title: A synthesis of qualitative research exploring  the barriers to staying in work with chronic  musculoskeletal pain.
abstract: OBJECTIVE
  Qualitative research can help to advance our understanding, management and prevention of work disability. Our aim was to integrate qualitative research findings in order to increase our understanding of barriers to stay in work with chronic pain.
  
  
  METHODS
  We searched five electronic bibliographic databases until September 2012, supplemented by citation tracking and hand-searching. We used meta-ethnography to synthesis our findings. Central to meta-ethnography is identifying “concepts” and developing a conceptual model. Concepts were compared and organised into categories.
  
  
  RESULTS
  The following categories can have an impact on the decision to remain in work: struggling to affirm myself as a good worker; balancing life and work in the face of unpredictable symptoms; my work colleagues don't believe me; the system does not facilitate return to work; the battle for legitimacy.
  
  
  CONCLUSIONS
  Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic. The papers span 15 years of qualitative research. A significant finding is that these themes continue to pervade the current work environment for those in pain, and this has clear implications for education, social care and policy.
  
  
  CONCLUSIONS
  People with chronic pain face an adversarial struggle to maintain their credibility at work. Strategies to maintain personal credibility can have an adverse effect on working lives. Changes at a systems level are needed to facilitate continuance and return to work. Cultural changes in the way that we view people with pain would help to keep people in work.
authors.forename: Francine
authors.initials: F
authors.lastname: Toye
authors.forename: Kate
authors.initials: K
authors.lastname: Seers
authors.forename: Nick
authors.initials: N
authors.lastname: Allcock
authors.forename: Michelle
authors.initials: M
authors.lastname: Briggs
authors.forename: Eloise
authors.initials: E
authors.lastname: Carr
authors.forename: Karen
authors.initials: K
authors.lastname: Barker
mesh_terms: D000223:Adaptation, Psychological; D000884:Anthropology, Cultural; D059350:Chronic Pain / Q000534:rehabilitation*; D006801:Humans; D059352:Musculoskeletal Pain / Q000534:rehabilitation*; D036301:Qualitative Research; D062707:Return to Work / Q000523:psychology*