Bennen, E. (2014) Case complexity of patients with chronic non-specific musculoskeletal pain: A Delphi and feasibility study. thesis, Human Movement Sciences.
Full text available on request.Abstract
Introduction: In the Netherlands the WPN (Workgroup Pain Rehabilitation Netherlands) levels are used to assess the case complexity of the patient with chronic non-specific musculoskeletal pain (CMP), but the criteria are descriptive and its differentiation and interrater reliability are low. The objective of this study is to develop a new concept for the assessment of case complexity. Methods: A three-round Delphi study among professionals/clinicians involved in multidisciplinary Pain Rehabilitation Programs (PRP) was performed to gain insight on the potentially most important factors which are assumed to influence functioning in patients with CMP. In the first round the professionals/clinicians were asked to list all potential factors contributing to case complexity from their perspective. In the second round the participants received the answers of the first round and were asked to select the 20 most important factors. Factors were clustered and the 10 most selected factors were sent to the participants. In the third round the participants were asked to rate the influence of the 10 factors on the case complexity and indicate how they normally would assess those factors. A complexity index was formed with the mean ratings of importance per factor as weights. The feasibility of the complexity index was tested in a subsequent pilot study on 16 patients with CMP with WPN level as gold standard. Results: A total of 166 factors was listed in the first round. Ten biopsychosocial factors were found to be most important. The mean ratings of influence range from 1.75 (Features of complaints) to 3.56 (Psychiatric Disorders) on a scale of 0 (no weight) to 4 (severe weight). The assessments for the 10 factors were all more based on clinical examination and reasoning than on measurement tools. In the pilot study, the correlation between the complexity index and the WPN levels was rs=.729 (p=.003) as assessed by the treatment team and rs=.630 (p=.069) as assessed by the rehabilitation specialists. Discussion/conclusion: Based on the results of the Delphi study, we have identified 10, mainly psychosocial, factors which are assumed to be important for the assessment of the case complexity of a patient with CMP. With these factors a complexity index was created which is associated with the WPN level, is easy to use and might provide a basis for structured assessment of case complexity. In science it can be used to investigate the influence of case complexity on the outcome of a treatment. Keywords: Chronic non-specific musculoskeletal pain, multidisciplinary pain rehabilitation program, case complexity, complexity index, Delphi method, feasibility
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Waterschoot, F.P.C. and Reneman, M.F. and Schiphorst Preuper, H.R. and Woude, L.H.V. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 29 Mar 2022 08:04 |
| Last Modified: | 29 Mar 2022 08:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3002 |
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