Date Presented 03/26/20
Lifestyle Redesign is a manualized OT intervention that has shown significant clinical benefits for people with chronic pain. This occupation-based intervention has been translated, adapted in French, and tested with French-Canadian patients in the context of the Canadian healthcare system.
Primary Author and Speaker: Émilie Lagueux
Additional Authors and Speakers: Julie Masse
Contributing Authors: Mélanie Levasseur, Yannick Tousignant-Laflamme, Andréa Dépelteau, Raphaël Pagé, Anne-Marie Pinard, Marie-Hélène Lévesque
PURPOSE: Lifestyle Redesign® is an occupational therapy intervention aiming to support the development of health-promoting daily routines, to facilitate engagement in meaningful activities as well as to optimize occupational participation (Clark et al., 1997; 2012). This intervention has been initially developed in California for seniors. Recently, a research team translated, adapted and validated the training manual and the Lifestyle Redesign® intervention within the context of Quebec with seniors with and without disabilities (Levasseur et al., in press). Lifestyle Redesign® also has demonstrated significant improvements in occupational performance, physical health and well-being with adults living with chronic pain (Simon & Collins, 2017). Yet, there is no French-Canadian adaptation of this intervention. Thus, the objectives of this project were to translate, adapt and experiment the French-Canadian version of the Lifestyle Redesign® for chronic pain management.
DESIGN : A pre-experimental proof-of-concept study including quantitative pre-intervention (T0) and post-intervention (T1) measures was conducted in two pain management clinics. To be included in the study, individuals were required to: 1) be 18 years of age and older; 2) present a diagnosis of fibromyalgia syndrome for more than six months; 3) be able to speak, read and understand French; and 4) agree to participate in six group sessions and three individual meetings over a period of 13 weeks.
METHOD: This intervention will be adapted to the Quebec context through a transcultural validation process. To evaluate the effect quantitative data will be collected using T0 and T1 via self-administered questionnaires. Outcomes include occupational engagement (Engagement in Meaningful Activities Survey), life balance (Life Balance Inventory), quality of life (12-Item Short Form Health Survey), pain and physical function (Brief Pain Inventory), impact of fibromyalgia (Fibromyalgia Impact Questionnaire), anxiety and moods (Hospital Anxiety and Depression), global impression of change (Patient Global Impression of Change), insomnia (Insomnia Severity Index) and self-efficacy (Self-Efficacy for Management of Chronic Disease). According to the results, non-parametric tests (Wilcoxon signed-rank tests; asymmetric distribution) will be performed.
PRELIMINARY RESULTS : The intervention is underway (March to June 2019). Fifteen women (mean age: 48.63±10.12) with fibromyalgia are participating in the intervention. The average duration of fibromyalgia is 12±6.89 years. At baseline, participants perceive their engagement in meaningful activities as being low and live an occupational imbalance. Their average pain level is of 5±1.71/10. Complete results will be presented at the AOAT 2019 conference.
CONCLUSION: This original, innovative and evidence-based intervention will support the development and implementation of exemplary occupational therapy practice promoting sustainable lifestyles and successful pain management. This project is a critical first step in enabling the research team to conduct a larger study on the intervention’s implementation and effects.
References
Clark, F.A., Azen, S.P., Zemke, R., Jackson, J.M., Carlson, M.E., Mandel, D., Hay, J., Josephson, K., Cherry, B., Hessel, C., Palmer, J., Lipson, L. Occupational therapy for independent-living older adults: A randomized controlled trial. Journal of American medical association. 1997;278(16):1321-1326.
Clark, F., Jackson, J.M., Carlson, M., Chuo, C., Cherry, B.J., Jordan-Marsh, M., Knight, B., Mandel, D., Blanchard, J., Granger, D., Wilcox, R., Lai, M., White, B., Hay, J., Lam, C., Marterella, A., Azen, S. Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: Results of the Well Elderly 2 Randomised Controlled Trial. Journal of Epidemiology and Community Health. 2012;66:782-790. doi: 10.1136/jech.2009.099754.
Levasseur, M., Filiatrault, J., Larivière, N., Trépanier, J., Lévesque, M.-H., Beaudry, M., Parisien, M., Provencher, V., Couturier, Y., Champoux N., Corriveau, H., Carbonneau, H., Sirois, F. Influence of Lifestyle Redesign® on health, social participation, leisure and mobility of older French-Canadians. American Journal of Occupational Therapy. In Press.
Simon, U., Collins, C.E.R. Lifestyle redesign® for chronic pain management: A retrospective clinical efficacy study. American Journal of Occupational Therapy. 2017;71(4). doi: 10.5014/ajot.2017.025502.
