“He’s only young and he wants to work but no-one’ll hire him with a bad back, will they?” Findings from an exploratory study of ‘significant others’’ illness perceptions in relation to work disability due to low back pain

Background Individual illness perceptions have been shown to be important influences on clinical outcomes for low back, yet significant others' illness perceptions are rarely explored, particularly in relation to work disability.

Method Semi-structured interviews based on the Illness Perceptions Questionnaire were conducted with a purposive sample of UK disability benefit claimants, along with their significant others (n=5 dyads). Data were analysed using template analysis.

Results Significant others further reinforced and validated claimants' negative beliefs/illness perceptions, including fear of pain/re-injury associated with certain types of work, perceived job inflexibility and/or lack of support from employers. Keen in their desire to be viewed as a ‘good’ spouse/partner/close family member, significant others acted as a ‘witness to pain’, supporting claimants' self-limiting behaviour and statements of incapacity, often responding with assistance and empathy. In some cases, significant others were more pessimistic about the likelihood of claimants returning to work, and more resigned to the permanence of the claimant's condition. Interestingly, all significant others also experienced chronic illness, some being disability benefit claimants themselves, thus participants' lives were often intertwined and defined by illness.

Conclusions This exploratory study reveals novel and interesting insights about the illness beliefs and behaviours of significant others in relation to disabling back pain, and also the wider social circumstances that may act as obstacles to return to work