• M Löfvander.
• Rinkeby Health Centre, Spånga, Sweden.
• Scand J Prim Health Care. 1999 Sep 1; 17 (3): 164-9.

ObjectiveTo explore attitudes towards pain and returning to work in young immigrants on long-term sick leave because of chronic pain.DesignAs a part of a randomised-controlled rehabilitation programme for immigrants 16-45 years of age on sick leave > 6 weeks, the participants in the experimental group were interviewed about their attitudes towards their pain.SettingA primary health care centre in an immigrant district in Stockholm, Sweden.SubjectsTwenty-six first generation immigrants with long-standing musculoskeletal or imprecise pain.MeasuresSemi-structured interviews of explanatory models of pain. The content of the interviews was abstracted and categorised, with the focus on factors that might influence the rehabilitation process and especially cause pain anxiety.ResultsThe majority of the interviewees were Turks and Southern Europeans with a median age of 38.5 years and a median sick leave of 12.0 months. Nearly all assessed themselves as having no capacity to work and two-thirds reported pain anxiety. The shared characteristics of the attitude to pain were that rest is the best treatment and that occupational work is the main etiological factor for the pain. A difference was found regarding the meaning of the pain, with one cluster of interviewees focusing on a disorder (Type I attitudes) and the other cluster focusing on the pain sensation itself (Type II attitudes). These clusters were equally large and there were no significant differences regarding ethnicity, religion, or other data between them. However, persons in the Type II cluster were generally more fatalistic about their future health and significantly more were working, at least part-time, at the 3 (p < 0.05) and 8 month (p < 0.01) follow-ups.ConclusionDifferences in attitudes towards pain and in qualities of pain anxiety, either focusing on the meaning of pain and its consequences or on the immediate experience of pain, might influence rehabilitation.

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