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- Reme, Silje Endresen, et al.
(författare)
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Distressed, immobilized, or lacking employer support? : a sub-classification of acute work-related low back pain
- 2012
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Ingår i: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 22:4, s. 541-552
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: One possibility for reducing the disabling effects of low back pain (LBP) is to identify subgroups of patients who might benefit from different disability prevention strategies. The aim of this study was to test the ability to discern meaningful patient clusters for early intervention based on self-reported concerns and expectations at the time of an initial medical evaluation.Methods: Workers seeking an initial evaluation for acute, work-related LBP (N = 496; 58 % male) completed self-report measures comprising of 11 possible risk factors for chronicity of pain and disability. Outcomes of pain, function, and return-to-work were assessed at 3-month follow-up. A K-means cluster analysis was used to derive patient subgroups based on risk factor patterns, and then these subgroups were compared with respect to 3-month outcomes.Results: Eight of the 11 measures showed significant associations with functional recovery and return-to-work, and these were entered into the cluster analysis. A 4-cluster solution met criteria for cluster separation and interpretability, and the four clusters were labeled: (a) minimal risk (29 %), (b) workplace concerns (26 %); (c) activity limitations (27 %); and (d) emotional distress (19 %). Functional outcomes were best in the minimal risk group, poorest in the emotional distress group, and intermediate in the other two groups. A global severity index at baseline also showed highest overall risk in the emotional distressed group.Conclusions: Patterns of early disability risk factors from this study suggest patients have differential needs with respect to overcoming emotional distress, resuming normal activity, and obtaining workplace support. Classifying patients in this manner may improve the cost-benefit of early intervention strategies to prevent long-term sickness absence and disability due to LBP.
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| 2. |
- Shaw, William S., et al.
(författare)
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3(rd) place, PREMUS best paper competition : development of the return-to-work self-efficacy (RTWSE-19) questionnaire - psychometric properties and predictive validity
- 2011
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 37:2, s. 109-119
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The 19-item return-to-work self-efficacy (RTWSE-19) scale is a new self-report measure intended to assess workers’ beliefs of their current ability to resume normal job responsibilities following pain onset. The aim of this study was to evaluate the factor structure, internal consistency, and predictive and concurrent validity of RTWSE-19 among workers with acute low-back pain.Methods: Patients (N=399, 59% male, mean age 37 years) consulting for acute, work-related low-back pain completed an original 28-item version of the new scale along with concurrent measures of pain, functional limitation, activity avoidance, workplace physical demands, and pain catastrophizing. The assessment was repeated at visit 2, and work limitations and duration of sickness absence were assessed by questionnaire at 3-month follow-up. Exploratory factor analysis (principal component analysis with varimax rotation) was used to assess content validity of the scale, and scores were compared to concurrent pain measures and with disability outcomes at 3 months.Results: The full response range (1-10) was utilized on all 28 items, and there were no ceiling or floor effects. Mean item scores ranged from 4.9 (”reducing physical workload”) to 8.3 (”describing injury to supervisor”). The exploratory factor analysis supported three underlying factors (eigenvalue > 1.0): (i) meeting job demands; (ii) modifying job tasks; and (iii) communicating needs to others. Internal consistency (alpha) for the three scales were 0.98, 0.92, and 0.81, respectively. At visit 2, self-efficacy scores improved for “meeting job demands” and “modifying job tasks”, but not for “communicating needs to others”. After controlling for pain and functional limitation, both sickness absence and persistent work limitations were predicted by self-efficacy assessed at visit 2 (P < 0.05), but self-efficacy assessed at visit 1 did not predict sickness absence.Conclusions: The RTWSE-19 is a new measure with adequate reliability and validity to measure the confidence of workers to meet job demands, modify job tasks, and communicate needs to co-workers and supervisors. When assessed 1-2 weeks after pain onset, the scale is predictive of disability outcomes.
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| 3. |
- Shaw, William S., et al.
(författare)
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The Pain Recovery Inventory of Concerns and Expectations A Psychosocial Screening Instrument to Identify Intervention Needs Among Patients at Elevated Risk of Back Disability
- 2013
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 55:8, s. 885-894
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To reduce a full psychosocial test battery to a brief screening questionnaire to triage return-to-work strategies among patients with low back pain (LBP). Methods: Workers (N = 496) with acute, work-related LBP completed multiple psychosocial measures at intake, then a 3-month follow-up of pain, function, and work status. A sensitivity analysis was conducted to reduce the number of items while maintaining scale reliability, preserving associations with outcomes, and maintaining separation between patient subgroups. Results: The pool of items was trimmed from 129 to 46 items, describing elements of emotional distress, pain beliefs, organizational support, and activity limitation. A confirmatory cluster analysis replicated previous findings of three risk subgroups: distressed, avoidant, and lacking employer support. Conclusions: The reduced measure is a reliable and valid screening measure that can be used to identify early intervention needs among working adults with LBP.
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