Musculoskeletal pain rehabilitation A one-year follow-up of occupational performance, psychosocial functioning and disability
Author
Summary, in English
Multidisciplinary pain rehabilitation programmes are found decreasing pain and improve back-to-work rates. There is, however, a lack of knowledge in several
respects. The overall aim of this thesis was to study outcomes in terms of occupational performance, satisfaction with performance, psychosocial functioning, disability, and coping profiles at a one-year follow-up after a musculoskeletal pain rehabilitation programme. Part of the aim was to evaluate differences among subgroups of participants based on baseline characteristics and pain-related severities, regarding the above described outcomes. Better psychosocial functioning and less severe disability were in a sample of 509 individuals (Paper I) associated with: older age, being at work prior admission, being Nordic born, longer education, a diagnosis of fibromyalgia (compared with neck disorder or low back pain). At a one-year follow-up psychosocial functioning was significantly improved whereas less improvement was found in physical disability. Improvements at one-year follow-up were independently of participants’ characteristics. The participants’ prioritized occupational problems in all sorts of occupations pertaining to looking after one self (self-care), enjoying
life (leisure), and contributing to the social and economic fabric of a Community (productivity). The most prioritized subcategory of occupations to be improved on was household management (Paper II). The most frequently reported occupations were reported as: working, sitting and cleaning the house. Occupational performance and satisfaction with performance improved significantly at discharge and at the follow-up (Paper III). Improvements on occupational
performance at follow-up were significantly associated with the following factors: female gender, less physical disability, less life interference and more life Control at baseline. However, participants with most perceived severities to perform their prioritized occupations had significantly higher chance to be improved. The pain coping profiles of Adaptive Copers significantly increased at the follow-up, whereas the Dysfunctional profiles significantly decreased (Paper IV). Having an Adaptive Coper profile at follow-up was associated with improvement on occupational performance and was significantly associated with: being Nordic born, having a longer education and an Adaptive Coper profile and higher scores on satisfaction with occupational performance at baseline. Having an Adaptive Coper profile at follow-up was significantly associated with improvements on occupational performance and satisfaction with performance.
respects. The overall aim of this thesis was to study outcomes in terms of occupational performance, satisfaction with performance, psychosocial functioning, disability, and coping profiles at a one-year follow-up after a musculoskeletal pain rehabilitation programme. Part of the aim was to evaluate differences among subgroups of participants based on baseline characteristics and pain-related severities, regarding the above described outcomes. Better psychosocial functioning and less severe disability were in a sample of 509 individuals (Paper I) associated with: older age, being at work prior admission, being Nordic born, longer education, a diagnosis of fibromyalgia (compared with neck disorder or low back pain). At a one-year follow-up psychosocial functioning was significantly improved whereas less improvement was found in physical disability. Improvements at one-year follow-up were independently of participants’ characteristics. The participants’ prioritized occupational problems in all sorts of occupations pertaining to looking after one self (self-care), enjoying
life (leisure), and contributing to the social and economic fabric of a Community (productivity). The most prioritized subcategory of occupations to be improved on was household management (Paper II). The most frequently reported occupations were reported as: working, sitting and cleaning the house. Occupational performance and satisfaction with performance improved significantly at discharge and at the follow-up (Paper III). Improvements on occupational
performance at follow-up were significantly associated with the following factors: female gender, less physical disability, less life interference and more life Control at baseline. However, participants with most perceived severities to perform their prioritized occupations had significantly higher chance to be improved. The pain coping profiles of Adaptive Copers significantly increased at the follow-up, whereas the Dysfunctional profiles significantly decreased (Paper IV). Having an Adaptive Coper profile at follow-up was associated with improvement on occupational performance and was significantly associated with: being Nordic born, having a longer education and an Adaptive Coper profile and higher scores on satisfaction with occupational performance at baseline. Having an Adaptive Coper profile at follow-up was significantly associated with improvements on occupational performance and satisfaction with performance.
Department/s
Publishing year
2014
Language
English
Publication/Series
Lund University Faculty of Medicine Doctoral Dissertation Series
Volume
2014:39
Full text
Document type
Dissertation
Publisher
Rehabilitation medicine
Topic
- Other Medical Sciences not elsewhere specified
Keywords
- Activities of Daily living
- rehabilitation
- chronic pain
- pain management
- treatment outcome
- disability evaluation
- coping behavior
- occupational therapy
- fibromyalgia
Status
Published
Research group
- Rehabilitation medicine
Supervisor
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-87651-64-9
Defence date
4 April 2014
Defence time
09:00
Defence place
Sal H01, Health Science Center, Baravägen 3, Lund
Opponent
- Carl Molander (Docent, MD)