title: Psychosocial coping profiles after pain rehabilitation: associations with occupational performance and patient characteristics.
abstract: Purpose The aims of the present study were to assess: (i) changes in coping by use of Multidimensional Pain Inventory profiles from baseline to follow-up, (ii) associations between Adaptive Coper (AC) profiles at follow-up and improvements in occupational performance (by Canadian Occupational Performance Measure COPM) and (iii) ability to predict AC profiles at follow-up by participants' baseline characteristics. Method Data at baseline, discharge and follow-up from 525 participants in a pain rehabilitation program were analyzed with multivariate statistics. Results AC profiles increased and Dysfunctional (DYS) profiles decreased at follow-up. Clinically relevant improvements on COPM were associated with having an AC profile at follow-up. Being Nordic born, having longer education, an AC profile and higher baseline scores on satisfaction with performance predicted an AC profile at follow-up. Conclusions Pain rehabilitation seems to result in sustainable and favourable coping strategies at follow-up, and improved occupational performance is associated with favourable coping at follow-up. Outcomes need to be measured independently of improved coping strategies and improvements of participant's individual goals such as difficulties to perform their most meaningful occupations. Patients at risk for unfavourable coping strategies may need modified interventions. Implications for Rehabilitation More participants reported a beneficial coping, MPI profile, in a long-term perspective after a pain rehabilitation program. Improvements on occupational performance prioritized as meaningful by each of the participants are related to adequate coping strategies at follow-up. The associations between improved occupational performance and beneficial coping profiles need to be better understood. Patients with worse initial occupational performance may need modified pain rehabilitation interventions to improve their coping strategies.
authors.affiliation: a Department of Health Sciences , Lund University , Lund , Sweden.|b Department of Pain Rehabilitation Medicine , Skane University Hospital , Lund , Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Persson
authors.affiliation: a Department of Health Sciences , Lund University , Lund , Sweden.
authors.forename: Mona
authors.initials: M
authors.lastname: Eklund
authors.affiliation: a Department of Health Sciences , Lund University , Lund , Sweden.|c Department of Neurology and Rehabilitation Medicine , Skane University Hospital , Lund , Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Lexell
authors.affiliation: a Department of Health Sciences , Lund University , Lund , Sweden.|b Department of Pain Rehabilitation Medicine , Skane University Hospital , Lund , Sweden.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Rivano-Fischer
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D013548:Sweden; D016896:Treatment Outcome
keywords: Activities of daily living; chronic pain; coping behaviour; pain management; psychosocial; treatment outcome