Occupational therapists' assessments of adults with long‐term pain: the Swedish experience

Abstract

The purposes of this study were to describe the needs for occupational therapy among people of working age with long-term pain, and to describe treatment interventions based on these assessments. Occupational therapists working in primary health care and/or with special interest in pain management (n=109) assessed 113 people aged 18-58 years with long-term pain with the Occupational Therapy Needs Assessment--Pain (OTNA--P) questionnaire. The occupational therapists recommended treatment interventions where appropriate. The results generated categories of needs that have implications for interventions: 1) need for patient education, 2) needs due to limitations in activity performance, 3) needs due to patient's discouragement, 4) need as a result of patient's dependency and 5) needs related to work. The suggested interventions focused on increased knowledge of how to handle daily occupations, mainly categorized as education and stress management' and behavioural' interventions. Significant correlations were found between the assessed needs and the suggested interventions. The results of this study could assist in developing guidelines for practitioners working in occupational therapy pain management programmes. It is recommended that further research is done on the effectiveness of occupational therapy interventions with patients with long-term pain.

Patient-Reported Outcome of a Multidisciplinary Pain Management Program, Focusing on Occupational Performance and Satisfaction with Performance

“…Results from this and other studies suggest that aspects of psychological wellbeing and psychosocial functioning must be addressed together with occupational performance [29] and that improvements in performance and satisfaction with performance are associated with increased self-efficacy and improved observed performance [28]. Accordingly, promoting self-management and teaching positive strategies seem to be effective for long-term pain patients, which is supported by our study as well as other studies [30,41]. A multidisciplinary pain management program should address the multiple factors that influence pain management and coping skills [42], where the key to success is considered to be based on ongoing communication between team members and the patient [43].…”

Needs and Problems Related to Occupational Therapy as Perceived by Adult Swedes with Long-Term Pain

“…In a previous study, occupational therapists rated their patients' need for occupational therapy [40] using a slightly different version of the assessment instrument (OTNA -P) than used in the present study (OTNA -PP). Occupational therapists and persons with long-term:recurrent pain differed with regard to what needs:problems were reported most frequently.…”

“…The rst questionnaire, OTNA -PP, is intended for use by persons with long-term:recurrent pain to assess self-perceived needs for occupational therapy (Appendix 1). It includes 19 items, of which one concerns the location of pain (item 1b) and one whether the respondent has ever been referred to occupational therapy (item 19), both with a yes:no for assessing cancer patients' need for occupational therapy [44,45] and on literature reviews concerning pain and occupational therapy in pain management [2,40]. The OTNA -P was used in a previous study [40], where signi cant correlations were found between patients' needs:problems as judged by occupational therapists and interventions in occupational therapy suggested by the occupational therapists.…”

“…All items in the factor ''limitations in activity performance'' are related to interference with activity, mainly in terms of primary effects such as ''interruption'' or response format. The remaining 17 items were based on a review of areas, goals and interventions in occupational therapy [40]; two items (2 -3) used a yes:no response format and 15 items (1, 4-18) rated on an ordinal scale (never, sometimes, often, always).…”

“…In a previous study [40], Swedish occupational therapists rated need for occupational therapy among adult persons (18-58 years) with long-term pain. The highest frequencies of needs:problems were related to interruption of or giving up performance of activities, and perception of increased pain when performing housework.…”