Demand and Ability Protocol – a method to use in pain rehabilitation to strengthen cooperation between care, employee and employer?
In the field of pain rehabilitation, multimodal rehabilitation is a successful method to improve patients' ability to achieve a well-functioning everyday life despite their pain and to improve their chances of returning to work. Traditionally, rehabilitation has a clear structure for how the staff, in interaction with the patient, should work with function, activity and participation, but there is still a lack of a clear structure for interventions aimed at work. The aim of this project is to create knowledge about how the Demand and Ability Protocol contributes to the work-oriented part of pain rehabilitation.
Details
- Funder: AFA
Project description
The aim is to investigate how patients who participate in pain rehabilitation and their manager experience a conversation based on the Demand and Ability Protocol (DAP) and to identify enabling and hindering factors for collaboration between caregiver, patient/employee and employer in cases where the DAP is used. Furthermore, the aim is to compare the rehabilitation outcome of people where DAP has been part of the rehabilitation with people who underwent pain rehabilitation before DAP was introduced.
The project consists of three sub-studies, two of which are qualitative studies and one which is a small register study. The qualitative sub-studies are based on two semi-structured interview guides developed by the research team. The third sub-study is based on data from the National Pain Rehabilitation Register (NRS). This sub-study includes historical controls and people who have attended a pain rehabilitation programme and completed DAP during the period 2019-2021.
Results from the project show that the structured approach to the conversation, the facilitator's support and the balance between manager and patient/employee were aspects that were highlighted as promoting factors for good dialogue and collaboration. Neither patient/employee nor manager described any major obstacles, but some patients/employees described feeling anxious before the dialogue. Both managers and patients/employees described that the conversation contributed to an increased insight into both the demands of the job and the employee's functional capacity and that the conversation strengthened their relationship and continued dialogue about work adaptations and return to work. The occupational therapists who facilitated the DAP dialogues felt that they contributed to rehabilitation and several stated that they wanted to continue using the tool after the project had ended. However, they felt that some questions were awkwardly worded and sometimes difficult to explain to the participants in the dialogue.
Furthermore, the results indicate that the pain rehabilitation programme, regardless of whether DAP is included as a component, can provide improvement on self-rated depression, current health status and sleep. However, no changes were observed in self-rated work ability, anxiety and life satisfaction (in general and in terms of employment situation). The analyses did not take into account possible influencing factors, such as gender and age.