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Svanholm F, Turesson C, Löfgren M, Björk M. Acceptability of the eHealth Intervention Sustainable Worker Digital Support for Persons With Chronic Pain and Their Employers (SWEPPE): Questionnaire and Interview Study. JMIR Hum Factors 2023; 10:e46878. [PMID: 37768708 PMCID: PMC10570892 DOI: 10.2196/46878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Sick leave and decreased ability to work are the consequences of chronic pain. Interdisciplinary pain rehabilitation programs (IPRPs) aim to improve health-related quality of life and participation in work activities, although implementing rehabilitation strategies at work after IPRPs can be difficult. Employers' knowledge about pain and the role of rehabilitation needs to be strengthened. The self-management of chronic pain can be improved through eHealth interventions. However, these interventions do not involve communicating with employers to improve work participation. To address this deficiency, a new eHealth intervention, Sustainable Worker Digital Support for Persons with Chronic Pain and Their Employers (SWEPPE), was developed. OBJECTIVE This study aimed to describe the acceptability of SWEPPE after IPRPs from the perspective of patients with chronic pain and their employers. METHODS This study included 11 patients and 4 employers who were recruited to test SWEPPE in daily life for 3 months after IPRPs. Data were collected using individual interviews at the end of the 3-month test period and questionnaires, which were completed when SWEPPE was introduced (questionnaire 1) and at a 3-month follow-up (questionnaire 2). Data were also collected on how often SWEPPE was used. Qualitative data were analyzed through a qualitative content analysis using an abductive approach. The framework used for the deductive approach was the theoretical framework of acceptability. Quantitative data were analyzed through descriptive statistics and the differences between the responses to questionnaires 1 and questionnaire 2 using the Wilcoxon signed rank test. RESULTS Both patients and employers reported that SWEPPE increased their knowledge and understanding of how to improve work participation and helped them identify goals, barriers, and strategies for return to work. In addition, participants noted that SWEPPE improved employer-employee communication and collaboration. However, experiences and ratings varied among participants and the different SWEPPE modules. The acceptability of SWEPPE was lower in patients who experienced significant pain and fatigue. A high degree of flexibility and choice of ratings in SWEPPE were generally described as helpful. CONCLUSIONS This study shows promising results on the user acceptability of SWEPPE from both patient and employer perspectives. However, the variations among patients and modules indicate a need for further testing and research to refine the content and identify the group of patients who will best benefit from SWEPPE.
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Affiliation(s)
- Frida Svanholm
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Christina Turesson
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Svanholm F, Björk M, Löfgren M, Gerdle B, Hedevik H, Molander P. Work Interventions Within Interdisciplinary Pain Rehabilitation Programs (IPRP) - Frequency, Patient Characteristics, and Association with Self-Rated Work Ability. J Pain Res 2023; 16:421-436. [PMID: 36820016 PMCID: PMC9938662 DOI: 10.2147/jpr.s390747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
Background Interdisciplinary pain rehabilitation programs (IPRPs) help people with chronic pain improve their health and manage their work; however, the way IPRPs address sick leave could be improved. Although work interventions can be a part of IPRP, it is not well known how and to what extent. Aim This study explores the frequency of work interventions and the characteristics of patients who participate in work interventions as part of IPRP at specialist pain rehabilitation departments in Sweden. In addition, this study explores the association between participation in work interventions and change in patients' self-rated work ability after IPRP. Methods Data from the Swedish quality registry for pain rehabilitation (SQRP), which includes 3809 patients between 2016 and 2018, were analysed with descriptive statistics and regression analyses. Results The results indicate a high participation rate in work interventions (90%). Some differences were evident concerning characteristics of patients who participated in different work interventions. The return-to-work (RTW) plan, the most frequently used work intervention, had the strongest association with change in self-rated work ability after IPRP. However, the effect sizes were small, and the initial score best explained the change. Furthermore, there were differences between employed and unemployed patients and employment had a positive association with change in self-rated work ability. Conclusion More research is needed to understand IPRP's mechanisms and work interventions to support patients with chronic pain, reduce sick leave, and manage work. Employment status needs to be considered and interventions should be tailored to match the individual needs.
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Affiliation(s)
- Frida Svanholm
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Correspondence: Frida Svanholm, Pain and Rehabilitation Centre, County Council of Östergötland, Brigadgatan 22, Linköping, S-58185, Sweden, Tel +46 730-447785, Email
| | - Mathilda Björk
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden,Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Henrik Hedevik
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Peter Molander
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Pravalika B, Yamuna U, Saoji AA. Effect of Yoga on musculoskeletal pain and discomfort, perceived stress, and quality of sleep in industrial workers: Study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sarria-Santamera A, Kuntuganova A, Alonso M. Economic Costs of Pain in the Spanish Working Population. J Occup Environ Med 2022; 64:e261-e266. [DOI: 10.1097/jom.0000000000002497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Blake H, Somerset S, Greaves S. The Pain at Work Toolkit for Employees with Chronic or Persistent Pain: A Collaborative-Participatory Study. Healthcare (Basel) 2021; 10:healthcare10010056. [PMID: 35052220 PMCID: PMC8775489 DOI: 10.3390/healthcare10010056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 12/16/2022] Open
Abstract
Self-management tools for people with chronic or persistent pain tend to focus on symptom reporting, treatment programmes or exercise and do not address barriers to work, facilitators of work ability, or workplace pain self-management strategies. We developed the Pain at Work (PAW) toolkit, an evidence-based digital toolkit to provide advice on how employees can self-manage their pain at work. In a collaborative-participatory design, 4-step Agile methodology (N = 452) was used to co-create the toolkit with healthcare professionals, employers and people with chronic or persistent pain. Step 1: stakeholder consultation event (n = 27) established content and format; Step 2: online survey with employees who have persistent pain (n = 274) showed employees fear disclosing their condition, and commonly report discrimination and lack of line manager support. Step 3: online employer survey (n = 107) showed employers rarely provide self-management materials or education around managing pain at work, occupational health recommendations for reasonable adjustments are not always actioned, and pain-related stigma is common. Step 4: Toolkit development integrated findings and recommendations from Steps 1–3, and iterative expert peer review was conducted (n = 40). The PAW toolkit provides (a) evidence-based guidelines and signposting around work-capacity advice and support; (b) self-management strategies around working with chronic or persistent pain, (c) promotion of healthy lifestyles, and quality of life at work; (d) advice on adjustments to working environments and workplace solutions to facilitate work participation.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (S.G.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
- Correspondence:
| | - Sarah Somerset
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (S.G.)
| | - Sarah Greaves
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.S.); (S.G.)
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Frumkin MR, Rodebaugh TL. The role of affect in chronic pain: A systematic review of within-person symptom dynamics. J Psychosom Res 2021; 147:110527. [PMID: 34082154 PMCID: PMC9009535 DOI: 10.1016/j.jpsychores.2021.110527] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/14/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Chronic pain is conceptualized as a biopsychosocial phenomenon that involves both physical and emotional processes. The vast majority of research regarding these facets of chronic pain characterizes differences between individuals. In this review, we describe problems with assuming that differences between persons accurately characterize within-person processes. We also provide a systematic review of studies that have examined within-person relationships between pain and affect among individuals with chronic pain. METHOD Articles published by December 2020 that pertained to within-person assessment of pain and emotion, affect, or mood were identified. Data regarding study design, adherence, and concurrent and prospective relationships among pain and affect variables were extracted and summarized. RESULTS Of 611 abstracts, 55 studies met inclusion criteria. Results suggest that individuals with chronic pain tend to experience increased negative affect and decreased positive affect when experiencing more severe pain (rpooled = .18 and - .19, respectively). However, the size of these effects appeared smaller than between-person associations, and there was evidence of significant variability between individuals. Examination of predictive relationships between pain and affect largely suggested the tendency of symptoms to predict themselves, rather than pain predicting affect or vice versa. CONCLUSIONS Consistent with group-level relationships, experiencing more severe pain relative to an individual's average seems to be associated with more negative affect and less positive affect. However, individuals vary in the size and even direction of these effects. More research is necessary to understand the implications of such variability for the assessment and treatment of chronic pain.
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Affiliation(s)
- Madelyn R. Frumkin
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States,Correspondence regarding this article should be addressed to Madelyn R. Frumkin, Department of Psychological and Brain Sciences, Washington University in St. Louis, One Brookings Drive, Campus Box 1125, St. Louis, MO 63105. Phone: (314) 935-8627.
| | - Thomas L. Rodebaugh
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
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Lahav Y, Levy D, Ohry A, Zeilig G, Lahav M, Golander H, Guber AC, Uziel O, Defrin R. Chronic Pain and Premature Aging - The Moderating Role of Physical Exercise. THE JOURNAL OF PAIN 2020; 22:209-218. [PMID: 32798763 DOI: 10.1016/j.jpain.2020.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
Chronic pain induces a multitude of harmful effects; recently it has been suggested that chronic pain is also associated with premature aging, manifested in shortened telomere length (TL). However, evidence for this hypothesis is scarce and inconsistent. The aim was twofold: 1) Investigate whether chronic pain is associated with premature aging, and 2) Determine whether physical exercise (PE) moderates this association if it exists. Participants were 116 male subjects, with (n = 67) and without chronic pain (n = 49). Blood samples for TL analysis were collected and participants were interviewed and completed questionnaires. As a part of the cohort, we included people with physical disability; this variable was controlled in the analysis. The TL of individuals with chronic pain was significantly shorter than that of pain-free individuals. Regression analysis revealed a significant moderating effect of PE on chronic pain and TL, above and beyond the effects of disability, age, and weight. Whereas chronic pain was associated with shorter telomeres in participants who did not exercise, this association was nonsignificant among participants who did exercise. The results suggest that chronic pain is associated with premature ageing; however, PE may mitigate this association and may protect individuals against the harmful effects of chronic pain. PERSPECTIVE: The study suggests that it is important to monitor signs of premature ageing among chronic pain patients as they are at risk. However, chronic pain patients may benefit from regular PE in this respect as it may moderate premature ageing.
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Affiliation(s)
- Yael Lahav
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - David Levy
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Avi Ohry
- Section of Rehabilitation Medicine, Reuth Medical and Rehabilitation Center, Tel Aviv, Israel; Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer, Israel; Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Meir Lahav
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva, Israel
| | - Hava Golander
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | | | - Orit Uziel
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva, Israel
| | - Ruth Defrin
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
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Svensson M, Larsson I, Aili K. Women's experiences of the journey to chronic widespread pain: a qualitative study. BMC Musculoskelet Disord 2020; 21:417. [PMID: 32605553 PMCID: PMC7329526 DOI: 10.1186/s12891-020-03442-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/22/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chronic widespread pain (CWP) is a musculoskeletal disorder that affects approximately 10% of the population. It is more common in women than in men. It is important to understand how CWP develops and how it is maintained in order to prevent poor pain prognosis. Long term studies have shown that a mere part improves over time or fluctuates in their CWP condition. Female gender is one of the factors associated with persistence of CWP, suggesting men and women may experience their journey to CWP differently. The aim of the study was to explore women's experiences of the journey to CWP. METHODS 19 women between 45 and 67 years of age who had not reported CWP in the EPIPAIN survey in 1995, but reported CWP in 2016, participated in the study. Data was collected through individual interviews, where open-ended questions were used to explore the women's experiences of their pain journey. The interviews were analyzed with a manifest qualitative content analysis. RESULTS The women described their journey to CWP in terms of triggering, aggravating, and consolidating factors, from which three different categories emerged. Experiencing that environmental circumstances affect the pain journey refers to factors outside the women's immediate control, which appeared as unmanageable work-related demands, lack of social support, unfavorable physical environments, and traumatic events. Experiencing that lifestyle affects the pain journey refers to events that are consciously or unconsciously carried out by the women, including different levels of physical efforts and unfavorable behaviors. Experiencing that personal attributes affect the pain journey refers to the women's characteristics in terms of an anxious state of mind and adverse biological impact. CONCLUSIONS The women experienced that environmental circumstances, lifestyle, and personal attributes affected their CWP. How these adversities influenced the pain journey varied among the women. These findings show that women are conscious of the complexity of the condition and can describe the broad context of their pain journey. This study confirms the complexity of pain progress and highlights the individual's awareness of this complexity, which is important to consider when introducing interventions, and when expecting compliance to interventions.
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Affiliation(s)
- Miriam Svensson
- School of Health and Welfare, Halmstad University, P.O. Box 823, S-301 18, Halmstad, Sweden.,Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, P.O. Box 823, S-301 18, Halmstad, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden.,Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Katarina Aili
- School of Health and Welfare, Halmstad University, P.O. Box 823, S-301 18, Halmstad, Sweden. .,Spenshult Research and Development Centre, Halmstad, Sweden. .,Unit of occupational medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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