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Early psychologically informed interventions for workers at risk for pain-related disability: does matching treatment to profile improve outcome?
Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))
Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))ORCID-id: 0000-0003-2718-7402
Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))ORCID-id: 0000-0001-9429-9012
Örebro universitet, Institutionen för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))ORCID-id: 0000-0001-5359-0452
2014 (Engelska)Ingår i: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 24, nr 3, s. 446-457Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: This randomized controlled trial had two main aims. The first aim was to investigate the effect of early preventive, psychologically informed, interventions for pain-related disability. The second aim was explore whether people who are matched to an intervention specifically targeting their psychological risk profile had better outcomes than people who were not matched to interventions.

Methods: A total of 105 participants were recruited from their workplace, screened for psychological risk factors and classified as being at risk for long-term pain-related disability. They were subgrouped into one of three groups based on their psychological profile. Three behaviorally oriented psychological interventions were developed to target each of the three risk profiles. Half of the participants were assigned a matched intervention developed to target their specific profile, and half were assigned an unmatched intervention. After treatment, repeated measure ANOVAs and χ2 tests were used to determine if treatments had an effect on primary and secondary outcomes including perceived disability, sick leave, fear and avoidance, pain catastrophizing and distress, and if matched participants had better outcomes than did unmatched.

Results: Treatments had effects on all outcome variables (effect sizes d ranging between 0.23 and 0.66), but matched participants did not have better outcomes than unmatched.

Conclusions: Early, preventive interventions have an impact on a number of outcome variables but it is difficult to realize a matching procedure. More in-depth research of the process of matching is needed.

Ort, förlag, år, upplaga, sidor
Springer, 2014. Vol. 24, nr 3, s. 446-457
Nyckelord [en]
Musculoskeletal pain, Occupational health services, Disability leave, Return-to-work, Pain management, Randomized controlled trial
Nationell ämneskategori
Psykologi Medicin och hälsovetenskap
Forskningsämne
Psykologi
Identifikatorer
URN: urn:nbn:se:oru:diva-34090DOI: 10.1007/s10926-013-9478-1ISI: 000340487900008Scopus ID: 2-s2.0-84905444201OAI: oai:DiVA.org:oru-34090DiVA, id: diva2:703409
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärdTillgänglig från: 2014-03-06 Skapad: 2014-03-06 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
Ingår i avhandling
1. Matchmaking in pain practice: challenges and possibilities
Öppna denna publikation i ny flik eller fönster >>Matchmaking in pain practice: challenges and possibilities
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

All people experience pain and for some people, acute pain may over time develop into long-term disabling problems. Already at an early stage, it is possible to identify people at risk for long-term problems and psychologically oriented interventions have been shown to successfully prevent future disability. However, not all people are helped by treatment and there is room for improvement. Moreover, subgroups of people suffering from pain, with different profiles of psychological factors have been identified, indicating that people with pain problems differ. The first aim of this dissertation was to improve the understanding of how people differ. The second aim was to use these individual differences and to match people to psychological treatment based on their psychological profile. The third aim was to explore what happens during treatment that might be important for treatment outcome.

The findings show that people who belonged to subgroups with elevated levels of psychological factors had less favorable outcomes over time, despite treatment, than people with no elevations. Moreover, people with elevations in several psychological factors had even less favorable outcomes. Psychological treatments aimed at preventing future disability performed well, but using profiles to match people to treatment did not improve outcomes further; people who were matched to a treatment and people who were unmatched had similar outcomes. However, the profiles used for matching were unstable over time and there is need to improve the identification of psychological variables used for treatment matching. Finally, a number of psychological factors were shown to be valuable targets for treatment; if the treatments successfully produced change in people’s thoughts and emotions related to pain the treatment outcomes were better. The findings were summarized in a flow chart showing the recommended clinical approach to people seekinghealth care for acute pain problems.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro universitet, 2014. s. 91
Serie
Örebro Studies in Psychology, ISSN 1651-1328 ; 29
Nyckelord
pain, psychological profiles; psychological treatment; early intervention; secondary prevention; treatment matching
Nationell ämneskategori
Psykologi
Forskningsämne
Psykologi
Identifikatorer
urn:nbn:se:oru:diva-33751 (URN)978-91-7529-006-5 (ISBN)
Disputation
2014-03-28, Hörsal L3, Långhuset, Örebro universitet, Fakultetsgatan 1, Örebro, 10:15 (Engelska)
Opponent
Handledare
Tillgänglig från: 2014-02-14 Skapad: 2014-02-14 Senast uppdaterad: 2018-04-17Bibliografiskt granskad

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Journal of occupational rehabilitation
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