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Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study

Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study
Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study
Objectives: to understand what we can learn from the impact of the COVID-19 pandemic and lockdown about what enables work participation for people with inflammatory arthritis and chronic pain conditions.

Design: qualitative interviews embedded within an observational questionnaire study of individuals with musculoskeletal (MSK) conditions.

Setting: UK primary care (general practices), and secondary care-based rheumatology services.

Participants: individuals with axial spondyloarthritis, psoriatic arthritis and MSK pain from three established cohorts completed an online/paper-based questionnaire (July–December 2020). A subset of respondents were selected for semistructured interviews.

Primary and secondary outcome measures: the survey quantified the effects of lockdown on work circumstances. Qualitative interviews explored the impacts of these changes and the advantages and disadvantages of changes in work circumstances.

Results: 491 people (52% female, median age 49 years) who were employed at the time of lockdown responded to the questionnaire. The qualitative analysis included 157 free-text comments on work from the questionnaire and data collected within 18 interviews.

Participants reported impacts on mental and physical health, and significant financial anxieties. The impact of work changes varied depending on individual and home circumstances. Some felt forced to ignore advice to shield and continue working. The flexibility offered by home working and changes in commuting enabled greater physical activity for some, while others missed the exercise normally undertaken as part of their commute. Others reported a constant need to be ‘present’ online, which heightened anxiety and worsened MSK symptoms.

Conclusion: lockdown showed that flexible working arrangements, which consider the positive and negative aspects of commuting, posture, movement, and work environment matter for work participation, and can have wider benefits in terms of health and well-being for those with long-term MSK conditions. Incorporating these into new models of work will help make the workplace more equitable and inclusive for people with long-term MSK conditions.
COVID-19, OCCUPATIONAL & INDUSTRIAL MEDICINE, QUALITATIVE RESEARCH, RHEUMATOLOGY
2044-6055
e057919
Morton, LaKrista
511379f3-7f4d-457a-8753-2c3dd5676529
Stelfox, Kevin
4e4b3d2c-9ce9-4abd-a3a7-3b2ace623785
Beasley, Marcus
c83a3017-2ddc-4cb2-bf61-dcd496ddcde3
Jones, Gareth.T.
4a081913-b60d-4916-996f-298cfd47cd88
Macfarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Hollick, Rosemary J.
0be6ad0a-16c1-4529-9ced-12ed89996e4f
Morton, LaKrista
511379f3-7f4d-457a-8753-2c3dd5676529
Stelfox, Kevin
4e4b3d2c-9ce9-4abd-a3a7-3b2ace623785
Beasley, Marcus
c83a3017-2ddc-4cb2-bf61-dcd496ddcde3
Jones, Gareth.T.
4a081913-b60d-4916-996f-298cfd47cd88
Macfarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Hollick, Rosemary J.
0be6ad0a-16c1-4529-9ced-12ed89996e4f

Morton, LaKrista, Stelfox, Kevin, Beasley, Marcus, Jones, Gareth.T., Macfarlane, Gary J., Walker-Bone, Karen and Hollick, Rosemary J. (2022) Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study. BMJ Open, 12 (4), e057919. (doi:10.1136/bmjopen-2021-057919).

Record type: Article

Abstract

Objectives: to understand what we can learn from the impact of the COVID-19 pandemic and lockdown about what enables work participation for people with inflammatory arthritis and chronic pain conditions.

Design: qualitative interviews embedded within an observational questionnaire study of individuals with musculoskeletal (MSK) conditions.

Setting: UK primary care (general practices), and secondary care-based rheumatology services.

Participants: individuals with axial spondyloarthritis, psoriatic arthritis and MSK pain from three established cohorts completed an online/paper-based questionnaire (July–December 2020). A subset of respondents were selected for semistructured interviews.

Primary and secondary outcome measures: the survey quantified the effects of lockdown on work circumstances. Qualitative interviews explored the impacts of these changes and the advantages and disadvantages of changes in work circumstances.

Results: 491 people (52% female, median age 49 years) who were employed at the time of lockdown responded to the questionnaire. The qualitative analysis included 157 free-text comments on work from the questionnaire and data collected within 18 interviews.

Participants reported impacts on mental and physical health, and significant financial anxieties. The impact of work changes varied depending on individual and home circumstances. Some felt forced to ignore advice to shield and continue working. The flexibility offered by home working and changes in commuting enabled greater physical activity for some, while others missed the exercise normally undertaken as part of their commute. Others reported a constant need to be ‘present’ online, which heightened anxiety and worsened MSK symptoms.

Conclusion: lockdown showed that flexible working arrangements, which consider the positive and negative aspects of commuting, posture, movement, and work environment matter for work participation, and can have wider benefits in terms of health and well-being for those with long-term MSK conditions. Incorporating these into new models of work will help make the workplace more equitable and inclusive for people with long-term MSK conditions.

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More information

Accepted/In Press date: 2 March 2022
e-pub ahead of print date: 7 April 2022
Published date: 7 April 2022
Additional Information: Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Keywords: COVID-19, OCCUPATIONAL & INDUSTRIAL MEDICINE, QUALITATIVE RESEARCH, RHEUMATOLOGY

Identifiers

Local EPrints ID: 456792
URI: http://eprints.soton.ac.uk/id/eprint/456792
ISSN: 2044-6055
PURE UUID: 1be9b3d2-b9a2-4059-84bc-88084d1a0d68
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

Catalogue record

Date deposited: 11 May 2022 16:46
Last modified: 17 Mar 2024 02:50

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Contributors

Author: LaKrista Morton
Author: Kevin Stelfox
Author: Marcus Beasley
Author: Gareth.T. Jones
Author: Gary J. Macfarlane
Author: Rosemary J. Hollick

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