Illness Perceptions in the Context of Differing Work Participation Outcomes: Exploring the Influence of Significant Others in Persistent Back Pain

Conducted by: Dr Joanna Brooks (Project Leader), Dr Serena McCluskey, Professor Nigel King and Professor Kim Burton

March 2011 – March 2012

Co-researchers and affiliations: Dr Dimple Vyas, Calderdale and Huddersfield NHS Foundation Trust

Funding: The BUPA Foundation

This project aimed to draw attention to the ways in which ‘significant others’ and wider social circumstances may impact on functional outcomes, including work participation, for those with persistent back pain. People with persistent low back pain, amongst other illnesses, who are receiving benefits because they cannot work, are now being encouraged and helped to return to employment, in line with the UK government's welfare reform agenda.

Previous research (link to other project page here) has demonstrated that ‘significant others’, defined as those close to individuals with persistent back pain, may have important influences on work participation outcomes. During this project, the research team conducted interviews with both back pain patients and their nominated significant other. Some patients had remained in work despite their back pain, whilst others had ceased employment. Clear differences were identified between beliefs and responses to back pain symptoms amongst the significant others of individuals who had remained in employment; compared with the significant others of those patients who had ceased work.

Findings suggested that in order to be effective, work participation programmes should be designed with flexibility and have the ability to assess and manage individuals and their wider social circumstances. Programmes intended to facilitate return to work also need to acknowledge the potential social stigma faced by individuals with ‘unseen’ health complaints and their families. It was also recommended that such programmes recognise that participants’ attempts to achieve legitimisation of their symptoms may act as a barrier to full engagement, and that any less adaptive beliefs about back pain, in terms of its causes, symptoms and consequences, on the part of individuals and their significant others may need identifying and addressing to facilitate optimal engagement and outcomes.

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