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The Clinical Utility of the Multidimensional Pain Inventory (MPI) in Characterizing Chronic Disabling Occupational Musculoskeletal Disorders
Purpose The Multidimensional Pain Inventory (MPI) was designed to help capture unique characteristics of chronic pain patients. The present study examined the proportion of subgroups classified by the MPI in a chronic disabling occupational musculoskeletal disorder (CDOMD) patient cohort, and described characteristics of MPI profile groups in terms of other psychosocial variables. Methods A cohort of 1,270 CDOMD patients undergoing an interdisciplinary functional restoration program was studied. Before the start of the program, all patients received a standard psychosocial assessment battery. A...
Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: An assessment of health literacy
Briggs, Andrew M. et al. (2011). Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain: An assessment of health literacy. BMC Musculoskeletal Disorders , 12: 161. Background. Despite the large volume of research dedicated to understanding chronic low back pain (CLBP), patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course...
Work status and life changes in the first year after breast cancer diagnosis
Johnsson, Aina et al. (2011). Work status and life changes in the first year after breast cancer diagnosis. Work 38 (4): 337-346. Objective: The aims of this study were to generate new knowledge about factors predicting return to work (RTW) among women treated for early-stage breast cancer, and about changes in life satisfaction, and coping, and to examine the association between these concepts and RTW. Methods and Participants: A cohort of 102 women aged 18–64 were assessed six weeks, six months, and ten months after surgery using data from questionnaires and medical files. Results: Factors...
Help-seeking behaviour for the treatment of chronic pain
There are more people living with chronic pain than cardiovascular disease and cancer combined. Many people with chronic pain do not seek help from health professionals and suffer in silence for many years. Untreated chronic pain can lead to increased disability, increased risk of fall, depression, sleep deprivation, reduced quality of life and social isolation. The aim of this review is to determine the factors associated with help-seeking for chronic pain in an effort to highlight potential reasons why help may or may not be sought. A total of 23 studies were included in the review. On the whole...
Managing pain in the workplace: a focus group study of challenges, strategies and what matters most to workers with low back pain
Purpose .Most working adults with low back pain (LBP) continue to work despite pain, but few studies have assessed self-management strategies in this at-work population. The purpose of this study was to identify workplace challenges and self-management strategies reported by workers remaining at work despite recurrent or persistent LBP, to be used as a framework for the development of a workplace group intervention to prevent back disability. Method .Workers with LBP ( n =38) participated in five focus groups, and audio recordings of sessions were analysed to assemble lists of common challenges...
Work Related Factors and Sick Leave After Rehabilitation in Burnout Patients: Experiences from the REST-Project
Introduction The aim of this study was to investigate the impact of psychosocial working conditions and coping strategies at work on change in sick leave level for patients on long-term sick leave due to burnout. Methods A cohort sample of patients ( n = 117) on long-term sick leave due to burnout was analyzed. The patients answered a questionnaire at baseline and sick leave information was collected from the Swedish Social Insurance Agency at baseline and at follow-up 2 years later. Two groups were formed depending on whether the patients had “improved” and reduced their sick leave...
Maintaining a balance: a focus group study on living and coping with chronic whiplash-associated disorder
There is little qualitative insight into how persons with chronic whiplash-associated disorder cope on a day-to-day basis. This study seeks to identify the symptoms persons with whiplash-associated disorder describe as dominating and explore their self-initiated coping strategies. Methods: Qualitative study using focus groups interviews. Fourteen Norwegian men and women with whiplash-associated disorder (I or II) were recruited to participate in two focus groups. Data were analyzed according to a phenomenological approach, and discussed within the model of Cognitive Activation Theory of Stress...
Evidence and Practice in the Self-Management of Low Back Pain: Findings From an Australian Internet-based Survey
Low back pain (LBP) is common, but sufferers pursue a range of management options and only some seek professional advice. This study examines how Australian consumers report that they manage LBP, with emphasis on the extent to which their practices match clinical recommendations and guidelines. Methods: A self-reported cross-sectional online survey comprising 29 questions in English (see Supplemental Digital Content 1, http://links.lww.com/CJP/A13 ) was conducted in February 2009. The internet-based survey sample was matched with national population proportions; 1220 respondents were screened and...
The personal and workplace factors relevant to work readiness evaluation following acquired brain injury: Occupational therapists’ perceptions
This study examined the personal and workplace/environmental factors perceived most relevant to work readiness evaluations following acquired brain injury. Research design : Using a qualitative secondary analysis design ‘indicators of success' and ‘risks of failure', identified as relevant in a primary study of occupational therapists' evaluation practices, were explored further. Method : Data collected in the primary study, e.g. interviews, practice surveys, evaluation protocols, were re-analysed. Surveys and protocols were used to define participant and practice context...
Psychological and behavioural predictors of pain management outcomes in patients with cancer
To better understand the phenomenon of patient-related barriers to cancer pain management and address them more effectively in interventional studies, a theoretical model related to psychological aspects of pain experience and pain-related behaviours was elaborated. The aim of the study was to analyse the impact of patient-related barriers on cancer pain management outcomes following this model. Thirty-three patients responded to the Brief Pain Inventory Pain scale, the Danish Barriers Questionnaire II (DBQ-II), the Hospital Anxiety and Depression scale (HADS), the Danish version of Patient Perceived...
The Adequacy of Chronic Pain Management Prior to Presenting at a Tertiary Care Pain Center: The Role of Patient Socio-Demographic Characteristics
The Pain Management Index (PMI) is used to assess pain medication adequacy in black and white chronic pain patients (18–50 years) at referral to tertiary pain care. Using WHO guidelines for pain treatment, PMI was calculated from pain severity and drug analgesic potency. From 183 patients recruited, 128 provided treatment information for analyses (53% white, 60% female). Most (51.6%) had adequate PMI. Blacks were prescribed fewer pain medications ( P = .03); fewer women had adequate medication strength ( P = .04). In hierarchical regression, PMI was predicted at entry by female gender, lower...
The adaptation process after traumatic brain injury An individual and ongoing occupational struggle to gain a new identity
The aim of this study is to understand better how individuals with traumatic brain injury make sense of their adaptation process and their performance of occupations within this process. For this study, four participants were interviewed twice. Thereafter analyses following a narrative approach led to the construction of four individual narratives. The results indicate that the adaptation process following traumatic brain injury is (1) a necessary struggle to gain a new identity; (2) facilitated by engagement in familiar occupations in familiar environments; (3) a protracted learning process that...
What Concerns Workers with Low Back Pain? Findings of a Qualitative Study of Patients Referred for Rehabilitation
Health and workplace strategies to address work loss and sickness absence due to low back pain are urgently required. A better understanding of the experiences of those struggling to stay at work with back pain may help clinicians and employers with their treatment and management approaches. Methods A qualitative approach using thematic analysis was used. Individual semi-structured interviews were conducted with a convenience sample of 25 low back pain patients who had been referred for multidisciplinary back pain rehabilitation. All were in employment and concerned about their ability to work...
Resilience in the face of coping with a severe physical injury
A study of trajectories of adjustment in a rehabilitation setting Objective: Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design. Participants: Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas. Design: Classification into the three trajectories...
An exploratory study of the rehabilitation process of people with stress-related disorders
The aim was to describe how former clients with stress-related disorders and rehabilitation team members experience the rehabilitation process, and to describe how experiences from the rehabilitation have been integrated into the former clients' everyday lives. A qualitative grounded theory approach was used. The sample consisted of seven team members working at a vocational rehabilitation clinic and eight former clients who were interviewed. The participants were involved in four different rehabilitation programmes, all of which used cognitive approaches. In addition, two of the programmes...
Patients' experience of groups in outpatient mental health services and its significance for daily occupations
The prevalence of mental health problems such as depression and anxiety in the Swedish population is increasing and individuals' daily occupations are seriously affected. Occupational therapy groups have long been used in mental health services. Now, with the increase in the number of outpatients and the current principle of patients' participation there is a need for further knowledge of this group of patients' perspective on the method. The aim of this study was thus to explore how outpatients in mental health services experience treatment in occupational therapy groups and what significance...
Perceptions of illness and their impact on sickness absence
A patient's perception of their illness can influence their coping ability, compliance with treatment and functional recovery. Psychological interventions to address negative beliefs may facilitate an earlier return to work. Aims To compare perceptions of illness, fitness to return to work and time to return to work among employees with those of their occupational physicians (OPs). Methods A cross-sectional study of employees off sick for >2 weeks, with the return to work date ascertained at 3 months. Employees and their OPs completed similar questionnaires that included the Brief Illness...
Understanding how traumatic re-enactment impacts the workplace: Assisting clients' successful return to work
This research explores the observation that people who have had traumatic life experiences may connect with work in an unhealthy way, impacting their ability to return to work successfully. Purpose: This research aims to understand how past traumatic experiences influence career choice and workplace behaviour and, given this understanding, consider how occupational therapists can facilitate change towards a successful return to work. Methods: Semi-structured interviews were used to gather information from twenty-five clients experiencing depression, anxiety or post-traumatic stress disorder. Clients...
Engagement in patterns of daily occupations and perceived health among women of working age
The aim of the present cross-sectional study was to examine how subjective experiences of engagement in patterns of daily occupations (gainful employment, domestic work, enjoyable and recreational occupations) were associated with perceived health among women of working age. The sample ( n =488) was drawn from a longitudinal cohort study of women of working age in Gothenburg, Sweden. Participants were women 38 ( n =202) and 50 ( n =286) years of age. They completed a questionnaire including questions about occupational experiences in relation to their patterns of daily occupations, perceived health...
What are the experiences of adults returning to work following recovery from Guillain-Barr syndrome? An interpretative phenomenological analysis
Guillain-Barré syndrome (GBS) is a transient inflammatory disorder affecting peripheral nerves, characterised by weakness and numbness in limbs, upper body and face. Residual problems affect a large minority, and complicate return to work. This qualitative study explored the experiences of people who returned to work following their diagnosis of GBS and recovery, to gain insight into factors that facilitated or inhibited this process. Method. Five people participated in in-depth interviews. Individual and common experiences were explored through interpretative phenomenological analysis....

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