome.

Item Type: Thesis (PhD)
Keywords: return-to-work policy, work absence, occupational health, chronic pain, biopsychosocial model of pain
Divisions: School of Sciences
Date Deposited: 03 Oct 2021 19:01
Last Modified: 03 Oct 2021 19:05
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