Can a rural community-based work-related activity program make a difference for chronic pain-disabled injured workers?
OBJECTIVE
To assess the effectiveness of a clinical guidelines-informed multidisciplinary work-related activity program, and to improve the physical, psychological and occupational functioning of chronic pain-disabled injured workers.


METHODS
An uncontrolled, repeated-measures, pilot study was conducted.


METHODS
The intervention was delivered in a community setting in regional New South Wales.


METHODS
Participants (n = 30), mean age of 41 years, had a compensable musculoskeletal injury: 60% were male, 63% had back injuries; the mean time off work was 13 months.


METHODS
A cognitive-behavioural, interdisciplinary intervention was delivered using a multi-contributor provider model (a clinical psychologist and physiotherapist from separate practices, working in liaison with the participant's occupational rehabilitation provider and treating doctor). Groups of six participants attended for one half day per week for six weeks.


METHODS
The outcome measures included: physical functioning, pain intensity and psychological variables, which were assessed pre- and post-program; and medical certification and work participation, which was recorded pre-program and at six-month follow up.


RESULTS
Significant gains were made in pain intensity, physical and psychological functioning, and medical certification. The mean effect size of the intervention was medium to large (d = 0.70). There was no significant change in employment status at six-month follow up.


CONCLUSIONS
The results of this pilot study suggest that independent, rural or community-based practitioners, working collaboratively using an integrated treatment program, can produce positive outcomes for pain-disabled injured workers, and achieve results similar to those reported by metropolitan-based pain clinics.
Dunstan
Debra A
DA
School of Social Science and Liberal Studies, Charles Sturt University, Bathurst, Australia. ddunstan@une.edu.au
Covic
Tanya
T
D000203:Activities of Daily Living; D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003153:Community Health Services / Q000458:organization & administration*; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D009786:Occupational Health Services / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D010348:Patient Care Team / Q000458:organization & administration; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D020377:Self Efficacy; D011795:Surveys and Questionnaires