“Belief in oneself is the way back to work”

“By believing in their work ability, despite back and neck disorders, women find different way of coping with their pain,” says Mamunur Rashid, researcher at the University of Gävle.

All over the Western world, and especially in Sweden, researchers see that women are overrepresented when it comes to sick leave due to neck, shoulder and back pain, but knowledge concerning why some women can return to work despite pain is limited.

For a long time, Mamunur Rashid has followed more than 200 women on long-term sick leave due to neck, shoulder and back pain to determine factors that bring about, as well as factors that hinder, return to work.

Belief in oneself the most important factor

Belief in oneself was the most important enabling factor that the researcher found; such a belief in oneself could predict a change in behaviour and return to work.

“If I believe that I can return to work, this means that I will develop strategies to cope with my pain. This is our most important finding,” Mamunur Rashid says.

Must learn to cope with their pain

Mamunur Rashid states that pain patients need to learn to cope with their pain and the strategies they use to do so are very important. The researchers saw that patients could reduce their stress by changing their behavior and by engaging in regular activities. When becoming more active, their focus moved away from the pain.

“If someone found good strategies to cope with her pain, we could see that this meant that she would be able to return to work soon.”

Work ability and well-being are different things

In the group of women in the study, work ability and well-being were different things. Despite the fact that one individual said that she felt well, she could not return to work. However, although another individual stated that her well-being was poor, she could still return to work.

The researchers were surprised by the fact that social support from family, friends and society including well-being outside work did not matter, or could even have a negative impact, regarding return to work.

“Too much support will increase the fear for returning to work. We also see that these patients attempt to avoid activities that could give them the strength to cope with their situation, which affects the crucial belief that they are capable of returning to work.”

Work-oriented rehabilitation

“This research can be of immediate use at rehabilitation centres and in the medical profession,” Mamunur says. He calls for therapy, for instance cognitive behavioural therapy, that focus on activities that promote patients’ ability to cope and to develop their belief that they are capable of returning to work.

“It has to be realistic. They must think about work and how they can deal with it. They cannot change the pain, but they can be helped to find a belief that they can cope with their pain.”

Results from the study:

• A strong belief in one’s ability to return to work means return to work
• Good strategies to deal with one’s disorder means an early return to work
• Work and ability and well-being are different things

Mamunur Rashid defended his doctoral dissertation Women on sick leave for long-term musculoskeletal pain: Factors associated with work ability, well-being and return to work at the University of Gävle on 10 January, 2020.

Principal supervisor: Annika Nilsson, associate professor, University of Gävle

External examiner: Katja Boersma, professor, Örebro University

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