Multidisciplinary pain rehabilitation programs in Iceland: An exploration and description of the short-term and long-tern effects
About the project
The overall aim of the thesis was to explore and describe the short- and long-term effects of three multidisciplinary pain rehabilitation programs on pain severity and pain interference and the long-term effects on pain self-management, sleep quality, well-being, health, and health-related quality of life (HRQOL).
People in chronic pain who were on a waiting list for multidisciplinary pain rehabilitation at one of three centres in Iceland were invited to participate in both phenomenological study and answering questionnaires. The program lasted between four and seven weeks, with data collected pre-treatment, at program completion, three months after program completion and in a one-year follow-up.
Most participants were women aged 20-69, unemployed, married or living with partner. The main results were that prior to attending rehabilitation, the participants were in survival mode, stuck in a vicious circle of chronic pain. They used a variety of strategies to relieve and conceal their pain. Reaching out for professional help was a positive turning point. Whilst attending the pain rehabilitation program, participants learned to deconstruct their habitual but inefficient ways of dealing with chronic pain. Three months after completing the program, they were still rebuilding their daily lives. Pain was still present but interfered much less with daily activities than previously.
Average self-reported pain severity decreased at program completion and at one-year follow-up, and the interference of pain with general activities, mood, walking ability, sleep and enjoyment of life also declined. At one-year follow-up, more than a fifth (21%) of participants rated their health as good or very good, which was markedly better than before treatment (7%). The three most commonly used pain self-management strategies pre-treatment were positive thinking (68%), medication (58%) and distraction (58%). At one year follow-up, three times as many participants (18%) slept through the night as had done so pre-treatment (6%). HRQOL increased at one-year follow-up.
Keywords: Chronic pain, sleep quality, health-related quality of life, rehabilitation
Funds: Rannsóknasjóður Háskólans á Akureyri, Háskólasjóður KEA, Menningar-og viðurkenningasjóður KEA, Rannsóknasjóður Ingibjargar R. Magnúsdóttur og Minningasjóður Kristínar Thoroddsen
Members
- Dr. Hafdís Skúladóttir, Associate professor, School of Health Sciences University of Akureyri
- Dr. Herdís Sveinsdóttir, Professor, School of Health Sciences/Faculty of Nursing, University of Iceland
- Dr. Sigríður Halldórsdóttir, Professor, School of Health Sciences/Faculty of Graduate Studies, University of Akureyri
- Dr. Amalía Björnsdóttir, Professor, School of Education, University of Iceland
- Dr. Þóra Jenný Gunnarsdóttir, Associate Professor, School of Health Sciences, Faculty of Nursing, University of Iceland, Iceland
- Dr. Janean Erickson Holden, Professor, University of Michigan School of Nursing, Ann Arbor, MI
Collaborators
- Rannsóknastofnun Háskólans á Akureyri (RHA)
- Þóra Hjartardóttir hjúkrunarfræðingur, Endurhæfingardeildin á Reykjalundi, 270 Mosfellsbær
- Ingvar Þóroddsson, yfirlæknir, Endurhæfingardeildin á Kristnesi Eyjafjarðarsveit, 601 Akureyri
- Aðalbjörg S. Helgadóttir, hjúkrunarfræðingur, NLFÍ Hveragerði, Grænumörk 10, 810 Hveragerði
Publishing
- Skuladottir, H., Gunnarsdóttir, Th. J., Halldórsdóttir, S., Sveinsdóttir, H., Holden, J. E. og Björnsdóttir, A. (2020). Breaking the vicious circle: Experience of people in chronic pain on the pain rehabilitation journey. Nursing Open, 7, 1412-1423.
- Skuladóttir, H., Sveinsdottir, H., Holden, J. E., Gunnarsdóttir, Th. J., Halldorsdóttir, S., og Björnsdóttir, A. (2021). Pain, sleep, and health-related quality of life after multidisciplinary intervention for chronic pain. International Journalf of Environmental Research and Public Health, 181, 233.
- Skuladottir, H. Björnsdóttir, A., Holden, J. E., Gunnarsdóttir, Th. J., Halldórsdóttir, S. og Sveinsdóttir, H. (2021). Pain rehabilitation’s effect on people in chronic pain: A prospective cohort study. International Journal of Environmental Research and Public Health, 18, 10306.