Encouraging worker self-management strategies
Self-management strategies are an essential part of a management plan, particularly when dealing with persistent pain [1].
Self-management empowers a worker to become independent of health professionals, and fosters self-efficacy. Independence does not imply being symptom-free, but rather the ability to live a functional and productive life while managing symptoms if and when they arise [1].
This is achieved through a combination of education and the application of cognitive and behavioural strategies that assist the worker to become actively involved in their treatment, take control of their injury or pain, and reduce the amount of time required off work and the risk of a long-term disability [2,3].
From the outset of treatment, all health providers should apply basic self-management principles.
Basic self-management strategies:
- educating the worker about their injury, the expected recovery pathway, treatment goals (short and long term) and timeframes to achieve these treatment goals
- helping the worker develop specific, realistic, achievable and relevant goals focussed upon improving function and returning to occupational, social and recreational activities
- the use of positive encouragement to develop self-efficacy (the worker's confidence in themselves and their ability to perform certain activities), which may motivate the worker to engage in health promoting behaviours and adhere to treatment recommendations
- encouraging ‘pacing' of activities throughout the day – rather than doing more activity when in less pain, and little or nothing when pain is aggravated
- enquiring about barriers to undertaking pre-injury activities (for example, light exercise, returning to work, or resuming recreational pursuits) – this can be addressed by asking "Is there anything that prevents you from [……]"
- addressing fear avoidance (where it exists) (ie, beliefs such as "increased pain means I've made my injury worse, so I must avoid any activity that aggravates my pain") through education, reassurance and activity pacing
- addressing catastrophising (where it exists) (ie, thoughts such as "I can't cope with this… I will never get better") through education, reassurance and activity pacing.
Failure to empower a worker to become independent may result in dependency on passive treatment and/or medication (opiates/benzodiazepines), reinforce illness behaviour, and possibly result in the development of a chronic condition or persistent pain.
References
- Health Services Group. Clinical framework for the delivery of health services. Melbourne: Transport Accident Commission and WorkSafe Victoria July 2008.
- WorkCoverSA. Clinical framework: for the delivery of physiotherapy services to injured workers. Adelaide 2008.
- TRACsa Trauma Injury and Recovery. Clinical guidelines for best practice management of acute and chronic whiplash-associated disorders. Canberra: National Health and Medical Research Council; 2008.
Key principles for all health providers
- Maintaining a stepped approach to care
- Considering biopsychosicial factors
- Screening for risks of long term disability
- Encouraging worker self-management strategies
- Maintaining a focus on return to work
- Having an evidence-based approach
- Using outcome measures to assess functional goals
- Communicating with other parties
© 2012 WorkCover Corporation of South Australia
|
Accessibility
Updated: 07.03.2012
|
Privacy
|
Conditions of use
|
Email the Web Administrator
http://main.workcover.com/health-provider/key-principles-of-injury-management/encouraging-worker-self-management-strategies
