The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: "taking initiative and making choices", doing something physical", "doing something social", and "doing something for others". Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.
BackgroundTo describe the design of the study aiming to examine intensive targeted cognitive rehabilitation of attention in the acute (<4 months) and subacute rehabilitation phases (4–12 months) after acquired brain injury and to evaluate the effects on function, activity and participation (return to work).Methods/DesignWithin a prospective, randomised, controlled study 120 consecutive patients with stroke or traumatic brain injury were randomised to 20 hours of intensive attention training by Attention Process Training or by standard, activity based training. Progress was evaluated by Statistical Process Control and by pre and post measurement of functional and activity levels. Return to work was also evaluated in the post-acute phase. Primary endpoints were the changes in the attention measure, Paced Auditory Serial Addition Test and changes in work ability. Secondary endpoints included measurement of cognitive functions, activity and work return. There were 3, 6 and 12-month follow ups focussing on health economics.DiscussionThe study will provide information on rehabilitation of attention in the early phases after ABI; effects on function, activity and return to work. Further, the application of Statistical Process Control might enable closer investigation of the cognitive changes after acquired brain injury and demonstrate the usefulness of process measures in rehabilitation. The study was registered at ClinicalTrials.gov Protocol.Trial registrationNCT02091453, registered: 19 March 2014.
Objective: This study explored and analysed how patients experienced possibilities for, and barriers to, work return after participation in a multi-professional pain-rehabilitation program followed by a coached work-training program (CWT). Participants: Eleven informants (8 women/3 men) with long-term musculoskeletal pain who had participated in the CWT program for 4-21 months (mean = 11) comprised the study. Methods: A qualitative emergent design was used. Data collected with interviews were analysed using the constant comparison method of grounded theory. Triangulation in researchers were used. Results: The analyses of the interviews resulted in the development of a three-category theoretical model, which was named "a way back to work". The main category "Experience of a way back to work" consisted of the informants' experience during the process between unemployment and employment. The category "Support" describes the help the informants received from various actors, and the category "Negative response" describes negative responses from the actors involved, which was an important barrier in the process between unemployment and employment. Conclusion: Professional individualised support, participants feeling involved in their rehabilitation process, coaching at real workplaces and multi-professional team including health care personnel, were valuable during the process towards work.
The informants described living with long-term whiplash-associated pain as 'chaos' before the rehabilitation programme. Participation helped them realise that there was a possible way for them to control their pain, regain their daily occupation and return to work. One year after rehabilitation the informants had started to accept their situation and regain occupations and life roles.
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