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Work. 2013 Jan 1;44(1):11-36. doi: 10.3233/WOR-2012-01559.

Chronic pain in episodic illness and its influence on work occupations: a scoping review.

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School of Occupational Therapy, University of Western Ontario, London, ON, Canada.



The aim of this review was to understand and synthesize the realm of knowledge on intermittent work capacity (IWC) about strategies to support work sustainability. Specifically, this review focused on literature that examined productive work with individuals who have chronic pain due to Fibromyalgia, Breast Cancer, Multiple Sclerosis, and Human Immunodeficiency Virus.


A scoping review of research conducted across 10 databases. Nature of the knowledge base on return to work barriers and strategies and future recommended strategies needed to support persons with IWC in maintaining work participation were charted and thematically analyzed and organized into micro, meso and macro categories.


Majority of the knowledge base reflects factors impeding and facilitating employment or re-employment at the micro level. At the micro level, self advocacy was a strategy that persons with IWC used to maintain employment and navigate stigmatizing work environments to meet their needs. At the meso level education and knowledge sharing with employers to increase awareness was underscored; at the macro level introduction of new policies was recommended.


These findings suggest the need for future greater examination of the dialectical relationships across micro, meso and macro level strategies to overcome work disparities for persons with IWC.

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