Publications by authors named "Fiona Aanesen"

6 Publications

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Fidelity of a Motivational Interviewing Intervention for Improving Return to Work for People with Musculoskeletal Disorders.

Int J Environ Res Public Health 2021 09 30;18(19). Epub 2021 Sep 30.

Nidelv Community Mental Health Centre, Department of Mental Health, Trondheim University Hospital, P.O. Box 3250, 7006 Trondheim, Norway.

The objective of this study was to conduct a fidelity evaluation of a motivational interviewing (MI) intervention delivered by social insurance caseworkers, in a three-arm randomized controlled trial (RCT) for improving return to work for people on sick leave with musculoskeletal disorders. The caseworkers received six days of MI training, including an intervention manual prior to the trial onset, as well as supervision throughout the trial. The caseworkers recorded 21 MI sessions at regular intervals during the trial. An independent MI analysis center scored the recordings using the MI treatment integrity code (MITI 4). In addition, three experienced MI trainers assessed the adherence to the MI intervention manual on a 1-4 Likert scale and MI competence. Total MITI 4 mean scores were at for two components (global technical, mean 3.0; SD 0.6 and the reflections/questions ratio, mean 1.1; SD 0.2) and for two components (global relational, mean 3.2; SD 0.7 and complex question, mean 34.0; SD 21.2). The MI trainers' assessment showed similar results. The mean adherence score for the MI sessions was 2.96 (SD 0.9). Despite delivering a thorough course and supervision package, most of the caseworkers did not reach proficiency levels of good MI competence during the study. The fidelity evaluation showed that a large amount of training, supervision and practice is needed for caseworkers to become competent MI providers. When planning to implement MI, it is important that thorough consideration is given regarding the resources and the time needed to train caseworkers to provide MI in a social insurance setting.
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http://dx.doi.org/10.3390/ijerph181910324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507704PMC
September 2021

Implementing a Stratified Vocational Advice Intervention for People on Sick Leave with Musculoskeletal Disorders: A Multimethod Process Evaluation.

J Occup Rehabil 2021 Oct 4. Epub 2021 Oct 4.

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.

Purpose To perform a process evaluation of a stratified vocational advice intervention (SVAI), delivered by physiotherapists in primary care, for people on sick leave with musculoskeletal disorders participating in a randomised controlled trial. The research questions concerned how the SVAI was delivered, the content of the SVAI and the physiotherapists' experiences from delivering the SVAI. Methods We used qualitative and quantitative data from 148 intervention logs documenting the follow-up provided to each participant, recordings of 18 intervention sessions and minutes from 20 meetings with the physiotherapists. The log data were analysed with descriptive statistics. A qualitative content analysis was performed of the recordings, and we identified facilitators and barriers for implementation from the minutes. Results Of 170 participants randomised to the SVAI 152 (89%) received the intervention and 148 logs were completed. According to the logs, 131 participants received the correct number of sessions (all by telephone) and 146 action plans were developed. The physiotherapists did not attend any workplace meetings but contacted stakeholders in 37 cases. The main themes from the recorded sessions were: 'symptom burden', 'managing symptoms', 'relations with the workplace' and 'fear of not being able to manage work'. The physiotherapists felt they were able to build rapport with most participants. However, case management was hindered by the restricted number of sessions permitted according to the protocol. Conclusion Overall, the SVAI was delivered in accordance with the protocol and is therefore likely to be implementable in primary care if it is effective in reducing sick leave.
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http://dx.doi.org/10.1007/s10926-021-10007-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489360PMC
October 2021

Study protocol for a randomized controlled trial of the effectiveness of adding motivational interviewing or stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders. The MI-NAV study.

BMC Musculoskelet Disord 2020 Jul 28;21(1):496. Epub 2020 Jul 28.

Department of Physiotherapy, OsloMet - Oslo Metropolitan University, St. Olavs plass, 0130, Oslo, Norway.

Background: Little research exists on the effectiveness of motivational interviewing (MI) on return to work (RTW) in workers on long term sick leave. The objectives of this study protocol is to describe a randomized controlled trial (RCT) with the objectives to compare the effectiveness and cost-effectiveness of usual case management alone with usual case management plus MI or usual case management plus stratified vocational advice intervention (SVAI), on RTW among people on sick leave due to musculoskeletal (MSK) disorders.

Methods: A multi-arm RCT with economic evaluation will be conducted in Norway with recruitment of 450 participants aged 18-67 years on 50-100% sick leave for > 7 weeks due to MSK disorders. Participants will be randomized to either usual case management by the Norwegian Labour and Welfare Administration (NAV) alone, usual case management by NAV plus MI, or usual case management by NAV plus SVAI. Trained caseworkers in NAV will give two MI sessions, and physiotherapists will give 1-4 SVAI sessions depending upon risk of long-term sick leave. The primary outcome is the number of sick leave days from randomization to 6 months follow-up. Secondary outcomes are number of sick leave days at 12 months follow-up, time until sustainable RTW (≥4 weeks of at least 50% of their usual working hours) at 12 months, proportions of participants receiving sick leave benefits during 12 months of follow-up, and MSK symptoms influencing health at 12 months. Cost-utility evaluated by the EuroQoL 5D-5L and cost-benefit analyses will be performed. Fidelity of the interventions will be assessed through audio-recordings of approximately 10% of the intervention sessions.

Discussion: The results from this RCT will inform stakeholders involved in supporting RTW due to MSK disorders such as staff within NAV and primary health care.

Trial Registration: ClinicalTrials.gov ID: NCT03871712 registered March 12th 2020.
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http://dx.doi.org/10.1186/s12891-020-03475-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385885PMC
July 2020

Risk assessment for prolonged sickness absence due to musculoskeletal disorders: protocol for a prospective cohort study.

BMC Musculoskelet Disord 2020 May 25;21(1):326. Epub 2020 May 25.

Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, St.Olavs plass, 0130, Oslo, Norway.

Background: Musculoskeletal disorders are the leading cause of sickness absence and disability pension in Norway. There is strong evidence that long-term sickness absence due to musculoskeletal disorders are associated with a reduced probability of return to work (RTW). A way to meet the economic and resource-demanding challenges related to individual follow-up of this group is to identify and treat those individuals with a high risk of prolonged sickness. The overall purposes of this project are 1) to determine the most accurate screening tool to identify people at a high risk of prolonged sickness absence due to an musculoskeletal disorder, and 2) to investigate severity of musculoskeletal health, health-related quality-of-life, health care utilization, and costs across different risk profiles in people on sick leave due to a musculoskeletal disorder.

Methods: People older than 18 years of age on sick leave for at least 4 weeks due to a musculoskeletal disorder will be invited to participate in this prospective observational cohort study conducted within the Norwegian Welfare and Labor Administration (NAV) system in collaboration with OsloMet - Oslo Metropolitan University. The main outcome is sickness absence, obtained from the NAV registry. Data on sickness absence will be retrieved prospectively in the period from study inclusion to 12 months follow-up, and retrospectively 12 months before inclusion in the study. Possible risk factors will be self-reported by the participants at inclusion while health care utilization will be retrieved from registry data. To conduct analyses including 15 to 20 predictor variables, we aim at including 500-600 people on sick leave due to musculoskeletal disorders.

Discussion: This study may provide tools that can be used to identify individuals with high risk of prolonged sickness absence and may thus be important from both a socioeconomic and individual perspective. Further, the study may give valuable insight into identification of sickness absence profiles and the associations between these profiles and musculoskeletal health status, health-related quality of life and costs.

Trial Registration: Retrospectively registered in ClinicalTrials.gov (NCT04196634, 27.11.2019).
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http://dx.doi.org/10.1186/s12891-020-03354-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249352PMC
May 2020

Motivational Interviewing and Return to Work for People with Musculoskeletal Disorders: A Systematic Mapping Review.

J Occup Rehabil 2021 03;31(1):63-71

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.

Purpose There is limited knowledge about motivational interviewing (MI) for people on sick leave with musculoskeletal disorders. Hence, our objective was to investigate what research on MI as a method to facilitate return to work for individuals who are on sick leave due to musculoskeletal disorders exists, and what are the results of the research? Methods We systematically searched MEDLINE, PsycINFO, EMBASE, Cochrane Library, CINAHL, Web of Science, Sociological Abstracts, Epistemonikos, SveMed + and DARE & HTA (covering 1983 to August 2019). We also searched the MINT bulletin and relevant web pages. Eligibility criteria: empirical studies investigating MI and return to work for people with musculoskeletal disorders. Two authors independently screened the records, critically appraised the studies and charted the data using a data extraction form. Results The searches identified 1264 records of which two studies were included. One randomized controlled trial (RCT) found no effect of MI on return to work for disability pensioner with back pain (n = 89, high risk of bias), while a cluster RCT found that MI increased return to work for claimants with chronic musculoskeletal disorders (n = 728, low risk of bias). Conclusions This mapping review identified a huge gap in research on MI to increase return to work for individuals with musculoskeletal disorders. Registration Current Research Information System in Norway, project id: 635823 ( https://app.cristin.no/projects/show.jsf?id=635823 ).
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http://dx.doi.org/10.1007/s10926-020-09892-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954732PMC
March 2021

Gender differences in subjective health complaints in adolescence: The roles of self-esteem, stress from schoolwork and body dissatisfaction.

Scand J Public Health 2017 Jun 6;45(4):389-396. Epub 2017 Apr 6.

1 Department of Health, Social and Welfare Studies, University College of Southeast Norway, Tønsberg, Norway.

Aims: The aims of this study were to examine subjective health complaints among Norwegian adolescents and assess the development of gender differences in subjective health complaints between age 14 and 16; to investigate whether self-esteem, stress from schoolwork or body dissatisfaction affected adolescents' subjective health complaints; and determine whether these factors could explain the excess of subjective health complaints among girls.

Methods: We used multiple linear regression analyses to analyse longitudinal survey data from 751 Norwegian adolescents at the ages of 14 and 16. The results from various cross-sectional and prospective analyses were compared.

Results: Girls reported more subjective health complaints than boys, and gender differences increased from age 14 to 16. Self-esteem and stress from schoolwork had cross-sectional and prospective associations with subjective health complaints. Stress from schoolwork at age 14 was also associated with changes in subjective health complaints from age 14 to 16. The cross-sectional mediation analyses indicated that self-esteem and stress from schoolwork accounted for 61% of the excess of subjective health complaints among girls at age 16. The same variables measured at age 14 accounted for 24% of the gender differences in subjective health complaints two years later. The investigated factors could not account for the increase in gender differences in subjective health complaints between ages 14 and 16.

Conclusions: The findings showed that self-esteem and stress from schoolwork were associated with subjective health complaints during adolescence. These factors could partially explain the excess of subjective health complaints among girls.
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http://dx.doi.org/10.1177/1403494817690940DOI Listing
June 2017
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