Rehabilitation of young immigrants in primary care. A comparison between two treatment models.

OBJECTIVE

To evaluate the effect on well-being and sickness certification of interviews and three dialogue sessions concerning ideas about pain in young immigrants suffering from longstanding, benign pain.

DESIGN

A randomized clinical four-week trial between two treatment groups.

SETTING

A primary health care centre, Stockholm, Sweden.

SUBJECTS: 92 persons, 25-45 years of age, on sick leave > 6 weeks.

MEASURES: Physical and psychiatric examinations and self-ratings of work ability and pain anxiety were made before and after the programme. Sick leave data were studied at three and eight-month follow-ups.

RESULTS

45 immigrants, mean age 38 years, mean sick leave 13 months, completed the programme. There were no significant differences in general or diagnostic data between the treatment groups. All had pain. Three-quarters reported pain anxiety. Nearly half had depressive disorders. Only ten persons had self-rated ability for part-time work. After the programme, there were significant differences in favour of the experimental group in number of participants with pain anxiety (p = 0.01), with diagnosed depression (p < 0.05), with self-rated work ability (p = 0.05), and in the number of participants who had returned to work at the eight-month follow-up (p < 0.05).

CONCLUSIONS

This study indicates that, for young immigrants suffering from long-standing benign pain, a structured dialogue with focus on concepts of pain may reduce pain anxiety and depressive mood, improve self-rated work ability, and increase the prospects of successful rehabilitation back to work.