Affiliations: Faculty of Health Sciences, University of Sydney,
Lidcombe, NSW, Australia | Ageing, Work and Health Research Unit, Faculty of
Health Sciences, University of Sydney, Lidcombe, Australia
Abstract: In Australia, evidence of an ageing population and a skills shortage
are imminent challenges for employers [5,50]. A further concern arises from the
work injury and motor accident compensation schemes, where many claims for soft
tissue injuries result in permanent impairment depriving the community of
otherwise productive workers [85]. In many cases, it is chronic pain that
becomes the major barrier to a return to productive work. Objective: This study will review the operation of rehabilitation within Australian Workers'
and Motor Accidents compensation systems in order to identify values and
attitudes underpinning the vocational rehabilitation ethos. The models
underlying current practice will also be identified. Methods: A comprehensive review of published literature and policy documents was
undertaken. Results: We identified a variety of contextual factors that
influenced progress back into the workforce for people living with persistent
pain. The conceptual models underpinning these factors within rehabilitation
systems were explored. They were all driven by a strong focus on early return
to work and at the same time the sustainability of rehabilitation as a
profitable industry. Conclusions: Implications of these findings on the
relationship between the rehabilitation provider and the person in pain are
discussed. Rehabilitation professionals are influenced by and in turn influence
the context in which chronic pain is experienced. Empirical data about the
experiences of vocational rehabilitation professionals in Australian personal
injury rehabilitation systems is lacking, yet the implications of the cost of
chronic pain to the nation are significant. It is recommended that
rehabilitation providers increase their awareness of the perhaps unforeseen
traps within the various practice models they might be using on the goal of
sustainable return to work for people living with pain.
Keywords: Labour force participation, Cartesian dualism, medical model, biopsychosocial model, workers' compensation, contextual factors
