Staying at work with back pain: patients' experiences of work-related help received from GPs and other clinicians. A qualitative study

Abstract

BackgroundLow back pain commonly affects work ability, but little is known about the work-related help and advice that patients receive from GPs and other clinicians. The purpose of this study was to explore the experiences of employed people with back pain and their perceptions of how GPs and other clinicians have addressed their work difficulties.MethodsA qualitative approach with thematic analysis was used. Individual interviews were carried out with twenty-five employed patients who had been referred for back pain rehabilitation. All had expressed concern about their ability to work due to low back pain.ResultsThe perception of the participants was that GPs and other clinicians had provided little or no work-focused guidance and support and rarely communicated with employers. Sickness certification was the main method that GPs used to manage participants' work problems. Few had received assistance with temporary modifications and many participants had remained in work despite the advice they had received. There was little expectation of what GPs and other clinicians could offer to address work issues.ConclusionsThese findings question the ability of GPs and other clinicians to provide work-focused support and advice to patients with low back pain. Future research is recommended to explore how the workplace problems of patients can be best addressed by health professionals.

Experiences of chronic low back pain: a meta-ethnography of qualitative research

“…Although not exclusively so, this theme was particularly associated with studies that explicitly referred to a large proportion of participants still in paid employment (Coole, Drummond, & Watson, 2010;Coole, Watson, & Drummond, 2010a, 2010bHush et al, 2009;Liddle et al, 2007;May, 2001May, , 2007McPhillipsTangum et al, 1998;Strunin & Boden, 2004;Young et al, 2011).…”

“…Care could be depersonalising rather than person-centred: 'you don't feel that you are being treated as a person at all' (Walker, Holloway, & Sofaer, 1999, p. 623). In particular, the typical GP was perceived as having limited resources and skills (Campbell & Guy, 2007;Chew & May, 1997;Coole, Watson, & Drummond, 2010a;Slade et al, 2009a). This description of the standard GP protocol for care 72 P. MacNeela et al…”

Factors promoting staying at work in people with chronic nonspecific musculoskeletal pain: A systematic review

“…#1 CINAHL heading terms and free text words related to work (MH "Work") or (MH "Occupations and Professions") or (MH "Employment+") or (MH "Absenteeism") or (MH "Sick Leave") or (MH "Occupational Health") OR TI ("sickness absence" OR "work status" OR "occupational status" OR "work ability" OR "work disability" OR "work attendance" OR "work performance" OR "occupationally active" OR "job retention" OR "work capacity" OR presenteeism OR "job status" OR "vocational status" OR "vocational rehabilitation" OR "employment status" OR occupation OR absenteeism OR employment OR "sick leave" OR "occupational health" OR "occupational ability" OR "stay at work" OR "return to work" OR "work participation") or AB ("sickness absence" OR "work status" OR "occupational status" OR "work ability" OR "work disability" OR "work attendance" OR "work performance" OR "occupationally active" OR "job retention" OR "work capacity" OR presenteeism OR "job status" OR "vocational status" OR "vocational rehabilitation" OR "employment status" OR occupation OR absenteeism OR employment OR "sick leave" OR "occupational health" OR "occupational ability" OR "stay at work" OR "return to work" OR "work participation") #2 CINAHL heading terms and free text words related to pain (MH "Chronic Pain") or (MH "Back Pain") or (MH "Neck Pain") or (MH "Shoulder Pain") or (MH "Pelvic Pain") or "widespread pain" OR "musculoskeletal pain" OR "work related pain") #3 #1 AND #2 #4 #3 AND Age Groups: Young Adulthood (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) MeSH descriptor Pain explode all trees #19 (#17 AND #18) #20 "sickness absence" OR "work status" OR "occupational status" OR "work ability" OR "work disability" OR "work attendance" OR "work performance" OR "occupationally active" OR "job retention" OR "work capacity" OR presenteeism OR "job status" OR "stay at work" OR "occupational ability" OR "vocational status" OR "vocational rehabilitation" OR "employment status" OR "return to work" OR "Work participation" OR "Occupation" OR "Absenteeism" OR "Employment" OR "Sick Leave" OR "Occupational Health":ti,ab,kw #21 "Back Pain" OR "Neck Pain" OR "Shoulder Pain" OR "Pelvic Pain" OR Fibromyalgia OR Whiplash OR Tendinopathy OR "Musculoskeletal pain" OR "Myofascial Pain" OR "Joint Instability" OR "Cumulative Trauma Disorder" OR "repetitive strain injury" OR (complaints AND (arm OR neck OR shoulder)) OR "chronic pain" OR "widespread pain" OR "work related pain":ti,ab,kw #22 (#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #19 OR #21) #23 (#11OR #12 OR #13 OR #14 OR #15 OR #16 OR #20) #24 (#22 AND #23) Box 1. Criteria for assigning grade of evidence.…”

“…Several terms are used for working with pain, such as staying at work (SAW) [26,27], remaining or continuing a work role [28], working despite pain [29][30][31], continuing work with pain [32,33], remaining in employment [34], work maintenance [35], staying on the job [36], retaining work [26] and keeping on working [37]. For the purpose of this review, SAW was defined as sustained work participation despite CMP for at least 1 year, without present sick leave due to CMP.…”

Fit for purpose? Using the fit note with patients with chronic pain: a qualitative study

“…[3][4][5][6][7][8][9][10][11][12] Studies have concluded that there is a need for more information about how and why sickness certification is problematic and how to improve the process. 12,25,26 The primary goal of this study is to address this gap in knowledge, and gain an insight into how the new fit note might be used to improve sickness certification for the chronic pain patient.…”