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Identification of obstacles for chronic pain patients to return to work: Evaluation of a questionnaire
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
2002 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 12, no 2, 65-75 p.Article in journal (Refereed) Published
Abstract [en]

The Obstacles to Return-to-Work Questionnaire (ORQ) was developed and evaluated. A total of 154 patients with chronic musculoskeletal pain and prolonged work disability participated in the study. Factor analyses reduced the ORQ to 55 items grouped into 9 subscales. The subscales were named "Depression," "Pain intensity," "Difficulties at work return," "Physical workload and harmfulness," "Social support at work," "Worry due to sick leave," "Work satisfaction," "Family situation and support," and "Perceived prognosis of work return." The subscales showed satisfactory reliability. In order to determine predictive validity a discriminant analysis was conducted with sick leave 9 months after assessment as the outcome. This analysis indicated that the scales "Perceived prognosis of work return," "Social support at work," "Physical workload and harmfulness," "Depression," and "Pain intensity" could significantly predict sick leave and correctly classified 79% of the patients. The Multidimensional Pain Inventory and the Disability Rating Index could also significantly predict sick leave in this sample and correctly classified as many patients as the ORQ. However, these questionnaires do not include any work-oriented items and they had a lower specificity than the ORQ. This study suggests that patients' perceptions and beliefs about work and returning to work may be a significant hindrance for actual recovery.

Place, publisher, year, edition, pages
2002. Vol. 12, no 2, 65-75 p.
National Category
Social Sciences
Identifiers
URN: urn:nbn:se:uu:diva-89652DOI: 10.1023/A:1015056429505PubMedID: 12014227OAI: oai:DiVA.org:uu-89652DiVA: diva2:161316
Available from: 2002-02-20 Created: 2002-02-20 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Musculoskeletal Pain and Return to Work: A Cognitive-Behavioral Perspective
Open this publication in new window or tab >>Musculoskeletal Pain and Return to Work: A Cognitive-Behavioral Perspective
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Musculoskeltal pain is the most common diagnosis for being on sick leave two months or longer in Sweden. The societal costs have been estimated at almost 30 billion Swedish kronor per year. Research aimed at improving occupational rehabilitation is therefore crucial.

In Study I a multidisciplinary cognitive-behavioral in-patient program conducted at a rehabilitation clinic was empirically evaluated. A randomized controlled trial with 36 chronic pain patients showed a difference in favor of the treated patients compared to their controls on measures of occupational training and activity level at a 1-month follow-up. A consecutive trial with 85 chronic patients showed a decrease in sick leave, pain intensity, depression, and use of analgesics, and an increase in life control and physical fitness from pre-treatment to a 2-month and a 1-year follow-up. Study II was a randomized controlled evaluation of a return-to-work focused cognitive-behavioral out-patient program with a 6-month follow-up conducted by a psychologist. Effects were compared over 36 pain patients on short-term sick leave (2-6 months) and 36 patients on long-term sick leave (>12 months). The treated patients on short-tem sick leave reduced their sick leave and returned to work more than their controls. They also improved their abilities to control and decrease the pain more. However, the patients on long-term sick leave did not improve on any outcome variables compared to their controls. In Study III a questionnaire aimed at identifying obstacles to return to work was developed and evaluated. The questionnaire was administrated to 154 chronic pain patients and was found to predict sick leave nine months after assessment. Important obstacles were perceived prognosis of a work return, social support at work, physical workload and harmfulness of work, pain intensity, and depression.

In conclusion, this thesis shows that cognitive-behavioral treatment focused on return to work is effective in helping chronic musculoskeletal pain patients back to work. A questionnaire developed to identify obstacles to return to work was shown to predict sick leave.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2002. 78 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 113
Keyword
Psychology, Back pain, cognitive-behavioral, multidisciplinary, musculoskeletal, neck pain, prediction, prevention, rehabilitation, return to work, shoulder pain, sick leave, treatment, Psykologi
National Category
Psychology
Research subject
Clinical Psychology
Identifiers
urn:nbn:se:uu:diva-1751 (URN)91-554-5234-5 (ISBN)
Public defence
2002-03-15, universitetshusets lärosal IX, Uppsala, 13:15
Opponent
Available from: 2002-02-20 Created: 2002-02-20Bibliographically approved

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