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. 2022;71(1):119-132.
doi: 10.3233/WOR-205173.

The role of contextual factors on participation in the life area of work and employment after rehabilitation: A qualitative study on the views of persons with chronic pain

Thomas Friedli  1 , Brigitte E Gantschnig  1   2
Affiliations

The role of contextual factors on participation in the life area of work and employment after rehabilitation: A qualitative study on the views of persons with chronic pain

Thomas Friedli et al. Work. 2022.

Abstract

Background: A deeper understanding of how contextual factors affect the ability to participate in the life area of work and employment despite chronic musculoskeletal pain is needed as a basis for interprofessional rehabilitation programs.

Objective: To investigate which contextual factors influence rehabilitation program clients' ability to participate in the life area of work and employment, and how they do this.

Methods: Nested case study using a realist evaluation framework of interprofessional interventions. Qualitative content analysis of problem-centered interviews to identify influential context-mechanism-outcome configurations.

Results: We identified several important context-mechanism-outcome configurations. In the pre-interventional phase, socioeconomic and environmental factors affected two mechanisms, "exhaustion" and "discrimination". In the intra-interventional phase, the social skills of health professionals and opportunities for discussion with peers affected the ability of program participants to engage with program content. In the post-intervention phase, volitional competences of the social system affected the sustainable application of program content in everyday life.

Conclusion: The identified context-mechanism-outcome configurations shows that the ability to participate in the life area of work is interdependent with the ability to participate in other areas of life. In practice and research, assessment and treatment should be carried out based on this understanding.

Keywords: Evaluation study; disability and health; international classification of functioning; quality of life; realist evaluation; rehabilitation.

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Conflict of interest statement

None to report.

Figures

Fig. 1
Fig. 1
The ICF Framework of Functioning, Disability and Health.
Fig. 2
Fig. 2
Pre-interventional CMO configurations.
Fig. 3
Fig. 3
Intra-interventional CMO configurations.
Fig. 5
Fig. 5
Overview of relevant activities, participation, environmental and personal factors as contextual factors of a rehabilitation program. (Basic framework: WHO, 2001).
Fig. 4
Fig. 4
Post-interventional CMO configurations.
See this image and copyright information in PMC

References

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