PURPOSE: The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. METHODS: The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10,000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1,849 persons and was answered by 1,448 respondents (study group n = 1,305, control group n= 117). Results: Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. Conclusions: As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.
The overall aim of this thesis was to describe (1) needs for occupational therapy among persons with self-perceived activity limitations and/or participation restrictions due to long-term/recurrent pain, and (2) treatment interventions in occupational therapy to meet demonstrated needs. The Liss’ model for assessing health care needs was used as a structural scheme. A randomly selected sample (n=10,000) from the Swedish general population aged 18-58 years was the foundation for the study population with and without pain. In addition, occupational therapists were included (n=109). Data collection was made by postal questionnaires. The results showed a prevalence of 26 % and an incidence rate of 0.07. Demographic characteristics of the sample were female gender, ages 40-58 years and fewer years of education than those without pain. Pain in shoulders/lower back of searing/aching/gnawing character was the most frequently reported. A majority of the respondents reported affective/emo-tional effects of pain mainly of depressive character and they had previously been on sick leave due to pain. Women reported higher frequencies of self-perceived activity limitations/ participation restrictions due to pain, more difficulties with intermediate ADL, perceived higher job demands and had longer sick leave than men. Men perceived poorer social support than did women. Needs for occupational therapy were reported mainly as a consequence of activity and temporal imbalance. High health care consumers reported higher frequencies of needs/problems than did low health care consumers. The main goals and interventions suggested by occupational therapists to meet the needs in pain management focused on increased knowledge of handling daily occupations with the purpose to reduce pain, maintain competence/improve performance of home maintenance, reduce consequences of pain and increase knowledge how to handle effects of pain.