Musculoskeletal (MSK) disorders Musculoskeletal Diseases Musculoskeletal disorders
Conditions
Interventions
Motivational Interviewing (MI) is a client-centered practice focusing on patients’ intrinsic motivation for change whereby a health care provider guides the patient towards behavioural change by assis
Sponsors
Workers' Compensation Board of Alberta
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Workers’ compensation claimants with musculoskeletal injuries being treated at Millard Health Centre in Edmonton, Canada. Specific inclusion criteria for this study consist of the following: 1. Injured workers 18 years and older who have an open WCB-Alberta claim 2. Off work 3 to 12 months post injury 3. Not job attached or have experienced an unsuccessful gradual RTW 4. Participating in a provider-based RTW program with integrated vocational services 5. Not scheduled for surgery 6. No major psychological or psychiatric diagnosis (including severe depression, psychosis, brain injury or traumatic psychological injury)
Exclusion criteria
Exclusion criteria: 1. Injured workers less than 18 years old who have an open WCB-Alberta claim 2. Off work more than 12 months post injury 3. Have a job to return to 4. Not participating in a provider-based RTW program with integrated vocational services 5. Scheduled for surgery 6. Major psychological or psychiatric diagnosis (including severe depression, psychosis, brain injury or traumatic psychological injury)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Return-to-work outcomes and rehabilitation program outcomes will be compared between the two groups using appropriate statistical techniques. Work Disability Outcomes: The key outcome measures currently used in the rehabilitation programs at Millard Health include the percentage of clients who are no longer receiving wage replacements benefits. These are surrogate indicators of recovery and RTW, but are often used as outcome measures in studies of worker’s compensation claimants. We will obtain these outcomes for all claimants in our study to provide an indirect but meaningful indication of the proportion of claimants who RTW in both the intervention and control groups. The follow-up period for these measures will be 1,3, and 6 months after discharge from Millard Health. | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 11/01/2018: We will also evaluate changes in claimant self-reported readiness to return-to-work and expectations of return-to-work. Ambivalence and Readiness to Change: Each participant will complete the Readiness for Return to Work (RRTW) scale befor and after participating in rehabilitation, which will identify each claimant’s readiness for work by categorizing the workers into specific stages of change identified in the Transtheoretical Model of Change. These stages include precontemplation, contemplation, prepared for action (self-evaluative) and prepared for action (behavioural). The stages of change identified by this scale are consistent with the stages of change used in MI. The RRTW scale will allow us to determine the stage of change each claimant is in to help identify ambivalence about RTW and improvements in this psychological state. Claimants who have reduced ambivalence at the end of rehabilitation are anticipated to progress within the stages. Completing the RRTW scale as part of this study will also provide an opportunity to determine the reliability/validity of this scale in identifying the accurate stage of readiness for RTW for each participant and its potential utility in work rehabilitation. Work-Related Recovery Expectations: The RTW expectations questionnaire that will be used in this study was developed and tested at Millard Health by the lead investigator. It has previously demonstrated adequate internal consistency and has been shown to correlate moderately with measures of pain intensity and reported disability in patients with low back pain.11 It has also demonstrated some predictive validity in claimants with chronic low back pain.12 Subjects are asked to use a 5-point Likert scale (1=strongly disagree, 5=strongly agree) to rate their agreement with three statements about their likelihood of RTW. We anticipate that claimants who overcome ambivale | — |
Countries
Canada
Outcome results
None listed