WorkAbilities : A study of chronic pain and work disability
Degree GrantorUniversity of Canterbury
Degree NameMaster of Science
Many people in New Zealand stop working, and then remain off work after developing musculoskeletal pain. Some individuals return to work after some time, others remain off work despite receiving a great many biomedical and other interventions. That one group of individuals with the diagnosis of chronic pain syndrome are able to return to work while others with the same diagnosis fail to return to work suggests that factors other than the presence or absence of pain determine whether an individual develops and maintains a work disability. This thesis explores the generation of a model of work disability for individuals with chronic musculoskeletal pain who have completed a pain management programme at the Burwood Pain Management Centre. Abductive method of theory development has been used to guide the process. This method of reasoning works back from identified phenomenon to presumed cause, and explicitly acknowledges those parts of the research process that are not always considered important enough to be mentioned in the hypothetico-deductive method. These aspects include the constraints of the setting in which the research problem has arisen, the prominent role of early data collection and analysis, generation of models to explain data patterns which may have been identified during exploratory analysis, and the approach to theory appraisal which incorporates consideration of explanatory coherence, simplicity and analogy as well as empirical robustness. The thesis describes features of the clinical setting, and issues raised by the literature, in order to form the question: “Is it possible to conceptualise work disability so that individuals with chronic pain can develop skills to overcome their challenges for return to work?”. An assessment process and intervention programme developed for the Pain Management Centre, Burwood Hospital, was used as the vehicle for exploring individuals' understanding of their problem, and generating a model of work disability. The intervention programme also provided preliminary outcomes for evaluating and enriching the model of work disability.