Presentation T P16

T P16 (Poster Presentation):
Implementing a self-management intervention for those with a chronic compensable musculoskeletal injury in a workers compensation context: Lessons learned

Presented by: Venerina Johnston

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Authors

Sheppard DM1, Johnston V2, Gargett S3, Jull G2,4, Strong J4,5, MacKenzie A5,6, Battersby M6,7, Ellis N3,8

  1. Monash Injury Research Institute, Monash University, Melbourne, VIC
  2. NHMRC Centre for Clinical Research Excellence – Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD
  3. Institute for Safety, Compensation and Recovery Research (ISCRR), Melbourne, VIC
  4. Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD
  5. Centre for Australian Military and Veteran’s Health,The University of Queensland, School of Population Health, Herston, Brisbane, QLD
  6. Flinders Human Behaviour and Health Research Unit (FHBHRU), Department of Psychiatry, School of Medicine, Flinders University, Bedford Park, Adelaide, SA, AUSTRALIA

Abstract

Background

The need to review and improve current vocational rehabilitation (VR) practices in Australia has been recognised as essential for health reform. The addition of self-management (SM) training to VR was seen as having the potential to facilitate the integration of client-centred goals (a key aspect of health reform) and empower those with chronic MSDs so that they themselves may contribute more to their recovery and rate of return to work (RTW).

Methods

An RCT designed to test the effectiveness of a targeted SM program to improve the RTW for those with chronic compensated MSDs was downscaled to a Phase II small cohort-control feasibility study and process evaluation due to difficulties with participant recruitment.

Results

Several aspects of the results demonstrate the extent to which this population is disempowered and disabled: our pre-intervention sample reported a high incidence of comorbid medical conditions, significant levels of pain, general health issues and low confidence in RTW; they also manage poorly across most health-related self-efficacy domains. Client focus groups data portray feelings of being unheard, frustrated and depressed / anxious about their future. They are also very mixed in terms of their readiness to RTW and generally have a long road ahead in their recovery to pre-onset function.

Conclusions

A subsequent process evaluation concluded that future research with injured workers with chronic compensated MSDs should take into account the major barriers to RTW for these individuals. It also identified a number of critical factors that need to be considered in future intervention designs in terms of Where (i.e. in which setting) such interventions should be conducted; How the SM intervention should be offered; and When best to offer post-injury to facilitate optimal results. Despite having small numbers for the final sample, there were some potentially meaningful trends in the expected direction. For those who were able to overcome their barriers to attend the SM program, the descriptive (qualitative) results that speak to the program’s acceptability and the trends in the efficacy data are encouraging. If individuals are able to be appropriately targeted according to their readiness there would likely be an increase in attendance of SM programs and a strengthening of positive outcomes.

Schedule Details

Tuesday September 30
12:45 - 13:45 Poster Viewing
Session: Disability management