QUantifying the Impact of Chronic pain on engagement in paid worK (QUICK)
Lead Research Organisation:
University of Aberdeen
Department Name: Sch of Medicine, Medical Sci & Nutrition
Abstract
Background: Chronic pain is pain that persists over months or years and fails to respond to usual pain care. It has many causes but is often musculoskeletal (e.g. back pain). Chronic pain affects what work people do and how, in a range of different ways - for example, from impacting how much work one can do on a day-to-day basis, to long-term career choices. There is currently no questionnaire developed that can fully explore or measure the impact of chronic pain on ability to work. Existing questionnaires assume people have one job and are contracted to work a certain number of hours every week. They do not ask about the different ways pain might affect work and they are not designed for modern ways of working (holding several part-time jobs, having "zero hours" contracts, being self-employed).
Project aim: We plan to develop a questionnaire that can be used to assess the different ways in which chronic pain affects work ability, taking into account modern ways of working. We will carry out three pieces of work (called workpackages) to achieve this.
Workpackage 1: We will review the scientific literature to see if there are any existing questionnaires or part-questionnaires which cover impacts of chronic pain on work, or which have been developed for another health problem and could be adapted for use in people with chronic pain.
Workpackage 2: We want to find out how chronic pain affects work ability by asking people with chronic pain. Having understood patients' experiences, we also want to understand the impacts from the perspectives of employers, trades unions, leaders of the main organisations which deal with employers, healthcare workers and policy makers. Once this range of impacts are clear, we will create a new questionnaire to assess them. We will then look to see whether each of the issues raised are adequately captured in any existing questions or questionnaires identified in Workpackage 1. We will then develop a new questionnaire, using relevant items from existing questionnaires, or by adapting them, and/or by creating new ones as needed. We will refine the wording of the questions during rounds of feedback from patient partners, a range of employers, representatives of all the different relevant expert groups and policy-makers to make sure it is easy to understand and covers all the relevant areas.
Workpackage 3: We will ask people with chronic pain from a range of workplaces, with different types of chronic pain, and from the general public to complete the new questionnaire. At the end of the questionnaire, we will ask how easy it was to understand the questions and whether the questions made sense. We will ask if they thought that important work-issues were missed out by the questionnaire, and for any other feedback. We will collect face-to-face feedback from some participants. After this feedback, we will hold a final workshop involving patients, employers, policy makers and researchers to present the key issues raised and, if required, to come up with possible solutions. Through discussion, we will aim to finalise a questionnaire fit for purpose.
Output from this project: The output from this project will be a new questionnaire agreed by patients and all important expert groups which can measure the ways that chronic pain impacts on work in all types of settings. This questionnaire can then be widely promoted by funders, expert groups and researchers so that we collect the important facts about pain and work in every setting: the clinic, research and registers. The questionnaire can then be used to e.g. show whether pain treatments are good at helping people with pain cope better at work and e.g. whether changes made in workplaces have made it possible for more people with pain to be able to work.
Project aim: We plan to develop a questionnaire that can be used to assess the different ways in which chronic pain affects work ability, taking into account modern ways of working. We will carry out three pieces of work (called workpackages) to achieve this.
Workpackage 1: We will review the scientific literature to see if there are any existing questionnaires or part-questionnaires which cover impacts of chronic pain on work, or which have been developed for another health problem and could be adapted for use in people with chronic pain.
Workpackage 2: We want to find out how chronic pain affects work ability by asking people with chronic pain. Having understood patients' experiences, we also want to understand the impacts from the perspectives of employers, trades unions, leaders of the main organisations which deal with employers, healthcare workers and policy makers. Once this range of impacts are clear, we will create a new questionnaire to assess them. We will then look to see whether each of the issues raised are adequately captured in any existing questions or questionnaires identified in Workpackage 1. We will then develop a new questionnaire, using relevant items from existing questionnaires, or by adapting them, and/or by creating new ones as needed. We will refine the wording of the questions during rounds of feedback from patient partners, a range of employers, representatives of all the different relevant expert groups and policy-makers to make sure it is easy to understand and covers all the relevant areas.
Workpackage 3: We will ask people with chronic pain from a range of workplaces, with different types of chronic pain, and from the general public to complete the new questionnaire. At the end of the questionnaire, we will ask how easy it was to understand the questions and whether the questions made sense. We will ask if they thought that important work-issues were missed out by the questionnaire, and for any other feedback. We will collect face-to-face feedback from some participants. After this feedback, we will hold a final workshop involving patients, employers, policy makers and researchers to present the key issues raised and, if required, to come up with possible solutions. Through discussion, we will aim to finalise a questionnaire fit for purpose.
Output from this project: The output from this project will be a new questionnaire agreed by patients and all important expert groups which can measure the ways that chronic pain impacts on work in all types of settings. This questionnaire can then be widely promoted by funders, expert groups and researchers so that we collect the important facts about pain and work in every setting: the clinic, research and registers. The questionnaire can then be used to e.g. show whether pain treatments are good at helping people with pain cope better at work and e.g. whether changes made in workplaces have made it possible for more people with pain to be able to work.
Technical Summary
We will develop an instrument to assess the impacts of chronic pain on work ability. It will take account of the range of ways in which people now engage in paid work and the different impacts chronic pain may have: the quantity and quality of work, measures adopted in mitigation, and changes in employment.
Specific objectives are to:
- identify what instruments have been developed to measure impacts of chronic pain on work, or could be suitable for such (workpackage 1). We will undertake a systematic review of the literature to identify existing instruments that have been used to measure impacts of chronic pain on whether and how people work, or have been used to measure these in other long-term conditions.
- determine the key functional impacts of chronic pain on work and to map impacts of pain on work to existing instruments identified above (workpackage 2). We will undertake a narrative synthesis of qualitative literature; focus groups with patients, employers and policy makers; mapping impacts of chronic pain on work to existing instruments and establishing an initial item set to be included in an instrument.
These two workpackages will then inform the development of the instrument. This will involve a multi-stage Delphi study involving key stakeholders and the output from this will be a prototype instrument for testing. We will then:
- evaluate the performance of the newly-developed instrument. This will include: acceptability, feasibility, comprehension, readability, responder burden, test-retest reliability, and convergent validity with other measures, amongst individuals with chronic pain and in different types of work, and thereby to agree a finalised instrument (workpackage 3)
The output from this work will be a new instrument which allows the quantification of the impact of chronic pain (with possible use in other chronic diseases) on work ability, and to more widely identify the life-course impact on work trajectory.
Specific objectives are to:
- identify what instruments have been developed to measure impacts of chronic pain on work, or could be suitable for such (workpackage 1). We will undertake a systematic review of the literature to identify existing instruments that have been used to measure impacts of chronic pain on whether and how people work, or have been used to measure these in other long-term conditions.
- determine the key functional impacts of chronic pain on work and to map impacts of pain on work to existing instruments identified above (workpackage 2). We will undertake a narrative synthesis of qualitative literature; focus groups with patients, employers and policy makers; mapping impacts of chronic pain on work to existing instruments and establishing an initial item set to be included in an instrument.
These two workpackages will then inform the development of the instrument. This will involve a multi-stage Delphi study involving key stakeholders and the output from this will be a prototype instrument for testing. We will then:
- evaluate the performance of the newly-developed instrument. This will include: acceptability, feasibility, comprehension, readability, responder burden, test-retest reliability, and convergent validity with other measures, amongst individuals with chronic pain and in different types of work, and thereby to agree a finalised instrument (workpackage 3)
The output from this work will be a new instrument which allows the quantification of the impact of chronic pain (with possible use in other chronic diseases) on work ability, and to more widely identify the life-course impact on work trajectory.
