Development and validation of a method to screen for co-morbid depression by non-behavioral health practitioners treating musculoskeletal pain

被引:2
作者
Matheson, Leonard N. [1 ,2 ]
Verna, Joe [1 ,3 ]
Saunders-Enright, Dawne [3 ]
Gherscovici, Ezequiel [4 ]
Kemp, Bryan [5 ]
Mayer, John [1 ]
机构
[1] Vert Mooney Res Fdn, San Diego, CA USA
[2] Epic Neurorehabil & Psychol Serv, 2388 Bloomington Ave, Chico, CA 95928 USA
[3] Spine & Sport, San Diego, CA USA
[4] Spine Principles LLC, Los Angeles, CA USA
[5] Rancho Los Amigos Natl Rehabil Ctr, Downey, CA USA
来源
WORK-A JOURNAL OF PREVENTION ASSESSMENT & REHABILITATION | 2020年 / 67卷 / 01期
关键词
Mental health; work disability; Older Adult Health and Mood Questionnaire; psychologically-informed practice; chronic pain rehabilitation; LOW-BACK-PAIN; WORK; SCALE; COMORBIDITY; PREVALENCE; DISABILITY; MANAGEMENT; ANXIETY; RETURN;
D O I
10.3233/WOR-203252
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
BACKGROUND: Although diagnosis and treatment of depressive illness is outside the scope of practice for non-behavioral health practitioners such as occupational therapists, physical therapists, kinesiotherapists, and chiropractors, it frequently is comorbid with painful musculoskeletal disorders such as low back pain and it negatively affects outcomes, including return to work. As psychologically-informed practice becomes more widely implemented without the immediate availability of behavioral health practitioners, safe and effective methods to screen for and appropriately triage depressive illness by nonbehavioral health practitioners are necessary. OBJECTIVES: To demonstrate the efficacy and validity of a method employed by non-behavioral health practitioners to screen for and appropriately triage musculoskeletal pain patients who also are experiencing depressive illness. METHODS: As part of a previously-published psychometric research study conducted in a community-based musculoskeletal pain rehabilitation program, a method was developed for nonbehavioral health practitioners to screen for and appropriately triage patients for co-morbid depressive illness, thus providing the current opportunity to examine the effects of depressive illness on work outcomes. The first step in the two-step process involves a 22-item questionnaire, providing scores used in the second step to triage for outside consultation with behavioral health practitioners. This paper describes the screening method and its application in an observational study of the impact of depressive illness on work outcomes. RESULTS: Among 156 consecutive patients who were presenting with musculoskeletal pain disorders to an outpatient rehabilitation program, 22.3% also were identified to have co-morbid clinical depression. The screening process allowed all patients to continue in the rehabilitation program. Those who were already receiving behavioral health care were encouraged to inform care providers of their participation in the program. Those who were not receiving behavioral health care were successfully triaged to care outside of the clinic. Depressive illness was found to affect success in the program, confirming the validity of the screening process for outpatient rehabilitation program participants experiencing chronic pain. CONCLUSIONS: A simple and effective depression screening process that triages patients without interruption of musculoskeletal treatment can be employed by nonbehavioral health practitioners. Because return to work outcomes were found to be negatively affected by depressive illness, this approach has the potential to improve overall program efficacy.
引用
收藏
页码:55 / 65
页数:11
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