Factors of importance for return to work, experienced by patients with chronic pain that have completed a multimodal rehabilitation program – a focus group study

Abstract

Background and purpose

To reduce the individual, societal, and economic burden of the high sick leave rates due to chronic pain, it is essential to find effective strategies for increasing return to work (RTW). Although multimodal rehabilitation programs (MMRPs) may have positive effects on RTW, the results are inconsistent. This study explores the factors that contribute to decreasing sick leave and increasing RTW in patients with chronic pain who completed a MMRP.

Method

Four focus groups and three individual interviews were conducted. In total, 18 patients were interviewed. All patients had chronic pain and had completed a MMRP. They were either employed or unemployed, either working to some degree or fully on sick leave. The data were analysed using qualitative content analysis.

Results

Three main categories were identified: Knowledge and understanding–prerequisites for tailored solutions; Individual adaptations–necessary but difficult to implement; and Stakeholder collaboration–needs improvement.

Conclusion

The participants described a variety of facilitating and limiting factors that created complex prerequisites for RTW. This finding makes it clear that these patients need tailored interventions and strong collaboration among all stakeholders throughout the rehabilitation process. Tailored interventions and collaborations could improve the effectiveness of MMRPs.

IMPLICATIONS FOR REHABILITATION

• Patients with chronic pain need tailored solutions and adaptations based on their individual needs in the RTW rehabilitation process.

• To return to work, patients with chronic pain needs support to strengthen their selfconfidence and to be prepared with knowledge and strategies about their abilities and their rights and obligations in relation to the labour market.

• A well-designed and communicated RTW rehabilitation plan supports the patient in the RTW rehabilitation process.

• To improve the possibility for employees and employers to create a sustainable work situation, stakeholder reconciliation meetings should be held routinely over time to strengthen the transfer of knowledge and collaboration.

Keywords:

• Chronic pain
• return to work
• rehabilitation
• qualitative method

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

We would like to thank the interviewees who took part in the qualitative interview study, which made this research possible. We also thank our patient research partner, Jan Bagge from the Swedish Rheumatism Association, for scrutinizing and validating the data collection and analysis.

Additional information

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article: This work was supported by the Swedish Research for Health, Working Life and Welfare [grant number 2016-07414] and the County council of Östergötland [grant number LiO-582141].