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Resilience and return-to-work pain interventions: systematic review

Research output: Contribution to journalArticle

  • E Wainwright
  • D Wainwright
  • N Coghill
  • J Walsh
  • R Perry
Original languageEnglish
Article numberkqz012
Number of pages14
JournalOccupational Medicine
Early online date21 Mar 2019
DOIs
DateAccepted/In press - 14 Oct 2018
DateE-pub ahead of print (current) - 21 Mar 2019

Abstract

BACKGROUND: Resilience is a developing concept in relation to pain, but has not yet been reviewed in return-to-work (RTW) contexts.

AIMS: To explore the role of resilience enhancement in promoting work participation for chronic pain sufferers, by reviewing the effectiveness of existing interventions.

METHODS: Resilience was operationalized as: self-efficacy, active coping, positive affect, positive growth, positive reinforcement, optimism, purpose in life and acceptance. Five databases were searched for randomized controlled trials (RCTs) whose interventions included an element of resilience designed to help RTW/staying at work for chronic pain sufferers. Study appraisal comprised the Cochrane risk of bias (RoB) tool and additional quality assessment. Findings were synthesized narratively and between-group differences of outcomes were reported. Heterogeneous PICO (population, intervention, comparator, outcome) elements precluded meta-analysis.

RESULTS: Thirty-four papers from 24 RCTs were included. Interventions varied; most were multidisciplinary, combining behavioural, physical and psychological pain management and vocational rehabilitation. Four found RTW/staying at work improved with intensive multidisciplinary interventions compared with less intensive, or no, treatment. Of these, one had low RoB; three scored poorly on allocation concealment and selective outcome reporting. Four trials had mixed results, e.g. interventions enabling reduced sick leave for people on short-term not long-term leave; 16 showed no improvement. Five trials reported resilience outcomes were improved by interventions but these were not always trials in which RTW improved.

CONCLUSIONS: Effectiveness of resilience interventions for chronic pain sufferers on RTW is uncertain and not as helpful as anticipated. Further agreement on its conceptualization and terminology and that of RTW is needed.

Additional information

© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

    Research areas

  • chronic pain, occupational health, resilience, return to work, chronic disease

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via OUP at https://doi.org/10.1093/occmed/kqz012 . Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 683 KB, PDF-document

    Embargo ends: 21/03/20

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  • Supplementary information PDF

    Rights statement: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via OUP at https://doi.org/10.1093/occmed/kqz012 . Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 491 KB, PDF-document

    Embargo ends: 21/03/20

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    Licence: Other

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