Key Push and Pull Factors Affecting Return to Work Identified by Patients With Long-Term Pain and General Practitioners in Sweden

Abstract

Research shows that working is positive for people with long-term pain but that work-related support from health professionals is inadequate. One explanation for this inadequacy is that patients and providers differ in terms of perspectives on motivation to work. In this article, we compare factors that 31 patients and 15 general practitioners consider important to promote return to work for people with long-term pain. We analyzed the interviews with thematic analysis and a motivational push and pull framework to cover different motivational factors, societal and individual, that might push or pull patients from or toward work. Providers said that a difference between working and nonworking patients is their level of individual motivation, while the patients’ stories showed that the main difference was the physical (non)ability to push themselves to work. We suggest that work-related support can be improved by addressing such differences in clinical practice.

Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers

“…Other work has identified the importance of work adjustments as factors ‘pulling’ people back into work [30]. In our study, participants described how being in pain left them feeling isolated from wider society, including the working world, and this made them feel less confident when they considered returning to work.…”

Professional Coping Strategies in a Temporal Perspective: A Pilot Study on How Swedish General Practitioners Deal With Challenges Inherent in Pain Management

“…Several studies suggest that general practitioners face challenges in providing evidence-based and patient-centered chronic pain care. Some of these include dealing with the diverse perspectives that patients and health professionals hold regarding the causes of pain (Nielsen et al, 2013; Phelan et al, 2009) and the different expectations on appropriate interventions (Brown, 2004; Darlow, 2016; Lundberg & Melander, 2019; Matthias & Bair, 2010). Competing expectations of patients and providers give rise to situations where providers try to avoid conflicts with patients (Breen et al, 2007; Cushman et al, 2017; Egerton et al, 2017; Leppänen, 2008), for example, in negotiating treatment with opioids (Harle et al, 2015; Matthias et al, 2013, 2014, 2017).…”

Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) – Frequency, Patient Characteristics, and Association with Self-Rated Work Ability

“…High work value may facilitate work activities, but support is needed to balance work participation and work ability. [9][10][11] Bio-psycho-social interdisciplinary pain rehabilitation programs (IPRPs) are evidence-based rehabilitation programs offered to patients with chronic pain. 12,13 IPRPs generally include education, physical activity, cognitive behavioural therapy (CBT), and/or interventions to support social and work activities delivered by different professionals.…”