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The power of the personal account. How qualitative research offers important insights into the self-management of musculoskeletal conditions in the context of work. Part 1

Work itself should be considered as a form of self-management. This is the central finding of the study that The Work Foundation and Fit for Work UK launched on Friday, 5 September  entitled “Self management of chronic musculoskeletal conditions and employment”. Individuals whom we interviewed for the report found that partaking in work was an important way in which they managed several (often psychological) aspects of living with an MSD. However, the onus for managing one’s condition at work weighed far too heavily on the individual, and participants often described foregoing their home lives, social lives, and compromising their physical health to stay in work. Work as self-management was often being undermined as individuals struggled to self-manage in the context of work.

Other stakeholders have a far greater role to play in supporting self-management, and notable among those are the government, healthcare professionals, and employers. It was only through conducting an interview based study, and talking directly to individuals, that this tension between wanting to continue to work, yet often struggling to manage one’s condition successfully, could be revealed to the researchers.

Interview studies of course have their limitations. They are designed to provide depth rather than breadth meaning that statistical representativeness is foregone. The researchers are also far more ‘present’ in that they conduct and then analyse the interviews themselves meaning it is even more important that they are aware of how they may bias the results. However, this research demonstrates the power of speaking directly to individuals with lived experience of the phenomena being studied. There were some specific, very striking findings, which would be unlikely to have arisen if individuals living with chronic MSDs had not been interviewed.

Take the implications of the invisible nature of the condition, for example. Due to MSDs often not having easily visible external symptoms, individuals described how this meant others found it harder to understand their condition, and that they often were not offered support when they needed it. Some participants even described feigning alternative, more understandable, symptoms when in fact they felt unwell because of their MSD, in order to communicate to others that they were unwell.

People wouldn’t know [I had arthritis].  Sometimes that can go against me, because it’s a bit like you’re trying to do something and then you know that you’re struggling to do something.  And people go.. they don’t accept it.”

Participant 13

Sometimes I would.. if I’m not well, if things are a bit on top of me, in front of my colleagues I will say to them I have a headache, rather than go about the arthritis thing.”

Participant 10

These findings regarding the invisibility of the condition led the report to make several recommendations, including the need to employers and line managers to be more proactive in providing support, as sometimes individuals would be unwilling to come forward and identify their MSD as being the source of their problems. In my next blog, I’m going to explore the report further by discussing a subsequent set of findings related to the self-management of chronic conditions in the context of work – the crucial, yet often overlooked, relationship between workers and line-managers.

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This entry was posted on Tuesday, September 9th, 2014 at 12:42 and is filed under MSDs, Policy, Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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