umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
MPI profile changes after a pain rehabilitation programme indicate risk of receiving sick leave benefits one year later
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Dep of Public Health, University of Southern Denmark, Odense.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Purpose: to study whether changes of coping profiles derived from the Multidimensional Pain Inventory MPI can predict which persons disabled by chronic pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.

Method: An observational study of MPI data derived from 2784 patients, 709 men and 2075 women, who had participated in interdisciplinary cognitive-behavioural oriented pain rehabilitation programmes in Sweden, collected from the Swedish Quality Register for Pain Rehabilitation, before and at the end of the programme.

Results: After a pain rehabilitation programme, there was a significantly decreased share of dysfunctional profile among both men (44 % before compared to 31% after), and women (39% to 26%) as well as an increased share of Adaptive coper profiles (men 15% to 24% and women 14% to 24%). The number of those with full-time sick leave decreased significantly (p<0.001) both among men (from 57% to 46%) and women (57% and 50% respectively). At the same time level of women who had part-time sick leave increased from 20% to 30%. Persons staying with or moving into a dysfunctional profile after a rehabilitation programme had a low probability of having no or part-time sick leave.

Conclusion: Persons with dysfunctional profiles have higher levels of sick-leave compared to adaptive coper and interpersonally distressed. The presently used cognitive behavioural pain rehabilitation programmes in Sweden, decreased the levels of full-time sick leave one year later. Our findings suggest also the need to tailor rehabilitative strategies differently for men and women

Keywords: Chronic pain, sick leave benefits, pain rehabilitation, Multidimensional Pain Inventory

Identifiers
URN: urn:nbn:se:umu:diva-43807OAI: oai:DiVA.org:umu-43807DiVA: diva2:416141
Available from: 2011-05-12 Created: 2011-05-10 Last updated: 2015-11-11Bibliographically approved
In thesis
1. Pain rehabilitation in Sweden: a quality registry study
Open this publication in new window or tab >>Pain rehabilitation in Sweden: a quality registry study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Chronic pain, defined as non-malignant pain emanating from the musculoskeletal system, may limit everyday activities, social functioning and the quality of social and working life for individuals, creating disability as well as incurring high economic and public costs for society. Controlled studies show that cognitive-behavioural interdisciplinary rehabilitation has a positive effect on functioning in patients who have been disabled by chronic non-malignant pain conditions. Positive outcomes described include lower pain intensity, less preoccupation with pain, greater independence and lower consumption of healthcare. On the other hand, the return to work rate varies.

To facilitate comparisons on the national level and to enable audit spirals for single programmes as part of the ongoing quality assurance in healthcare the Swedish Quality Registry for Pain Rehabilitation (SQRP) has aggregated data since 1998 on all patients referred to the majority of Swedish rehabilitation units.

The aim of this dissertation was to improve the knowledge base of pain rehabilitation in Sweden using the validated self-reported instruments of pain and its consequences included in the SQRP.

Methods: The SQRP data were collected before, at the end and 1 year after the intervention for all individuals included, and concerns self-reported demographic variables, pain intensity, activities, thought patterns, impact of pain on daily life and life satisfaction. Individual sick leave data were collected from the Swedish Social Insurance after 1 year. Data collected from 19833 patients (6002 men and 13831 women) of which 7289 participate in work ability improving programmes, were used.

Results: The results of four studies included in this thesis showed that the SQRP provided a basis for scientific works since it use the validated self-report instruments of pain and its consequences and contain a large amount of patient’s data. However, a lack of follow-up data from some units influenced the opportunity of to analyse long-term outcomes. Nevertheless, the SQRP was a useful tool to audit and evaluate as well as to propose optimising of pain rehabilitation. It seemed that contextual factors such as patients’ own beliefs and expectations, education, gender, actual sick leave and employment situation had more importance for the effect of rehabilitation programme than pain characteristics, depression or activity limitation.

The Multidimensional Pain Inventory (MPI) scale scores and MPI coping profiles might be used for assessing the outcomes of treatment interventions. A reduction of MPI scale scores for Pain severity and Interference decreased the risk of being on full-time sick leave. On the other hand, the MPI coping profiles Dysfunctional, among both men and women, and Interpersonally distressed, among women, were associated with higher odds of being on full-time sick leave.

Conclusions: Attending cognitive-behavioural interdisciplinary pain rehabilitation programmes in Sweden resulted in improvements of the MPI scales after completing a pain rehabilitation programme and this improvement was sustained after 1 year. Moreover, these programmes decreased the levels of full-time sick leave 1 year after completed programme. The findings suggest also the need to tailor rehabilitative strategies differently for men and women as well as for different pain coping profiles.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2011. 49 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1423
Keyword
chronic pain, pain-related disability, pain rehabilitation, registry study, sick leave benefits, audit
Identifiers
urn:nbn:se:umu:diva-43852 (URN)978-91-7459-210-8 (ISBN)
Public defence
2011-06-10, Sal B, 9 tr, Tandläkarhögskolan, Norrlands Universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-05-13 Created: 2011-05-12 Last updated: 2011-05-27Bibliographically approved

Open Access in DiVA

No full text

Search in DiVA

By author/editor
Nyberg, VanjaNovo, Mehmed
By organisation
Rehabilitation Medicine

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 61 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf