1. Professional Status of Persistent Spinal Pain Syndrome Patients after Spinal Surgery (PSPS-T2): What Really Matters? A Prospective Study Introducing the Concept of 'Adapted Professional Activity' Inferred from Clinical, Psychological and Social Influence
- Author
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Pierre Pries, Delphine Rannou, Lisa Goudman, Philippe Page, Amine Ounajim, Géraldine Brumauld de Montgazon, Simon Teyssedou, Laure Poupin, Philippe Cornet, Yassine Abdollah Moufid, Sandrine Baron, Elodie Charrier, Bertille Lorgeoux, Cecile Swennen, Kevin Nivole, Manuel Roulaud, Romain David, Pierre François Descoins, Philippe Rigoard, Brigitte Roy-Moreau, Maxime Billot, Tanguy Vendeuvre, Nicolas Naiditch, Maarten Moens, Nelly Grimaud, Supporting clinical sciences, Neurosurgery, Pain in Motion, Neuroprotection & Neuromodulation, Radiology, prismatics (PRISMATICS), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Strasbourg (UNISTRA), Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Sorbonne Université - Département de médecine générale, Sorbonne Université (SU), Hôpital Saint-Louis de La Rochelle (CH La Rochelle), Centre hospitalier Nord des Deux Sèvres, ELSAN Polyclinique Majorelle, Institut Pprime (PPRIME), and Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Mediation (statistics) ,medicine.medical_specialty ,unemployment ,Hospital Anxiety and Depression Scale ,Article ,social workers ,surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine ,inference in medicine ,030212 general & internal medicine ,Failed Back Surgery Syndrome ,Prospective cohort study ,social factors ,Social influence ,Social work ,business.industry ,social gradient ,Chronic pain ,General Medicine ,medicine.disease ,Mental health ,professional status ,Oswestry Disability Index ,Anesthesiology and Pain Medicine ,Physical therapy ,Medicine ,business ,chronic pain ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030217 neurology & neurosurgery - Abstract
Persistent Spinal Pain Syndrome Type 2 (PSPS-T2) represents a main cause of work disruption. Beyond its societal consequences, occupational inactivity is responsible for a major decrease in physical/mental health in individuals but remains poorly analyzed. We designed a study to prospectively examine Professional Status (PS) evolution and its association with key bio-psychological markers. Data from 151 consecutively included working-age PSPS-T2 patients were analyzed to determine the proportion of professional inactivity and the relationships between PS and Social Gradient of Health (SGH), Numeric Pain Rating Scale (NPRS), EuroQol 5-Dimensional 5-Level (EQ-5D-5L), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), and Fear-Avoidance Belief Questionnaire work subscale (FABQ-W). Despite optimized medical management, 73.5% of PSPS-T2 patients remained inactive after 1 year of follow-up/p = 0.18. Inactive patients presented a low SGH/p = 0.002, higher NPRS/p = 0.048, lower EQ-5D-5L/p <, 0.001, higher ODI/p = 0.018, higher HADS-D/p = 0.019 and higher FABQ-W/p <, 0.001. No significant mediation effect of FABQ-W on SGH consequences regarding PS was observed in our structural model/p = 0.057. The link between unemployment and bio-psycho-social pain dimensions appears bidirectional and justifies intense collaboration with social workers. Optimizing therapeutical sequencing towards personalized professional plans implies restoring “Adapted Physical Function” as an initial goal, and tailoring an “Adapted Professional Activity”, matching with patient expectations and capabilities, as a final objective.
- Published
- 2021