The sense-of-coherence and the capability of performing daily occupations in persons with chronic pain

Article type: Research Article

Authors: Marie-Louise Schult, ^; | Ingrid S\"oderback, ^; | Karen Jacobs,

Affiliations: Rehabilitation Clinic, Karolinska Hospital, Stockholm, Sweden | Department of Public Health and Caring Sciences, Section of Caring Science, Uppsala University, Uppsala, Sweden | Department of Occupational Therapy, Sargent College of Allied Health Professions, Boston, MA, USA

Note: [] Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, S-75183 Uppsala, Sweden. Tel.: +46 18 471 3487; E-mail: [email protected]

Abstract: {\it Objectives:} It may be helpful for occupational therapists who promote enabling occupations among persons with chronic pain, to understand the relationship between the persons feelings of meaningfulness, comprehensibility and manageability in life and their capability to perform daily occupations. {\it Aim:} The aim of this study was to describe and investigate how these concepts of person and occupational performance of 27 daily occupations in terms of ``effort'', ``inconvenience'', ``avoidance'', ``give up'', ``frequency'' and ``satisfaction'' were related to each other. {\it Design:} A prospective correlative study was conducted. {\it Method:} A consecutive series of eighty-four patients with chronic pain completed a structured interview and responded to the self-assessment instruments Sense-of-Coherence Scale (SOC-13) and Capability of Performing Daily Occupations (CPDO). {\it Results:} Weak but significant correlation (p < 0.05) were found between the SOC-13 sub-scale ``manageability'' and the specific occupations ``physical exercise / training'' (r = - 0.24), ``climb stairs'' (r = - 0.27) ``social activity'' (r= - 0.25) and ``wash the laundry'' (r = - 0.30), as well as between the SOC-13 sub-scale ``meaningfulness'' and the CPDO occupations ``grocery shopping'' (r = -0.22), ``performing meals'' (r = - 0.24), and ``wash the laundry'' (r = - 0.31) and the CPDO question ``frequency of performing occupations'' r = -0.22). The participants' mean value (mean = 58) of SOC-13 was below the other populations represented in a literature review. The mean values for CPDO (3.4--4.3) (optimal score is zero) showed that the participants perceived themselves having activity limitations concerning performance of daily occupations, and the performance area of work productive activities were experienced as more disabling. The degree to which the participants perceived themselves having a strong sense of coherence or being disabled by pain varied greatly both for the results of SOC-13 ( range 32--90 points) and CPDO (range 1.1--7.8 points). {\it Conclusion:} The expected significant relationship between a person's sense of coherence and the performance of daily occupations was partly verified with weak significant correlations. In clinical practice the assessment instruments are suggested to be of value in rehabilitation clinics for occupational therapists who work with people with chronic pain.

Keywords: Activities of Daily Living, coping, occupational therapy, rehabilitation, self-assessment

Journal: Work, vol. 15, no. 3, pp. 189-201, 2000