Table 1.
Summary of the results from the focus group sessions
| Focus group sessions with employees with CANS |
| • Although employees with CANS tried various ways to reduce their complaints, they still suffered from CANS |
| • Employees are faced with the challenge to deal with their complaints on a daily basis in both their private and working life |
| • Employees are not fully aware of the possibilities to influence their symptoms and their own role in triggering and coping with their complaints |
| • Employees generally are often approaching their individual limits |
| • Fatigue has a serious impact on the daily life of employees |
| • Employees have to deal with disrupting physical/socio-environmental factors at work |
| • Employees have to deal with misunderstandings from supervisor and colleagues |
| • The identified recurring problem areas endorse the multifactorial etiology of CANS |
| • There is a need for information about possible (multifactorial) causes of the complaints |
| • The following needs were mentioned during the focus group sessions: knowledge about exercises, muscle relaxation, working with pain, the work environment, and socio-environmental and personal factors (including work style) |
| Focus group sessions with experts |
| • Awareness and behavioral change are found to be important for this group of employees |
| • The employee’s behavior is seen by experts as an important factor related to the onset of symptoms of CANS |
| • CANS is less related to workplace interior modifications than to the behavior (ie, experiences and the intensity) of the employee at work |
| • Experts indicate that employees with CANS generally have high demands (on themselves) and are often perfectionists |
| • Employees who experience a high workload and work pace should learn to be aware when the body gives signals of overloading, and one must react at the appropriate time, such as to take breaks at regular times |
| • Employees suffering from CANS have difficulty in managing their own health problem and work |
| • Employees with CANS should be more proactive; in the intervention, bottlenecks should be identified and employees should make their own choices and obtain reassurance. Most experts find it important that the intervention deals with the possible causes of the complaints and the underlying problems that may trigger CANS |
| • Experts stated that it is important that employees with CANS receive information about topics related to the possible relief of their complaints, such as load and capacity, setting limits, taking breaks, ergonomics, relaxation, social support, social relationships, and physical activity, including exercises |
| • Moreover, experts find it important that employees are aware of the possible facilities and treatment options within and outside their organization |
| • Experts seem to see a role for a self-management program for employees with CANS |
| • Complaints will not always go away, but a self-management program can offer support to these employees in learning how to handle their problems |
| • The intervention should focus on increasing employees’ self-efficacy and empowerment |
| • Experts indicate that the combination of group sessions and an eHealth module can work extremely well and can strengthen and complement each other |
| • The self-management intervention is seen as a roadmap, in which participants work on their personal goals, plus the interaction with other participants |
| • The eHealth module lends itself to providing more information. Participants could then use this information in the sessions in order to fulfil their action plans |
Notes: Adapted from Hutting N, Heerkens YF, Engels JA, Staal JB, Nijhuis-van der Sanden MW. Experiences of employees with arm, neck or shoulder complaints: a focus group study. BMC Musculoskelet Disord. 2014;15:14114 and Hutting N, Engels J, Staal J, Heerkens Y, Nijhuis-van der Sanden M. Development of a self-management intervention for employees with complaints of the arm, neck and/or shoulder (CANS): a focus group study with experts. J Occup Med Toxicol. 2015;10:9.27
Abbreviation: CANS, complaints of the arm, neck, and/or shoulder.