Research Updates

What helps RTW for people with chronic pain?

Joy Hewitt

Surveys can help identify factors that will improve RTW.
Take Home Messages:
  1. The Job Diagnostic Survey and Job Diagnostic Index are reliable tools for evaluating job satisfaction for people with chronic pain from work injuries.
  2. The Job Diagnostic Survey identifies the specific aspects of a job that require improvement. It can be used to assess whether individual workers would benefit from job changes to increase their work satisfaction and to identify those core job dimensions that require modification.
  3. These surveys don't assess the physical work environment, and should be used in conjunction with site visits and workplace assessments.
  4. These tools can assist return-to-work coordinators to identify those workers with low levels of job satisfaction who would benefit from job redesign and work accommodation.
Why the study matters:

Nonmedical factors play an important role in determining return to work after occupational illness or injury. Job satisfaction is one of a number of psychosocial factors that have been demonstrated to influence the success of return-to-work interventions and an early return to work.

What the study involved:

A Swedish study by Schult and Söderback investigated the use of specific questionnaires (tools) to assess job satisfaction and the need for job redesign in people suffering from chronic pain who were unable to work.

Over a seven month period, 84 patients with chronic pain who were off work for at least six months were interviewed twice. They were asked to complete two surveys, and provided information on their background, work absence, employment status, perceived working ability and work history.

The researchers also reviewed the medical histories of the study participants.

The two surveys were

1. The Job Diagnostic Survey

The Job Diagnostic Survey is a 58 question self-assessment questionnaire designed to assess the extent to which job design influences internal motivation and job satisfaction.

The key elements and items included in the survey are:

  • Core job dimensions, assessing skill variety, task integrity, task significance, autonomy, feedback from others, feedback from work and dealing with others
  • Critical psychological states, examining meaningfulness of the work, responsibility for the work outcome and knowledge of the actual results of the work activities
  • Satisfaction with frame factors, including salary, potential possibilities for growth, trade union, support from supervisors, security of employment and participation in decision making
  • Emotional reactions to the job personal and work outcomes, evaluating internal work motivation and job satisfaction

The Job Diagnostic Survey was used to assess the participants’ perceptions of their psychosocial work environment and to determine the potential need for job changes. The participants’ responses were compared with data collected from 6,930 people working in 876 different jobs in 56 organisations.

2. The Job Diagnostic Index

The Job Diagnostic Index assesses perceptions of the positive and negative characteristics of the job. In this study, the questionnaire was used to assess participants’ perceptions of and satisfaction with their job.

The study participants had been off work for an average of 18 months.

Summary of research findings:

The Job Diagnostic Survey found that subjects’ perceptions of their psychosocial job components varied greatly.

Negative assessments of key aspects of the job suggested that up to 30% of study participants would benefit from job redesign. Changes were most needed in the areas of feedback from others (26% negative response), skill variety (23%), task identity (20%), autonomy (17%) and feedback from work (14%).

Satisfaction was also low for support from superiors (30%), security of employment (25%), participation in decision making (24%) and potential possibilities for growth (20%).

Responses to questions assessing emotional reactions to work personnel and work outcomes indicated that only 5% of respondents had a negative perception of their internal work motivation but 23% had a low level of job satisfaction.

Through the Job Diagnostic Index, the study participants most frequently described their jobs as:

  • Stressful (77%)
  • Tiring (76%)
  • Meaningful (75%)
  • Routine (55%)
  • Stimulating (50%)

Of note, the score for work satisfaction in the study population was well below that of the comparison population (21.1 versus 36).


Here are some of the questions from the survey:

Skill variety

Positive answers

I have a chance to do a number of different tasks, using a wide variety of different skills and talents.

I get to use a number of complex skills on this job

My job involves doing a number of different tasks

Negative answers

The job is quite simple and repetitive

The demands of my job are highly routine and predictable

Task identity

Positive answers

I do a complete task from start to finish. The results of my efforts are clearly visible and identifiable.

My job provides me with the chance to finish completely any work I start

Negative answers

I make insignificant contributions to the final product or service

My job is arranged so that I do not have a chance to do an entire piece of work from beginning to end

Task significance

Positive answers

What I do affects the well-being of other people in very important ways

Many people are affected by the job I do

Negative answers

What I do is of little consequence to anyone else

My job is not very important to the company’s survival

Original Research

A method for “diagnosing” jobs before redesign in chronic-pain patients: preliminary findings.

Schult M-L, Söderback I.

Journal of Occupational Rehabilitation 2000; 10(4): 295-309.

Link to abstract