Relationship between the perceived burden of suffering and the observed quality of ADL task performance before and after a 12-week pain management programme.

BACKGROUND/OBJECTIVE: Constant pain causes suffering and affects performance of activities of daily living (ADL). In clients with chronic musculoskeletal pain, we wanted to determine (i) the relationship between the perceived burden of suffering (measured with the Pictorial Representation of Illness and Self Measure (PRISM)) and the observed quality of ADL task performance (measured with the Assessment of Motor and Process Skills (AMPS)); and (ii) the change in these assessments before and after a 12-week pain programme. METHODS: In this cross-sectional cohort study, we retrospectively collected data from participants in a Swiss pain management programme. We calculated the relationship, correlations and effect sizes for the PRISM and AMPS using non-parametric tests. We set the level of significance at α = 0.05. RESULTS: Out of 138 clients, 74 participated. We found no significant correlations between the PRISM and AMPS (p = 0.55-0.36), except for the PRISM and AMPS process ability measure after the pain management programme (p = 0.023). Pre-post-correlations of the AMPS and PRISM were significant, with medium to strong effect sizes (-0.48-0.66). CONCLUSION: Participation in this pain programme improved both, the PRISM and AMPS scores. The lack of correlation between these assessments in clients with chronic musculoskeletal pain, however, strongly argues for a thorough clinical assessment.

Effectiveness of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) programme for patients with chronic musculoskeletal pain: a cohort study.

QUESTIONS UNDER STUDY: Chronic pain has a high impact on individuals and society. (Cost-)effective interventions are desperately needed. We evaluated short- and long-term effects of the Bern Ambulatory Interprofessional Rehabilitation (BAI-Reha) for patients with chronic musculoskeletal pain. METHODS: We analysed data prospectively collected from patients with chronic musculoskeletal pain before and after BAI-Reha (at 12 weeks, 1 year and 2 years) using linear mixed-models and logistic generalised estimating equations. RESULTS: The first thirty consecutive patients with chronic musculoskeletal pain, aged between 20 and 73 years (mean 44.83, standard deviation 12.57 years) were included. We found significant changes over time compared with baseline for return to work (p <0.001), Euro quality of life visual analogue scale score (p = 0.026), burden of suffering (p = 0.001), self-rated and observed quality of daily life task motor performance (p <0.001 and p = 0.012, respectively) but not for pain intensity (p = 0.16) and observed quality of daily life task process performance (p = 0.28). At the first postintervention visit we found significant differences compared with baseline in return to work (odds ratio 5.26, 95% confidence interval [CI] 1.80-15.39], burden of suffering (mean difference 5.26, 95% CI 2.09-8.44], self-rated quality (mean difference 2.31, 95% CI 1.57-3.05) and satisfaction (mean difference 2.80, 95% CI 1.95-3.66) with daily life task performance, and observed quality with daily life task motor performance (mean difference 0.31, 95% CI 0.02-0.60). CONCLUSIONS: This study confirms earlier data and supports the effectiveness of interprofessional rehabilitation for patients with chronic musculoskeletal pain.

Becoming a member of the work force: perceptions of adults with Asperger Syndrome.

OBJECTIVE: Research has shown that comparatively few adults with Asperger Syndrome (AS) participate in the competitive work force. The purpose of this study was to gain in-depth knowledge about contextual factors, which contribute to successful labor market participation in some adults with AS. PARTICIPANTS: This study was conducted by indepth-interviewing six adults with AS working in the competitive job market in Switzerland. METHODS: A developmental and hermeneutic narrative approach was used for data collection and analysis. Two in-depth narrative interviews were conducted with each participant. A narrative analysis according to the theories of Paul Ricoeur was performed. RESULTS: Results showed that participants received pre-vocational requisites during their childhood through parents and friends that provided a feeling of security in social contexts. For participants, a supportive school setting resulted in academic achievements. The narratives reveal participants' capacities for understanding and adapting to social norms. Participants' understanding of their own needs was essential to the successful labor market participation. However, disclosure is rare and social stigma is still present. CONCLUSIONS: This study showed that successful labor participation of adults with AS can be enhanced through adequate social support already in the early stages of an individual's lifetime.

I think of my family, therefore I am: perceptions of daily occupations of some Albanians in Switzerland.

The purpose of this qualitative study was to increase the understanding of the relationship between culture and occupation by exploring the perceptions of current daily occupations of some immigrants living in Switzerland. Semi-structured interviews with eight healthy Muslim Albanian men doing blue-collar work were analysed in a comparative manner followed by an interpretation. Three themes were identified: "Everything I do I do for my family"; "Where do I belong?"; and "Doing something for myself". These themes reflect the occupational perceptions of the participants. The findings are discussed in relation to the ongoing discourses on individualism and collectivism. To offer occupational therapy appropriately to a multicultural clientele the findings indicate the necessity to be conscious of the differences between one's own and the client's attitudes regarding individualism and collectivism.