title: A self-management program for employees with complaints of the arm, neck, or shoulder (CANS): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Complaints of the arm, neck, or shoulder (CANS) have a multifactorial origin and cause considerable work problems, including decreased work productivity, sickness absence, and, ultimately, job loss. There is a need for intervention programs for people with CANS. Self-management is an approach used in chronic disease care to improve self-efficacy and wellness behaviors to facilitate participants to make informed choices and carry them out. This study will evaluate the effectiveness of a self-management program (including ehealth) and compare it to usual care among employees with chronic CANS (lasting >3 months).
  
  
  METHODS
  This is a randomized controlled trial in which 142 participants will be recruited and randomized (with pre-stratification) to either the intervention group (IG) or control group (CG). The IG will participate in a self-management program consisting of six group sessions and an ehealth module. The CG is allowed to use all usual care available. The primary outcome of the study is the self-reported disability of arm, shoulder, and hand, measured with the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes include: absenteeism, pain in the previous week, quality of life, catastrophizing pain, self-efficacy, workstyle, presenteeism, fatigue, the use of usual care, and limitations experienced on the job. Data are collected at baseline and at 3, 6, and 12 months follow-up.
  
  
  CONCLUSIONS
  Following the process of intervention mapping we developed a self-management program to suit and alleviate the problems and needs of employees with CANS. A strength of the study is that our intervention is specifically tailored to match the needs of employees with CANS. The study also has some potential weaknesses (for example, use of co-interventions, combination of group sessions and ehealth, self-reporting of data and possible contamination, Hawthorne effect, and recall or information bias) which are discussed.
  
  
  BACKGROUND
  The trial is registered with the Dutch Trial Register (http://www.trialregister.nlNTR3816): (January 2013). The first participant was randomized in September 2012.
authors: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Nathan.Hutting@han.nl
authors: Nathan
authors: N
authors: Hutting
authors: J Bart
authors: JB
authors: Staal
authors: Yvonne F
authors: YF
authors: Heerkens
authors: Josephine A
authors: JA
authors: Engels
authors: Maria W G
authors: MW
authors: Nijhuis-van der Sanden
mesh_terms: D000041:Absenteeism; D001132:Arm / Q000503:physiopathology*; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002985:Clinical Protocols; D017281:Cost of Illness; D004185:Disability Evaluation; D006801:Humans; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D019547:Neck Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009426:Netherlands; D016272:Occupational Health; D009786:Occupational Health Services; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011788:Quality of Life; D012107:Research Design; D012648:Self Care; D020069:Shoulder Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
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