PATIENT PARTICIPATION AND PSYCHOLOGICAL FACTORS IN MUSCULOSKELETAL PAIN REHABILITATION

Abstract

This chapter includes recent research concerning patient participation and psychological factors in musculoskeletal pain rehabilitation. Patient participation can be identified as an individualized process, as a patient–healthcare professional relationship and may contain both physical activities and cognitive processes. This may lead to a working partnership between the patient and their healthcare professionals, in decisions on assessment, goal setting, planning, implementation and evaluation a mutual agreement about implementation of treatment. Today, patient participation is important within patient-centred medicine and for high-quality healthcare. This will be described in the first part of this chapter.

The second part will contain a description and discussion of the importance of psychological factors for positive treatment outcomes in pain rehabilitation and the need of a holistic perspective on pain problems. We will describe and explain why different psychological factors are important to consider in pain rehabilitation, such as each patient´s: 1) Expectations on pain treatment and motivation, 2) Self-efficacy, thoughts, self-reflection and self-confidence as well as 3) Coping with pain and catastrophizing. In addition, psychological factors related to patient participation will be described.

To conclude, psychological factors are important to patient participation in pain rehabilitation, as well as to treatment outcomes of pain rehabilitation. The psychological factors that have an impact on results in pain rehabilitation are also emphasized in patient participation to a high extent. Dimensions of patient participation have been found to associate with treatment adherence and results in pain rehabilitation, as well as with health outcomes. It may be necessary to provide a patient – healthcare interaction that include a patient’s active participation through enhancing patient’s motivation, self-efficacy, and coping, to gain positive treatment outcomes.