University of Twente Student Theses


Kwaliteit van de intakeprocedure bij de revalidatie van chronische pijnpatiënten

Reefhuis, Elise (2010) Kwaliteit van de intakeprocedure bij de revalidatie van chronische pijnpatiënten.

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Abstract:This research has been conducted in order to answer the question which factors influence or play a role in assignments of patients to a specific treatment in Het Roessingh, using the current intake procedure. The answer will provide a better understanding of chronic pain, so that Het Roessingh and other revalidation centres can provide better indications for patients. The “zorg-op-maat” principle provides an important frame of reference for the current intake procedure. The “Zorg-op-maat” principle prescribes that patients should not receive a treatment that is more intensive than necessary. Treatments are divided by the intensity of the treatment, for which treatment criteria are drawn up as guidelines on how to assign patients. The assignments of patients is studied by using quantitative data, available from 2008 and 2009. Patients were included in the research if: data from a home sent questionnaire was available, permission was given by the patient on using the data for scientific research and the treatment assignment of the patient was known. Results show that some illness characteristics are different, statistical significant, between group treatments. Furthermore, there is an increase from polyclinical groups to clinical groups in duration of complaints, the number of life-events, use of medication, and a more extensive history in the medical circuit. Scores on the researched questionnaires (the SCL-90, MPI and the SF-36) differed statistical significant between group treatments; meaning that an increase or decrease in scores is shown, when heavier treatments are indicated. Variables that can significantly predict treatment indications are: (1) The amount of professionals that are visited in relation to current complaints, (2) contact with a psychologist, a social worker or a psychiatrist in the past and (3) restrictions in physical functioning. A model that takes into account the illness characteristics of patients and scores on the SF-36 (next to scores on the SCL-90), can predict indications for a polyclinical or semi clinical department more accurate than the SCL-90 alone. However this is not the case for the choice between a semi clinical or clinical department, in which the SCL-90 alone can predict indications. Within group treatments, the “zorg-op-maat” principle is applied accordingly. The “zorg-op-maat” principle is not applied to the individual treatments, because the study has not shown any differences between treatments on any variable. The differences on the researched variables in different group treatments, are to a large extent the same as the psychological, social and physical criteria from the current treatment criteria. However there are a couple important factors which could be added to the current treatment criteria. Therefore recommendations are to add (1) the history in the medical circuit and (2) restrictions in physical functioning as criteria and to write (3) criteria for the semi clinical individual treatment. (4) Cut off points for the SCL-90 to indicate patients to treatments should be set lower. Recommendations are scores up till 170 for the outpatient department and above 190 for the clinical department.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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