Raising Work-related Concerns in Primary Care Consultations for Musculoskeletal Conditions: A Qualitative Study

Musculoskeletal (MSK) conditions of a chronic nature affect work significantly often resulting in presenteeism, reduced productivity, sickness absence and long-term work incapacity. Good primary care management of such conditions can result in a positive impact on occupational health outcomes. However, despite a number of studies concerned with this area, research exploring primary care management in such cases is scarce. Moreover, insufficient research exists exploring the individually differing and complex work issues of older adults (50 +) living with MSK conditions. This study aimed to explore musculoskeletal and work-related discussions within the primary care consultation and the patient experiences of the process and surrounding issues. 100 video recorded consultations of patients aged 45 years plus were observed and analysed utilizing constructivist grounded theory to develop a coding frame. A purposive sample of 20 patients aged 50 years plus, having indicated experiences of both MSK and work related issues, were identified from a cohort study and interviewed. A comparative analysis of the two data sets is underway. Preliminary analysis has highlighted key themes including; 1) the normalisation or dismissal of work-related concerns as a barrier to support, 2) the patient struggle to negotiate legitimacy and deservedness as a barrier to both consulting and discussing work concerns and 3) the socio-cultural co-construction of credibility and deservedness to consult and raise work. The theoretical framework of ‘Candidacy’ is being utilized to explore and expand on the difficulties faced by patients in negotiating access to the consultation and work-related discussions.