Measuring the Impact of Injury to Enhance Recovery, Pam Garton, Managing Director of Abilita Services, Darwin, NT
- 1. Measuring the impact of injury to enhance recovery APS Consumer Forum 2011 Pam Garton Abilita Services www.abilita.net.au
- 2. “A biopsychosocial model which includes the patient as well as the illness….” George Engel, Science,1977 12 June 2011 2
- 3. BIO PSYCHO SOCIAL Diagnosis Thoughts RTW Surgery Beliefs Assess Medication Emotions Plan Physio Adjustment Coordinate Exercise 12 June 2011 3
- 4. Biopsychosocial Process PSYCHOLOGICAL • Fears, perceptions, BIO / expectations PHYSICAL • Blame, frustration • Pain • Low mood, anxiety. • De-conditioning • Med side-effects • Fatigue SOCIAL / WORKPLACE • Work incapacity • Loss of identity and roles at home and work. • Social isolation. 12 June 2011 4
- 5. What matters is the IMPACT of pain and injury on… Relationships Function Emotions Roles In the context of the person’s life. 12 June 2011 5
- 6. And the person’s responses to that IMPACT… And the INFLUENCE of those responses on recovery, pain and disability. 20 May 2011 6
- 7. How do we measure IMPACT and INFLUENTIAL factors Self-report questionnaire: Evidence based questions Sliding scale (1 to 6 or 10) provides numerical rating No need to re-tell story Informs treatment and rehabilitation needs Quantified, so can be re-measured. 12 June 2011 7
- 8. Abilita Assessment ABILITA REHABILITATION INDEX (ARI) • ARI: OMPSQ, PSEQ + 26 q. • Secure website. • Easy to use. • 15 mins to complete. • Self-report questionnaire. • Confidential responses • Triage - risk rating 1 to 4. • Factors amenable to change. • Immediate reports. • Repeatable. • Remote access available. 20 May 2011 8
- 9. Abilita Domains Pain: ratings, expectations Function: daily activities, exercise Emotions: distress, pain focus, blame Coping: active, passive, self-efficacy Confidence: control, optimism, identity Work Perceptions: expectations RTW, capacity Occupational Factors: worker & work risk factors 1 June 2011 9
- 10. CASE STUDY 1: Sophie - 24 years old • Referred 11 weeks post injury • Thoracic spine strain • Health professional • RTW 3 days per week • High reliance pain medication • Physiotherapy • Psychological counselling (distress and anger) 12 June 2011 10
- 11. 14 July 2011 11
- 12. BPS COACHING Individual or group Understanding pain Managing distress Skills and strategies Goals and choice 12 June 2011 12
- 13. 1 June 2011 13
- 14. 14 July 2011 14
- 15. How did the Abilita Questionnaire and Reports help Sophie? • Her responses to the questions were confidential. • Her responses were reported in meaningful domains. • The Initial Report delivered Bio-Psycho-Social clarity out of overwhelming confusion. (Insight & acceptance) • Sophie was then keen to learn new knowledge and strategies. (Engagement) • The Impact Report confirmed her progress and pathway forward. • Empowerment! 12 June 2011 15
- 16. CASE STUDY 2: Jenny - 51 years old • Referred 13 months post injury • Lumbar facet joint strain • Domestic Services Assistant • Unsuccessful RTW • Extensive work absence • Pain medication • Physiotherapy 12 June 2011 16
- 17. Initial Report: Jenny 1 June 2011 17
- 18. Impact Report: Jenny 20 May 2011 18
- 19. CASE STUDY 3: Chen - 47 years old • Referred 15 months post injury • Multiple injuries left leg • Tool setter • Unsuccessful RTW, job no longer available. • Extensive work absence. • First language - Mandarin 12 June 2011 19
- 20. IMPACT REPORT: Chen 20
- 21. REVIEW REPORT: Chen 21
- 22. Work Outcomes Average percentage reduction in Abilita score compared to average percent increase in work hours. 100 90 80 70 60 50 Mean %reduction ARI Mean %increase wk hrs 40 30 20 10 0 <26wks 26<wks<52 >52wks Attached Dettached 12 June 2011 22
- 23. We measure what matters. The impact of pain and disability, as reported by the person, matter. The influence of responses to that impact, matter. This knowledge leads to acceptance and empowerment. 20 May 2011 23
- 24. For further queries, discussion or debate please contact Pam Garton 08 89414200 [email protected]