Title

Student Poster Session - Reclaiming Lost Occupations: Empowering Upper Extremity Chronic Pain Clients to Re-enter Valued Participation

Start Time

18-10-2013 12:40 PM

End Time

18-10-2013 1:30 PM

Abstract

The occupation-based practice action research sketch presented in this poster was a final seminar paper in OTS 882 Advanced Occupational Science, offered in the Spring of 2013 at Eastern Kentucky University and taught by Dr. Doris Pierce. It illustrates both an innovative strategy for learning about occupation and a unique application of occupational science to interventions supporting clients challenged by chronic pain.

Purpose

The purpose of this action research study is to collaboratively develop a group intervention to support the reclaiming of lost occupations by clients with chronic pain. The study has two aims: 1) to understand the factors that influence chronic pain patient’s satisfaction with occupation/ADL participation in their social environments. 2) to help these clients find ways to re-integrate in these occupations despite pain.

Chronic pain patients often experience a sense of isolation as well as attitudinal barriers that contribute to their gradual exclusion from social networks, and benefits that these supports offer. (Rodham, Rance, & Blake, 2010). The new Medicare law that requires clinicians to report functional gains throughout the rehabilitation process resonates with interventions focused on engaging individuals to recapture engagement in social occupations (DHHS & CMS, 2012).

Methods

“Community-based action research seeks to change the social and personal dynamics of the research situation so that the research process enhances the lives of all those who participate” (Stringer, 2007). Participants in the study will include adult upper extremity chronic pain patients, specifically fibromyalgia, chronic regional pain syndrome, and other UE neurological pain conditions. Subjects who report pain symptoms lasting at least six months will be included. The aim is to form a chronic pain support group in which patients go through the process of discovering what are the occupations that matter most to each individual.

Stakeholders in the lives of clients with chronic pain will collaborate with the researcher/therapist to improve their occupational engagement in occupations that have been lost due to pain. Possible stakeholders will include clients, caregivers/significant others (Lauder, McCabe, Rodham, & Norris, 2011; Rodham et al., 2010), and the healthcare team. The plan is to use creative ways to identify all stakeholders such as concept maps, and link supportive networks (Stringer, 2007). The approximate timeline is one year. IRB approval will be obtained to publish findings from study.

The Reclaiming Group intervention

The researcher will engage clients and other stakeholders in sharing, investigating, and developing descriptions of the occupations in which clients have lost participation. The working group may use Stringer’s (2007) six questions of action research to complete this phase, as well as having clients complete the Self Discovery Tapestry (Meltzer, in press). In addition, the group will be given the opportunity to do something “with their hands” (Stringer, 2007) such as sharing tea/coffee and expressing their story of loss of occupational involvement through the use of “photovoice” (Stringer, 2007). Repeated trials of strategies to reclaim occupations will be attempted and reported back to the group, in order to develop lasting strategies to support the lives of clients with UE pain.

References

DHHS, & CMS. (2012). Federal Register 42 CFR Parts 410, 414, 415, et al.

Lauder, A., McCabe, C. S., Rodham, K., & Norris, E. (2011). An Exploration of the Support Person's Perceptions and Experiences of Complex Regional Pain Syndrome and the Rehabilitation Process. Musculoskeletal Care. doi: 10.1002/msc.211

Meltzer, P. J. (in press). Development of the Self-Discovery Tapestry. In D. Pierce (Ed.), Occupational science for occupational therapy. Thorofare, NJ: SLACK, Inc.

Rodham, K., Rance, N., & Blake, D. (2010). A qualitative exploration of carers' and 'patients' experiences of fibromyalgia: one illness, different perspectives. Musculoskeletal Care, 8(2), 68-77. doi: 10.1002/msc.167

Stringer, E. T. (2007). Action research in education. Columbus, Ohio: Pearson Prentice Hall.

Key words: chronic pain, caregiver, participation, action research, occupational therapy

Comments

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.

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Oct 18th, 12:40 PM Oct 18th, 1:30 PM

Student Poster Session - Reclaiming Lost Occupations: Empowering Upper Extremity Chronic Pain Clients to Re-enter Valued Participation

The occupation-based practice action research sketch presented in this poster was a final seminar paper in OTS 882 Advanced Occupational Science, offered in the Spring of 2013 at Eastern Kentucky University and taught by Dr. Doris Pierce. It illustrates both an innovative strategy for learning about occupation and a unique application of occupational science to interventions supporting clients challenged by chronic pain.

Purpose

The purpose of this action research study is to collaboratively develop a group intervention to support the reclaiming of lost occupations by clients with chronic pain. The study has two aims: 1) to understand the factors that influence chronic pain patient’s satisfaction with occupation/ADL participation in their social environments. 2) to help these clients find ways to re-integrate in these occupations despite pain.

Chronic pain patients often experience a sense of isolation as well as attitudinal barriers that contribute to their gradual exclusion from social networks, and benefits that these supports offer. (Rodham, Rance, & Blake, 2010). The new Medicare law that requires clinicians to report functional gains throughout the rehabilitation process resonates with interventions focused on engaging individuals to recapture engagement in social occupations (DHHS & CMS, 2012).

Methods

“Community-based action research seeks to change the social and personal dynamics of the research situation so that the research process enhances the lives of all those who participate” (Stringer, 2007). Participants in the study will include adult upper extremity chronic pain patients, specifically fibromyalgia, chronic regional pain syndrome, and other UE neurological pain conditions. Subjects who report pain symptoms lasting at least six months will be included. The aim is to form a chronic pain support group in which patients go through the process of discovering what are the occupations that matter most to each individual.

Stakeholders in the lives of clients with chronic pain will collaborate with the researcher/therapist to improve their occupational engagement in occupations that have been lost due to pain. Possible stakeholders will include clients, caregivers/significant others (Lauder, McCabe, Rodham, & Norris, 2011; Rodham et al., 2010), and the healthcare team. The plan is to use creative ways to identify all stakeholders such as concept maps, and link supportive networks (Stringer, 2007). The approximate timeline is one year. IRB approval will be obtained to publish findings from study.

The Reclaiming Group intervention

The researcher will engage clients and other stakeholders in sharing, investigating, and developing descriptions of the occupations in which clients have lost participation. The working group may use Stringer’s (2007) six questions of action research to complete this phase, as well as having clients complete the Self Discovery Tapestry (Meltzer, in press). In addition, the group will be given the opportunity to do something “with their hands” (Stringer, 2007) such as sharing tea/coffee and expressing their story of loss of occupational involvement through the use of “photovoice” (Stringer, 2007). Repeated trials of strategies to reclaim occupations will be attempted and reported back to the group, in order to develop lasting strategies to support the lives of clients with UE pain.