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I get by with a little help from my friends: chronic pain and the effect of workplace support on performance

At a glance:
Chronic pain is common and very costly: it often leads to sickness absence and reduced productivity. These effects are lessened when employees find their workplace supportive and believe that their contribution and wellbeing are valued.
Pain is not visible, so it can be hard for others to understand. Sometimes people say, “If my arm was in a cast people might understand”. It can help to be clear about your condition and find ways of explaining it to people. The explanation is best when it's simple, short, and expresses a wish to be productive. It's also important to be clear about what you need. One approach might be a statement like,

"I know I look okay but I'm really struggling with my sore shoulder. I want to do as much as I can, but I don't think I can work at my best without a bit of help."

Once you've started the conversation, you need to be as clear and precise as you can about what it is you need.

Most people find it difficult to ask for help. When you feel awkward about asking for something, the words may not come out like you hope. Take your time, and think carefully about what it is you need, and how you'll ask for it.
This study shows that employees with chronic
continuing a long time or recurring frequently
 pain are more productive when they feel supported at work.

To support employees with long-term pain, you can:

Ask them what they need, and find out how the organisation can help them
Be interested in the employee's concerns.
Be flexible with things like work start/finish times
Allow time off for medical or other appointments
Pain is not visible, so it can be harder to understand the impact it has on a person's wellbeing, abilities and productivity. It's important to realize that these effects exist, and employers can take action to reduce them. Anything you do to support employees and make them feel valued is likely to be helpful, and lead to improvements in productivity.
Chronic pain can be difficult to manage. Its impact is worsened by distress, which is a common consequence of the condition. Lack of support in the workplace may reduce the employee's productivity, or cause them to avoid attending work altogether.

 Treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
  can help patients by discussing these issues openly. The practitioner can also encourage the person to ask for help if they need it. Asking for help is hard, so it's often helpful to give the person an opportunity to work out what they need and how they can ask for it. It's important to encourage the person to be positive and emphasize their wish to be productive. Treating practitioners can also let the workplace know that a supportive approach will improve productivity.
This study indicates that productivity is improved when people feel supported.

Claims managers can help to improve outcomes by encouraging employers to take an interest in their employees' well-being. Some employers take a hard line in dealing with medical issues, because they feel there is a potential to be taken advantage of. This study shows that this may not be the most effective approach for employees with chronic pain. This is a point that claims managers can emphasize to employers.
Original Article, Authors & Publication Details:
Z. S. Byrne1 and W. A. Hochwarter2 (2006).

I Get by With a Little Help From My Friends: The Interaction of Chronic Pain and Organizational Support on Performance. Journal of Occupational Health Psychology 11(3):215-227.

1Department of Psychology, Colorado State University, Fort Collins, Colorado
2Wayne A. Hochwarter, Department of Management, Florida State University, Tallahassee, Florida.
Background, Study Objectives, How It Was Done:
Chronic pain is defined as physical discomfort lasting more than 6 months. The condition is common: about 20% of visits to the doctor are for chronic pain, and half of all employees will experience the condition at work. For jobs that involve heavy lifting or repetitive movement, the figures are much higher.

Chronic pain has profound effects on a person's general health and quality of life. It is associated with psychological, social and medical problems. In America, where this study was done, chronic pain is believed to be the most expensive medical condition in the country, and may cost as much as $US260 billion per year. Lost work productivity makes up much of this cost. Studies have estimated that those with chronic pain typically lose 5-6 hours of productive working time per week.

Not everyone with chronic pain can return to work, and those that do experience physical difficulty and mental fatigue. They may have problems with memory, concentration, problem solving and decision making. They may also become isolated at work.

As with all medical conditions, psychological
Refers to a person's perceptions, thought processes, emotions, personality and behaviour. Psychologists can treat mental health problems.
 and social factors influence a person's experience of chronic pain. Many studies have shown that social support lessens the distress
Severe suffering, pain, anxiety or sorrow
 associated with chronic pain, it also reduces the level of physical pain experienced. Social support is thought to help people to develop successful coping mechanisms.

This study explored “perceived organizational support.” Someone with a high level of perceived organizational support believes that the organization they work for values their contribution, and cares about their wellbeing. Workplaces might show support by offering practical help, resources or flexible work schedules, or they might offer support through encouragement and inclusion. Previous research has shown that employees who feel supported in the workplace are more committed to the organization and more willing to make the effort to continue at work.

Supportive environments also tend to be well-organised (helping workers with concentration difficulties) and flexible, offering employees some control over their work. This benefits all employees, but is especially helpful to those with chronic pain. It also promotes positive relationships and cooperation.

In this paper, three studies were carried out to determine the effects of perceived organizational support on work performance for those with chronic pain. In each study the same survey was given to a different group of people.

The survey assessed each worker's level of chronic pain and perceived organizational support, also asking how productive, hardworking and helpful they believed themselves to be. The questions and assessment methodology had all been used in previous research.

Study 1

101 surveys were completed by workers at a financial agency
The average workers' age was 36
Employees came from all levels of the company, including customer service clerks and the vice president
Employees had worked with the organization for an average of 8 years.

Study 2

337 surveys were completed by full-time employees in a range of blue-collar and white-collar occupations.
Average participant age was 37 years
Employees had worked for their current employer for an average of 7 years.

Study 3

171 surveys were completed by employees of three different insurance companies
Average participant age was 42 years
On average, employees had worked for their current employer for 8 years

In study 3, supervisors also rated the performance of each of their employees.
Study Findings:
Employees with chronic pain were found to perform less well at work if they had low levels of support. When employees had high levels of support, chronic pain had a smaller effect on their performance.

Study 1

Chronic pain had less of an impact on the productivity and helpfulness of employees with higher levels of perceived organizational support

Study 2

Chronic pain had significantly less impact on the effort, productivity and helpfulness of employees who had higher levels of perceived organizational support.

Study 3

Chronic pain had less of an impact on the productivity of employees who had higher levels of perceived organizational support.
Chronic pain causes physical and mental fatigue, making it difficult to perform well at work. This effect is reduced when employees believe that the organization they work for values their contribution and cares about their wellbeing. It's worth noting that this effect is only observed when the perception of organizational support is quite strong. Low level or intermittent support might not be sufficient to make a difference and is sometimes viewed as a “token effort.”

Managers need to be aware that chronic pain is common. It can lead to sickness absence, but more often it simply reduces employee productivity. This effect is more difficult to see, so managers will not always be aware that is operating. Employers can reduce the productivity effects of chronic pain by:

  • Ensuring that employees feel valued by the organization
  • Making employee wellbeing a priority
PubMed Abstract
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