Seminar Presentation 1-2

1-2 (Presentation within Topical Seminar 1):
Illness representations and work rehabilitation

Presented by: Fergal O'Hagan

Authors

Coutu MF1,2

  1. Trent University, Peterborough
  2. CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil, Québec, Canada

Abstract

Background

Patients are “common-sense scientists” who develop personal representations of health problems that lead to decisions about coping response and ultimately appraisal of the effectiveness of actions. Representations are also part of the patients recovery, reflecting their cognitive and emotional adaptation to an injury or illness. Our particular interest lies in how representations develop, transform and influence worker adaptation to illness and injury. Our overarching goal is to understand the complex self-regulatory system involved in response to disabling injury and illness.

Methods

Data synthesis of two qualitative research projects focusing on illness representations and work reintegration. Longitudinal interviews were conducted with 16 workers with chronic work-related MSK disability and 12 workers returning to work following disabling cardiovascular disease events. Themes were developed through constant comparative methods. Results were integrated with extant literature.

Results

The following themes developed from the data: 1. Health and illness are appraised for their functional consequences. 2. Symptoms like pain are appraised for their threat value. Pain can be reinterpreted leading to better rehabilitation participation and return to work. 3. The body is an important object of interpretation. Body representations enable and constrain adaptive response like exercise and work. 3. Expanding the scope of the disability problem to include social isolation and lack of purpose also expands range of coping response available to deal with the problem. 4. Illness uncertainty is anxiety provoking, diminishes personal control and leads to withdrawal from work and rehabilitation activities. 5. Personal construal of illness and injury is dynamic and influenced positively and negatively by a range of personal and social stimuli.

Conclusions

Representations provide a valuable window into the experience and perspectives of workers with disabling health conditions. Representations facilitate shared understanding and worker motivation to rehabilitate and provide a leading indicator of progress in rehabilitation. Workers’ representations should evaluated as part of evidence-based practice in work disability management.