Abstract
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.
Highlights
Chronic pain is defined as pain lasting for more than three months [1]
During the inclusion period 45 patients were identified, and, of those, 35 women and 7 men agreed to participate in the study
A patient-centered approach may be of value for patients with chronic pain in occupational healthcare improving pain and dysfunction according to multidimensional pain inventory (MPI) (Table 2)
Summary
Chronic pain is defined as pain lasting for more than three months [1]. Pain that persists for months and years will affect all aspects of a person’s life, physical, emotional, interpersonal, and social. This biopsychosocial model is the basis of a patient-centered approach [3]and of a cognitive-behavioral treatment for chronic pain [4, 5]. Most people with acute pain will recover and all patients with chronic pain do not become physically and emotionally disabled [4]. There are few clear-cut answers to what factors are the most important in the development of chronic pain. According to Bowlby’s theory of attachment [11], early attachment pattern between the child and its mother plays an important role in adult life
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
