{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:29:08Z","timestamp":1783020548422,"version":"3.54.6"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000279","name":"Nuffield Foundation","doi-asserted-by":"publisher","award":["OBF\/FR-000023820"],"award-info":[{"award-number":["OBF\/FR-000023820"]}],"id":[{"id":"10.13039\/501100000279","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The study explored the views of organisational stakeholders who participated in the feasibility trial of the Pain-at-Work Toolkit towards the implementation of the toolkit in \u2018real-world\u2019 workplace settings. This digital toolkit was co-created with healthcare professionals, employers, and people with chronic pain and aimed to inform and enable individuals to self-manage their chronic pain at work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Design\/methodology\/approach<\/jats:title>\n                    <jats:p>A qualitative study using semi-structured interviews with 15 stakeholders from 12 organisations that participated in a feasibility trial of the Pain-at-Work Toolkit. Purposive sampling was used to ensure the inclusion of stakeholders with management or supportive roles who have responsibility for the health and wellbeing of employees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The findings illuminate three key themes: not all disabilities are visible; not all line managers are equal; and who has control? These surmise that invisible disabilities such as chronic pain are underestimated, poorly understood, and inconsistently provisioned for in organisational policies. It highlights the key role that line managers play in employee disclosure and access to support but demonstrates that line managers vary in their delivery of support to employees. Lastly, it explores stakeholder perceptions of the roles of the employer relative to the employee with chronic pain. It confirms the need for additional resources to plug organisational gaps and give workers tools to self-manage their pain at work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Originality<\/jats:title>\n                    <jats:p>This study indicates the need for resources \/ supports to upskill line managers so they can intervene to proactively support employees with chronic pain to reduce sickness absence and presenteeism (working when unwell). The research demonstrates organisational stakeholders\u2019 interest in a multi-faceted approach to help employees self-manage chronic pain in all types at work, such as that provided by the Pain-at-Work Toolkit. In addition, it clearly identifies the potential for complementary resources to educate and facilitate line managers to better support their staff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0351938","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:07:02Z","timestamp":1783015622000},"page":"e0351938","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cShining a light on chronic pain\u201d: A qualitative study of stakeholder views towards chronic pain at work and the Pain-at-Work Toolkit"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-5344","authenticated-orcid":true,"given":"Angela 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Braun","year":"2013"},{"issue":"3","key":"pone.0351938.ref031","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"V Braun","year":"2021","journal-title":"Qualitative Research in Psychology"},{"issue":"3","key":"pone.0351938.ref032","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","article-title":"A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis","volume":"56","author":"D Byrne","year":"2021","journal-title":"Qual Quant"},{"issue":"2","key":"pone.0351938.ref033","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"issue":"13","key":"pone.0351938.ref034","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qual Health Res"},{"issue":"5","key":"pone.0351938.ref035","doi-asserted-by":"crossref","first-page":"607","DOI":"10.4300\/JGME-D-21-00752.1","article-title":"Beyond the Guise of Saturation: Rigor and Qualitative Interview Data","volume":"13","author":"KA LaDonna","year":"2021","journal-title":"J Grad Med Educ"},{"key":"pone.0351938.ref036","year":"2010"},{"issue":"6","key":"pone.0351938.ref037","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/S0003-9993(00)90103-5","article-title":"Multidisciplinary treatment of chronic pain patients: its efficacy in changing patient locus of control","volume":"81","author":"AM Coughlin","year":"2000","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"issue":"1","key":"pone.0351938.ref038","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.physio.2004.06.013","article-title":"Can four key psychosocial risk factors for chronic pain and disability (Yellow Flags) be modified by a pain management programme?","volume":"92","author":"M Sowden","year":"2006","journal-title":"Physiotherapy"},{"key":"pone.0351938.ref039","volume-title":"Disability and corporate social responsibility reporting: An analysis comparing reporting practices of 40 selected multinational enterprises","author":"J Cordero","year":"2014"},{"issue":"5","key":"pone.0351938.ref040","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1093\/occmed\/kqaf052","article-title":"Employees\u2019 experiences of chronic pain in the workplace","volume":"75","author":"H Blake","year":"2025","journal-title":"Occup Med (Lond)"},{"issue":"1","key":"pone.0351938.ref041","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/csr.1669","article-title":"Diversity in the workplace: An overview of disability employment disclosures among UK firms","volume":"26","author":"N Khan","year":"2018","journal-title":"Corp Soc Responsibility Env"},{"issue":"3","key":"pone.0351938.ref042","doi-asserted-by":"crossref","DOI":"10.1097\/AJP.0000000000001273","article-title":"It\u2019s Not Written All Over My Face: Constructing Chronic Pain as Invisible in Pain Clinic Consultations and Interviews","volume":"41","author":"J Declercq","year":"2025","journal-title":"Clin J Pain"},{"key":"pone.0351938.ref043","doi-asserted-by":"crossref","DOI":"10.21125\/edulearn.2025.0097","article-title":"Views and experiences of employers towards workplace support for people with chronic pain; a mixed methods study to inform line manager training.","author":"H Blake","year":"2025"},{"key":"pone.0351938.ref044","unstructured":"Ysasi NA, Becton AB, Chen RK. Stigmatizing effects of visible versus invisible disabilities. 2018."},{"key":"pone.0351938.ref045","first-page":"1","article-title":"Invisible Disabilities","author":"SF Javaid","year":"2024","journal-title":"The Palgrave Encyclopedia of Disability. Springer Nature Switzerland"},{"issue":"10","key":"pone.0351938.ref046","first-page":"551","article-title":"Decreasing the stigma burden of chronic pain","volume":"25","author":"DB Monsivais","year":"2013","journal-title":"J Am Assoc Nurse Pract"},{"issue":"1","key":"pone.0351938.ref047","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1186\/s12891-019-2877-5","article-title":"Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers","volume":"20","author":"M Grant","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"key":"pone.0351938.ref048","author":"England PH"},{"issue":"3","key":"pone.0351938.ref049","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1467-8551.2004.00419.x","article-title":"Bridging the Gap between Rhetoric and Reality: Line Managers and the Protection of Job Security for Ill Workers in the Modern Workplace","volume":"15","author":"I Cunningham","year":"2004","journal-title":"British J of Management"},{"issue":"2","key":"pone.0351938.ref050","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s10551-016-3290-8","article-title":"Board Heterogeneity and Organisational Performance: The Mediating Effects of Line Managers and Staff Satisfaction","volume":"152","author":"A Blanco-Oliver","year":"2016","journal-title":"J Bus Ethics"},{"issue":"4","key":"pone.0351938.ref051","first-page":"1","article-title":"Understanding the role of line managers in employment relations in the modern organisation","volume":"37","author":"K Townsend","year":"2015","journal-title":"Employee Relations"},{"key":"pone.0351938.ref052","volume-title":"Work and industrial relations in an age of austerity: disability, reasonable adjustments, and austerity","author":"R Harwood","year":"2011"},{"issue":"1","key":"pone.0351938.ref053","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s40900-025-00757-5","article-title":"Five years of patient and public involvement and engagement (PPIE) in the development and evaluation of the Pain-at-Work toolkit to support employees\u2019 self-management of chronic pain at work","volume":"11","author":"H Blake","year":"2025","journal-title":"Res Involv Engagem"},{"issue":"1","key":"pone.0351938.ref054","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/bmb\/ldae007","article-title":"The effectiveness of digital interventions for self-management of chronic pain in employment settings: a systematic review","volume":"151","author":"H Blake","year":"2024","journal-title":"Br Med Bull"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:07:17Z","timestamp":1783015637000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351938"}},"subtitle":[],"editor":[{"given":"Heather","family":"Leggett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":54,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0351938","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}