9 research outputs found
Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic painâa practice based evidence study from two SQRP centres
Long-term effect in ADL after an interdisciplinary rehabilitation programme for WAD patients: a mixed-method study for deeper understanding of participantsâ programme experiences
A screening questionnaire to predict no return to work within 3Â months for low back pain claimants
The objective of the present study was to develop a short prediction questionnaire for estimating the risk of no return to work (RTW) within 3Â months of sick leave to facilitate triage and management of a patient population of subacute low-back pain (LBP) sufferers. We conducted a prospective study with a 3-month follow-up on 186 patients with LBP introducing a claim for sickness benefits to the largest sickness fund in Belgium. Patients completed a screening questionnaire within 2Â weeks after claim submission. All patients were invited for clinical assessment, at 6â8 weeks of sick leave, by the medical adviser. Patientsâ work status was recorded by the sickness fund. About 20% of the patients did not resume work at 3Â monthsâ sick leave. They were more likely to experience pain below the knee, to have an own previous prediction of a 100% no RTW and to have a severe interference of pain on daily activities. The screening tool based on these three items correctly classified 73.7% of the non-resumers and 78.4% of the resumers at a cut-off score of 0.22. The findings of this study provide evidence of the utility of a short screening questionnaire for future use in intervention studies in a social security setting
Does multidisciplinary rehabilitation of tortured refugees represent âvalue-for-moneyâ? A follow-up of a Danish case-study
The functional barometer âa self-report questionnaire in accordance with the international classification of functioning, disability and health for pain related problems; validity and patient-observer comparisons
Design and preliminarily validation of a tool to assess the impact of chronic nonâcancer pain on peopleâs daily life in Spanishâlanguage: PAIN_Integral Scale ©
Aim: To build and preliminarily validate a Spanish-language
instrument to assess the
impact that CNCP has on the daily lives of people who suffer from it.
Background: The experience of pain is multifactorial and a correct assessment of it
helps to control the intensity of pain. Although there are instruments that evaluate
areas on which Chronic Non-Cancer
Pain impacts, it would be necessary to include
other aspects that scientific literature identifies as relevant.
Design: Instrument and construct cross-sectional
study for psychometric validation.
Methods: A total of 157 items based on items from validated questionnaires were
evaluated by a group of 21 chronic pain experts using Delphi methodology in three
evaluation rounds. A final questionnaire of 55 items with a 5-point
Likert-type
scale
was formed. This questionnaire was piloted on a total of 30 patients to assess their
understanding of the items and the psychometric validation process was carried out
(January to March 2020) on a subsequent sample of 395 people, all of whom attended
Pain Units and Primary Care Centres of the Public Health System in Spain.
Results: The PAIN_Integral Scale© showed acceptable internal consistency scores
measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of
nine factors that explain 71.02% of the total variance, from 157 to a final total of 36
items. Confirmatory Factor Analysis showing adequate values confirmed this structure.
The effect size was used to calculate the cut-off
points for the overall scale, setting
them at scores of 130 and 135.
Conclusion: This instrument would allow to assess other constructs and dimensions
not included in the instruments previously available such as treatment compliance,
proactivity, resilience, hopelessness due to pain and pain catastrophizing. However,
despite the fact that the preliminary analysis shows good results, it is necessary to
continue with its validation process in subsequent studies
Pain intensity and severe pain in young immigrant patients with long-standing back pain
The aim of this study was to explore if self-rated pain intensity and severe pain differed significantly between immigrants from different regions, and if other socio-economic, or clinical, characteristics could predict severe pain. A total of 129 men and 217 women at a primary health centre in Stockholm, Sweden, 27â45 years, on long-term sick leave, were recruited in consecutive order and grouped into a Turkish (n = 122), Southern European (n = 52), Middle East (n = 69) and one Mixed (n = 173) group of immigrants. All were employed in service jobs. Somatic status, depression and level of psychosocial stressors, including pain anxiety, were established by standardized procedures. All reported long-standing disabling back pain. Patients rated intensity of pain âright nowâ on a 0â100 mm visual analogue scale (VAS) as a last part of the consultation with two doctors. Severe pain was defined as VAS 75â100. Median values (md) with inter-quartile ranges (IQR) were calculated for interval and ordinal data. Non-parametric statistics were used to calculate significant differences between groups. Crude and age-standardized odds ratios (OR) with 95% confidence intervals (95% CI) as rating severe pain were calculated by binary and forward conditional logistic regression. Men and women were analyzed separately. Women had more tender points, (P < 0.001), and reported pain anxiety more often (P < 0.01). Frequency of depression did not differ between the immigrant groups. The VAS-values varied, but not significantly, between the immigrant groups of men and women. Men had lower VAS values than women (md 50, IQR 36â69 vs. md 72, IQR 51â85), (P < 0.001). Women had a three-fold risk to rate severe pain (OR 2.9, 95% CI 1.8â4.7). By sex, no immigrant group had significantly elevated OR to rate severe pain. Being 40â45 year old doubled the OR as rating severe pain. Men with depression, or little education, had high risks as rating severe pain (age-standardized ORs 4.1; 95% CI 1.7â10.0 and 2.7; 95% CI 1.1â6.8, respectively), and so had depressed women (age-standardized OR 1.9; 95% CI 1.1â3.4). Women with pain anxiety had a doubled, not statistically significant, elevated risk (age-standardized OR 2.0, 95% CI 0.95â4.3). The groups did not differ significantly in pain intensity or severe pain. Severe pain was predicted by depressed mood and probably linked to gender, age and sick roles
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners
Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.</p