Chronic Pain and Work

Abstract

The present research presents a comprehensive investigation of the Cognitive Appraisal Model within the context of chronic pain in the workplace. The research comprises two studies aimed at understanding the associations between chronic pain, occupational stress, perceptions of work relationships, work withdrawal behaviours, and depressive symptoms. Study 1 focused on the development and validation of the Perceptions of Work Relationships for Individuals with Chronic Pain (PoWR-CP) Scales, guided by Social Exchange Theory. Following a multi-stage scale development process, 20 items representing three factors—Perceived Support, Absence of Perceived Stigma, and Perceived Friendship—were identified as the final structure applicable across supervisor, co-worker, and supervisee relationships. The scales demonstrated strong reliability and validity, establishing their psychometric soundness and alignment with similar constructs such as social capital and organizational justice. Building upon the PoWR-CP Scales, Study 2 explored the complex interplay between work-specific factors and depressive symptoms in individuals with chronic pain. A cross-sectional online survey measured pain and occupational characteristics, occupational stress, work withdrawal behaviours, and depressive symptoms. The results revealed two distinct paths: one reducing depressive symptom severity and the other exacerbating it. Further, the findings highlighted the influence of sample characteristics, such as age, pain type and severity, interference, occupation type, and work setup, on the relationships examined. The findings emphasize the significance of understanding the intricate relationships between pain, occupational stress, work relationships, work withdrawal behaviours, and depressive symptoms. Importantly, this research aligns with the WHO Healthy Workplace Framework and recommends interventions rooted in Relational Frame Theory and Acceptance and Commitment Therapy to support employees with chronic pain in navigating their work environments.