Attitudes towards pain and return to work in young immigrants on long- term sick leave.
OBJECTIVE
To explore attitudes towards pain and returning to work in young immigrants on long-term sick leave because of chronic pain.


METHODS
As a part of a randomised-controlled rehabilitation programme for immigrants 16-45 years of age on sick leave > 6 weeks, the participants in the experimental group were interviewed about their attitudes towards their pain.


METHODS
A primary health care centre in an immigrant district in Stockholm, Sweden.


METHODS
Twenty-six first generation immigrants with long-standing musculoskeletal or imprecise pain.


METHODS
Semi-structured interviews of explanatory models of pain. The content of the interviews was abstracted and categorised, with the focus on factors that might influence the rehabilitation process and especially cause pain anxiety.


RESULTS
The majority of the interviewees were Turks and Southern Europeans with a median age of 38.5 years and a median sick leave of 12.0 months. Nearly all assessed themselves as having no capacity to work and two-thirds reported pain anxiety. The shared characteristics of the attitude to pain were that rest is the best treatment and that occupational work is the main etiological factor for the pain. A difference was found regarding the meaning of the pain, with one cluster of interviewees focusing on a disorder (Type I attitudes) and the other cluster focusing on the pain sensation itself (Type II attitudes). These clusters were equally large and there were no significant differences regarding ethnicity, religion, or other data between them. However, persons in the Type II cluster were generally more fatalistic about their future health and significantly more were working, at least part-time, at the 3 (p < 0.05) and 8 month (p < 0.01) follow-ups.


CONCLUSIONS
Differences in attitudes towards pain and in qualities of pain anxiety, either focusing on the meaning of pain and its consequences or on the immediate experience of pain, might influence rehabilitation.
Löfvander
M
M
Rinkeby Health Centre, Spånga, Sweden.
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology / Q000523:psychology; D001294:Attitude to Health; D002908:Chronic Disease; D003466:Cultural Characteristics; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology* / Q000534:rehabilitation; D011320:Primary Health Care; D018582:Sick Leave; D018709:Statistics, Nonparametric; D013548:Sweden; D014171:Transients and Migrants / Q000523:psychology*