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Factors of importance for return to work, experienced by patients with chronic pain that have completed a multimodal rehabilitation program - a focus group study
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.ORCID iD: 0000-0003-2980-2835
Karolinska Inst, Sweden; Danderyd Hosp, Sweden.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.ORCID iD: 0000-0002-1607-187X
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 5, p. 736-744Article in journal (Refereed) Published
Abstract [en]

Background and purpose:To reduce the individual, societal, and economic burden of the high sick leave rates due to chronic pain, it is essential to find effective strategies for increasing return to work (RTW). Although multimodal rehabilitation programs (MMRPs) may have positive effects on RTW, the results are inconsistent. This study explores the factors that contribute to decreasing sick leave and increasing RTW in patients with chronic pain who completed a MMRP. Method:Four focus groups and three individual interviews were conducted. In total, 18 patients were interviewed. All patients had chronic pain and had completed a MMRP. They were either employed or unemployed, either working to some degree or fully on sick leave. The data were analysed using qualitative content analysis. Results:Three main categories were identified: Knowledge and understanding-prerequisites for tailored solutions; Individual adaptations-necessary but difficult to implement; and Stakeholder collaboration-needs improvement. Conclusion:The participants described a variety of facilitating and limiting factors that created complex prerequisites for RTW. This finding makes it clear that these patients need tailored interventions and strong collaboration among all stakeholders throughout the rehabilitation process. Tailored interventions and collaborations could improve the effectiveness of MMRPs.

Place, publisher, year, edition, pages
Taylor & Francis, 2022. Vol. 44, no 5, p. 736-744
Keywords [en]
Chronic pain; return to work; rehabilitation; qualitative method
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-168573DOI: 10.1080/09638288.2020.1780479ISI: 000547985400001PubMedID: 32580604OAI: oai:DiVA.org:liu-168573DiVA, id: diva2:1461819
Note

Funding Agencies|Swedish Research for Health, Working Life and Welfare [2016-07414]; County council of _Osterg_otland [LiO-582141]

Available from: 2020-08-27 Created: 2020-08-27 Last updated: 2023-04-26
In thesis
1. Work Interventions in the Context of Interdisciplinary Pain Rehabilitation
Open this publication in new window or tab >>Work Interventions in the Context of Interdisciplinary Pain Rehabilitation
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic pain often leads to difficulties performing daily life and work activities. Sick-leave rates are high and work activities are valued both by people in general and patients with chronic pain. Therefore, it is important to find efficient ways to support patients to stay at work and return to work. Interdisciplinary pain rehabilitation programs (IPRP) aim to improve work participation for patients with chronic pain. However, results are diverging and it is unclear to what extent work interventions are part of IPRP. 

The overall aim with this thesis was to study work interventions in the context of interdisciplinary pain rehabilitation and identify how it can be improved to better support patients with chronic pain in their return to work (RTW) rehabilitation process. 

Participants were included from IPRPs at both primary and specialist care level in Sweden. Data were collected from focus groups, pair- and individual interviews, questionnaires, and the Swedish Quality Registry for Pain Rehabilitation. 

This thesis highlight four important factors to consider when planning and performing work interventions in the context of IPRP: 

  • Knowledge and understanding of patients and stakeholders, 
  • A RTW rehabilitation plan being anchored between stakeholders 
  • Tailored solutions in relation to patient’s needs 
  • Collaboration, coordination, and continuity during the RTW rehabilitation process. 

Knowledge and understanding are important as base for solid, concrete, and tailored RTW plans, and for increasing self-efficacy and empowerment of the patients. The RTW plan is a common and important work intervention within IPRP in Sweden. RTW plans need to be more concrete, and include tailored strategies and interventions aimed at the needs of patients. Tailoring interventions also need to consider employment status. In addition, RTW rehabilitation plans should be tightly anchored with stakeholders and followed-up continually during the RTW rehabilitation process. The context of IPRP has potential that should be taken care of, for example when improving knowledge transfer and collaboration. SWEPPE, a new e-health intervention designed to support patients with chronic pain and their employers includes the four factors described above and should be acceptable for users after they complete an IPRP, however, further development of content and identification of patients that best benefit from SWEPPE are needed. 

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2023. p. 24
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1839
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-193258 (URN)10.3384/9789180750387 (DOI)978-91-8075-037-0 (ISBN)978-91-8075-038-7 (ISBN)
Public defence
2023-06-02, Berzeliussalen, Campus US, Linköping, 09:00
Opponent
Supervisors
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-04-27Bibliographically approved

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Liedberg, GunillaBjörk, Mathilda

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