Abstract
BackgroundPrevious research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. The purpose of this research was to explore whether the illness beliefs of significant others differed depending on their relative’s working status, and to make some preliminary identification of how significant others may facilitate or hinder work participation for those with persistent back pain.MethodsInterviews structured around the Illness Perception Questionnaire (chronic pain version) were conducted with back pain patients recruited from a hospital pain management clinic along with their significant others. Some patients had remained in work despite their back pain; others had ceased employment. Data were analysed using template analysis.ResultsThere were clear differences between beliefs about, and reported responses to, back pain symptoms amongst the significant others of individuals who had remained in employment compared with the significant others of those who had ceased work. Three overarching themes emerged: perceived consequences of back pain, specific nature of employment and the impact of back pain on patient identity.ConclusionsSignificant others of employed individuals with back pain focused on the extent to which activity could still be undertaken despite back pain symptoms. Individuals out of work due to persistent back pain apparently self-limited their activity and were supported in their beliefs and behaviours by their significant others. To justify incapacity due to back pain, this group had seemingly become entrenched in a position whereby it was crucial that the individual with back pain was perceived as completely disabled. We suggest that significant others are clearly important, and potentially detrimental, sources of support to individuals with back pain. The inclusion of significant others in vocational rehabilitation programmes could potentially be a valuable way of mobilising readily accessible resources in a way that supports optimal functioning.
Highlights
Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes
There has been little consideration given to how significant others might usefully be involved in interventions to improve work participation for those individuals with persistent back pain, and the present study sought to further extend this area of research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others
New themes, emerging through analytic engagement with the data, may be defined and added to the template structure. The use of this technique allowed for analysis to be guided by and initially structured around our research focus on the dimensions of the Common Sense model of self-regulation (CSM), a model which is already wellestablished as a useful framework for exploring beliefs about illness and a logical starting point for this exploratory work
Summary
Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. It is widely accepted that psychosocial factors are important determinants for the consequences of back pain, including the transition to chronicity, [6,7,8,9]) It remains unclear which specific factors are of particular relevance in this context, and a comprehensive understanding of how pertinent psychosocial factors might operate in determining functional outcomes (including work participation) is still required. There have been several recent calls in the literature for more qualitative work in this area as the most suitable method through which to explore psychosocial risk factors for chronicity [10] and occupational outcomes [11]
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