Management of Chronic Pain by Occupational Therapist: A Description of Practice Profile.

Background. Current state of knowledge regarding occupational therapy's contribution to chronic pain (CP) management has evolved over the past decade. Yet, has this been transferred to clinical practice? Purpose. Describe the current state of practice of CP management-specific occupational therapy. Method. An online survey was sent to occupational therapists working with CP patients. Findings. Of the 90 respondents (11.9%), 42.2% worked in primary care and 52.2% in secondary care. They reported that their primary role aimed at enabling occupation and providing vocational rehabilitation. The Canadian Model of Occupational Performance and Engagement (CMOP-E) (87.8%), semi-structured interview (86.7%), and education on energy conservation (65.6%) and postural hygiene (60.0%) were the most frequently reported conceptual model, assessment, and intervention methods. Implications. Results illustrate the diversity of current occupational therapy practice in CP management and suggest opportunities for improvement to ensure best practices are adopted, by emphasizing an occupation-based vision of health and well-being.

Occupational Adaptation of People Living With Fibromyalgia: A Systematic Review and Thematic Synthesis.

IMPORTANCE: Fibromyalgia (FM) is a chronic pain disorder that interferes with daily activities. Because occupational adaptation varies among people, there is a need to determine which factors can influence adaptation to FM in order to better intervene with them. OBJECTIVE: To understand the occupational adaptation process of people living with FM. DATA SOURCES: A systematic review of the literature was conducted in the AMED, CINAHL, MEDLINE, OTseeker, OTDBASE, and PsycINFO databases. Articles dated before September 2020 were searched using a strategy with the keywords fibromyalgia and occupation. Study Selection and Data Collection: This article follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Qualitative articles were included if they documented occupational aspects of participants with FM. Two independent reviewers screened the articles and performed the quality assessment using the Critical Appraisal Skills Program checklist. A thematic synthesis was conducted. FINDINGS: Of the 560 articles identified, 347 remained after duplicates were removed. After screening titles and abstracts, 303 articles were rejected, and 44 articles were read in their entirety. Twelve qualitative articles were included in the review. The synthesis highlights that support from relatives is a key to successfully adapting to FM. Identity is crucial to a fulfilled life, and occupational competence is greatly affected by the experience of FM. Occupational adaptation is an issue for some people, but maintaining routines and integrating management strategies would help them to achieve it. CONCLUSIONS AND RELEVANCE: This review highlights the importance of considering the components of occupational adaptation while caring for people with FM. What This Article Adds: This systematic review identifies the factors influencing the occupational adaptation of people living with FM and emphasizes the importance of addressing those factors.