To evaluate the outcomes of this intervention on a larger group of injured workers, to determine acceptability to key stakeholders and recognise areas for improvement.
The intervention varied from four to six one-hour sessions and content was matched to individual’s needs. Injured workers were asked to fill out an initial outcome measure – “mini ePPOC”, which includes three items from the Brief Pain Inventory (BPI), the two item Pain Self-Efficacy Questionnaire (PSEQ2), the four item Patient Health Questionnaire (PHQ4), healthcare utilisation and medication items. At the completion of the sessions, mini ePPOC was readministered and supplemented by a global rating of change question and seven patient experience items.
The Institute for Safety, Compensation and Recovery Research (ISCRR) at Monash University undertook an evaluation of the intervention answering the following questions:
1. To what extent are pain education sessions successful for early intervention?
2. What barriers and facilitators have been identified?
3. What are the injured worker outcomes from the questionnaires
ISCRR analysed completed sets of deidentified questionnaire data from 50 injured workers and conducted 22 interviews with; injured workers (n=7), APA-titled pain physiotherapists (n=6), other treaters (n=2), and insurance agents (n=7). This 38-page analysis will become available on the ISCRR website in due course.
Injured workers reported substantially positive outcomes. They valued the support and community they found while participating in the program and some reported that it was lifesaving. Injured workers felt APA-titled pain physiotherapists went above and beyond to support their recovery. Over 80% of injured workers reported that their situation was better after the program.
Questionnaire results indicated that after the pain education program, injured workers experienced statistically significant differences with large effect sizes in average pain intensity (P=0.002, Cohen’s d=2.241), pain interference with daily activities (P=0.002, Cohen’s d=2.606), and sleep (P=0.05, Cohen’s d=3.187). There were also statistically significant differences with small to medium effect sizes in pain self-efficacy (P=0.003, Cohen’s d=-0.492), overall psychological distress (P=0.01, Cohen’s d=0.414), anxiety (P=0.05, Cohen’s d=0.343) and depression (P=0.01, Cohen’s d=0.503).
Barriers and facilitators to implementation in the compensation context were identified.
Injured worker-centred pain education sessions provided by APA titled pain physiotherapists had worthwhile outcomes and were acceptable to all stakeholders.
This study provides further evidence to support a broadening of physiotherapist lead pain education within a compensable healthcare context. However greater streamlining of implementation processes is recommended.
