What Challenges Manual Workers’ Ability to Cope with Back Pain at Work, and What Influences Their Decision to Call in Sick?
- 440 Downloads
- 4 Citations
Abstract
Introduction Although back pain (BP) is a very common cause for sickness absence, most people stay at work during BP episodes. Existing knowledge on the factors influencing the decision to stay at work despite pain is limited. The aim of this study was to explore challenges for coping with BP at work and decisive factors for work attendance among workers with high physical work demands. Methods Three focus groups (n = 20) were conducted using an explorative inductive method. Participants were public-employed manual workers with high physical work demands. All had personal BP experience. Thematic analysis was used for interpretation. Results were matched with the Flags system framework to guide future recommendations. Results Workers with BP were challenged by poor physical work conditions and a lack of supervisor support/trust (i.e. lack of adjustment latitude). Organization of workers into teams created close co-worker relationships, which positively affected BP coping. Workers responded to BP by applying helpful individual adjustments to reduce or prevent pain. Traditional ergonomics was considered inconvenient, but nonetheless ideal. When pain was not decisive, the decision to call in sick was mainly governed by workplace factors (i.e. sick absence policies, job strain, and close co-workers relationships) and to a less degree by personal factors. Conclusion Factors influencing BP coping at work and the decision to report sick was mainly governed by factors concerning general working conditions. Creating a flexible and inclusive working environment guided by the senior management and overall work environment regulations seems favourable.
Keywords
Back pain Workplace Sick leave Sickness absence Social support Focus groupsNotes
Acknowledgments
We are most grateful to the participants of the focus groups for sharing their experiences. Special thanks to the participating municipalities. Finally, special thanks to Sebastian Werngreen Nielsen for reviewing the manuscript. Funding was provided by The Danish Working Environment Research Fund (Arbejdsmiljøforskningsfonden), The Danish Rheumatism Association (Gigtforeningen), and Glostrup University Hospital.
Conflict of interest
Authors Pernille Frederiksen, Tom Bendix, and Mette Marie V. Karsten are employed at Glostrup University Hospital, which is one of the funders of this project. Author Aage Indahl declares that he has no conflict of interest. Neither contributing municipalities nor funders interfered in the scientific or publication process.
Ethical standard
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 [19]. Informed consent was obtained from all participants for being included in the study.
References
- 1.Phillips C. The costs and burden of chronic pain. Rev Pain. 2009;3(1):1–5.Google Scholar
- 2.Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain, work performance and litigation. Pain. 2003;103:41–7.CrossRefPubMedGoogle Scholar
- 3.Breivik H, Collett B, Ventafrida V, Cohen R, Gallagher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10:287–333.CrossRefPubMedGoogle Scholar
- 4.Ijzelenberg W, Burdorf A. Patterns of care for low back pain in a working population. Spine (Phila Pa 1976). 2004;29:1362–8.CrossRefGoogle Scholar
- 5.de Vries H, Reneman MF, Groothoff JW, Geertzen JHB, Brouwer S. Factors promoting staying at working people with chronic nonspecific musculoskeletal pain: a systematic review. Disabil Rehabil. 2012;34(6):443–58.CrossRefPubMedGoogle Scholar
- 6.de Vries H, Brouwer S, Groothoff JW, Geertzen JHB, Reneman MF. Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers’ experience. BMC Musculoskelet Disord. 2011;12:126.PubMedCentralCrossRefPubMedGoogle Scholar
- 7.Tevito TH, Shaw WS, Huang YH, Nicholas M, Wagner G. Managing pain in the workplace: a focus group study of challenges, strategies and what matters most to workers with low back pain. Disabil Rehabil. 2010;32(24):2035–45.CrossRefGoogle Scholar
- 8.Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Laperrière E. Obstacles to and facilitators of return to work after work-disabling back pain: the workers’ perspective. J Occup Rehabil. 2013;23(2):280–9.CrossRefPubMedGoogle Scholar
- 9.Buck R, Porteous C, Wynne-Jones G, Marsh K, Phillips CJ, Main CJ. Challenges to remaining at work with common health problems: what helps and what influence do organizational policies have? J Occup Rehabil. 2011;21:501–12.CrossRefPubMedGoogle Scholar
- 10.da Costa BR, Viera ER. Risk factors for work-related musculoskeletal disorders: a systematic review for recent longitudinal studies. Am J Ind Med. 2010;53:285–323.PubMedGoogle Scholar
- 11.Lauring J, Selmer J. Expatriate compound living: an ethnographic field study. Int J Hum Resour Manag. 2009;20(7):1451–67.CrossRefGoogle Scholar
- 12.Sandelowski M. Focus on research methods: whatever happened to qualitative description? Res Nurs Health. 2000;23:334–40.CrossRefPubMedGoogle Scholar
- 13.Dawson S, Manderson L, Tallo V. Introduction & team leader focus group training. In: The focus group manual. Methods for social research in tropical diseases No. 1. Geneve: UNDP/World Bank/WHO, 1992; p. 1–37.Google Scholar
- 14.Kendall NAS, Burton AK, Main CJ, Watson PJ. Tackling musculoskeletal problems: a guide for the clinic and workplace-identifying obstacles using the psychosocial flags framework. London: The Stationery Office; 2009.Google Scholar
- 15.Bach E, Jakobsen P. Work environment and health in Denmark 2012–2020. Copenhagen: NFA 2013. National Research Centre for Working Environment. Annual Report. In Danish.Google Scholar
- 16.Symonds TL, Burton AK, Tillotson KM, Main CJ. Do attitudes and beliefs influence work loss due to low back trouble? Occup Med. 1996;46(1):25–32.CrossRefGoogle Scholar
- 17.Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358:483–8.CrossRefPubMedGoogle Scholar
- 18.Carlsen B, Glenton C. What about N? A methodological study of sample-size reporting in focus group studies. BMC Res Methodol. 2011;11:26–36.CrossRefGoogle Scholar
- 19.WMA Declaration of Helsinki—Ethical principles for medical research involving human subjects [homepage on the Internet]. World Medical Association, Inc. No date [cited 17 Jul 2014]. http://www.wma.net/en/30publications/10policies/b3/index.html.
- 20.Mikkelsen B. Participatory methods in use. In: Mikkelsen B, editor. Methods for development work and research—a new guide for practitioners. New Delhi: Sage; 2005. p. 87–124.Google Scholar
- 21.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;19:349–57.CrossRefPubMedGoogle Scholar
- 22.Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRefGoogle Scholar
- 23.Patton MQ. Qualitative evaluation and research methods. 2nd ed. Newbury Park, CA: Sage; 1990.Google Scholar
- 24.O’Reilly K. Ethnographic analysis: from writing down to writing up. In: O’Reilly K, editor. Ethnographic methods. London: Routledge; 2005. p. 175–205.CrossRefGoogle Scholar
- 25.Shaw WS, Pransky GS, Main CJ. Work-related risk factors for transition to chronic back pain and disability. In: Hasenbring MI, Rusu AC, Turk DC, editors. From acute to chronic back pain: risk factors, mechanisms, and clinical implications. New York: Oxford University Press; 2012.Google Scholar
- 26.Kerr MS, Frank JW, Shannon HS, et al. Biomechanical and psychosocial risk factors for low back pain at work. Am J Public Health. 2001;91(7):1069–75.PubMedCentralCrossRefPubMedGoogle Scholar
- 27.Griffith LE, Shannon HS, Wells RP, et al. Individual participant data meta-analysis of mechanical workplace risk factors and low back pain. Am J Public Health. 2012;102(2):309–18.PubMedCentralCrossRefPubMedGoogle Scholar
- 28.Daltroy LH, Iversen MD, Larson MG, et al. A controlled trial of an education program to prevent low back injuries. NEJM. 1997;337(5):322–8.CrossRefPubMedGoogle Scholar
- 29.Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine. 2009;9:147–68.CrossRefGoogle Scholar
- 30.European guidelines for preventing in low back pain. On behalf of the COST B13 Working Group [homepage on the Internet]. No date [cited 28 July 2014]. http://www.backpaineurope.org/web/files/WG3_Guidelines.pdf.
- 31.Vancleef L, Flink I, Linton SJ, Vlayen J. Fear-Avoidance as a risk factor for the development of chronic back pain and disability. In: Hasenbring MI, Rusu AC, Turk DC, editors. From acute to chronic back pain: risk factors, mechanisms, and clinical implications. New York: Oxford University Press; 2012.Google Scholar
- 32.Danish Work Environment Authority. Løft, træk og skub. AT-vejledning D.3.1. September 2005 [guidelines online]. C2005 [cited 2015 Jan 29]. Available from Danish Work Environment Authority online. In Danish.Google Scholar
- 33.Foss L, Gravseth HM, Kristensen P, et al. The impact of workplace risk factors on long-term musculoskeletal sickness absence. A registry-based 5-year follow-up from the Oslo health study. J Occup Environ Med. 2011;53(12):1478–82.CrossRefPubMedGoogle Scholar
- 34.Shaw WS, Campbell P, Nelson CC, Main CJ, Linton SJ. Effects of workplace, family and cultural influences on low back pain: what opportunities exist to address social factors in general consultations? Best Pract Res Clin Rheumatol. 2013;27:637–48.CrossRefPubMedGoogle Scholar
- 35.Mannion AF, Horisberger B, Eisenring C, Tamkan O, Müller U, Elfering A. The association between beliefs about low back pain and work presenteeism. J Occup Environ Med. 2009;51(11):1256–66.CrossRefPubMedGoogle Scholar
- 36.Coggon D, Ntani G, Vargas-Prada S, et al. International variation in absence from work attributed to musculoskeletal illness: findings from the CUPID study. Occup Environ Med. 2013;70(8):575–84.PubMedCentralCrossRefPubMedGoogle Scholar
- 37.Wynne-Jones G, Buck R, Porteus C, et al. What happens to work when you’re unwell? Beliefs and attitudes of managers and employees with musculoskeletal pain in a public sector setting. J Occup Rehabil. 2011;21:31–42.CrossRefPubMedGoogle Scholar
- 38.Ryall SJ, Jenkins V, Roberts LC. Returning to work: issues for nurses and managers following an episode of low back pain. J Bone Joint. 2005;87-B(Supp I):34–5.Google Scholar
- 39.Svensson T, Müssener U, Alexanderson K. Sickness absence, social relations, and self-esteem: a qualitative study of the importance of relationships with family, workmates, and friends among persons initially long-term sickness absent due to back diagnoses. Work. 2010;37:187–97.PubMedGoogle Scholar
- 40.Kendall NA, Linton SJ, Main CJ. Guide to assessing psychosocial yellow flags in acute low back pain: risk factors for long-term disability and work loss. Wellington: Accident Rehabilitation and Compensation Insurance Corporation of New Zealand and the National Health Committee; 1997.Google Scholar
- 41.Hooftman WE, Westerman MJ, van der Beek AJ, Bongers PM, van Mechelen W. What makes men and women with musculoskeletal complaints decide they are too sick to work? Scand J Work Environ Health. 2008;43(2):107–12.CrossRefGoogle Scholar