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Vulnerability and Resilience in Patients with Chronic Pain in Occupational Healthcare: A Pilot Study with a Patient-Centered Approach.
Department of Molecular and Clinical Medicine/Pain Centre, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital.
Department of Molecular and Clinical Medicine/Pain Centre, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital.
Department of Chemistry and Molecular Biology, Gothenburg University.
Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. (Vårdande, hälsa och lärande)ORCID-id: 0000-0002-9194-3244
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2018 (engelsk)Inngår i: Pain Research and Treatment, ISSN 2090-1542, E-ISSN 2090-1550, Vol. 2018, artikkel-id 9451313Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives: The aim of this pilot study was to describe vulnerability and resilience and possible subgroups in patients with chronic work related musculoskeletal pain in occupational healthcare. A second aim was to evaluate a patient-centered approach.

Methods: This study was based on consecutive patients with chronic pain, seen by the same physician and sick-listed full or part time three months or longer. They were included during a period of three months. Patient reported outcome measures (PROM) were administered at baseline and at follow-up after 8 months. A patient-centered approach was applied where the patient's whole situation was taken into account.

Results: A dominance of an insecure dismissing attachment pattern and a subnormal sense of coherence (SOC) was reported both at baseline and at follow-up. The patients (n=38) reported significant improvement of pain severity (p=0.01), pain interference (p=0.001), life control (p=0.01), affective distress (p=0.02), and dysfunction (p=0.001) on the multidimensional pain inventory (MPI) and fewer patients were sick-listed full time at follow-up (13 patients versus 21). By means of multivariate data analyses this change in MPI was confirmed and was also correlated with a significant increase in health related quality of life (HRQoL). Moreover subgroups with different outcome at follow-up were identified according to attachment pattern and subgroups on MPI.

Conclusion: A patient-centered approach may be of value for patients with chronic pain in occupational healthcare, improving pain and dysfunction. Patients with chronic pain are a heterogeneous group where outcome of treatment might be influenced by individual resilience and/or vulnerability.

sted, utgiver, år, opplag, sider
2018. Vol. 2018, artikkel-id 9451313
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URN: urn:nbn:se:hb:diva-15950DOI: 10.1155/2018/9451313ISI: 000453808100001PubMedID: 30687552Scopus ID: 2-s2.0-85058874490OAI: oai:DiVA.org:hb-15950DiVA, id: diva2:1302961
Tilgjengelig fra: 2019-04-08 Laget: 2019-04-08 Sist oppdatert: 2019-04-12bibliografisk kontrollert

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