1. Measuring the impact of
injury to enhance recovery
APS Consumer Forum 2011
Pam Garton
Abilita Services
www.abilita.net.au

2. “A biopsychosocial model
which includes the patient as
well as the illness….”
George Engel, Science,1977
12 June 2011 2

3. BIO PSYCHO SOCIAL
Diagnosis Thoughts
RTW
Surgery Beliefs
Assess
Medication Emotions
Plan
Physio Adjustment
Coordinate
Exercise
12 June 2011 3

4. Biopsychosocial Process
PSYCHOLOGICAL
• Fears, perceptions,
BIO / expectations
PHYSICAL
• Blame, frustration
• Pain
• Low mood, anxiety.
• De-conditioning
• Med side-effects
• Fatigue SOCIAL / WORKPLACE
• Work incapacity
• Loss of identity and roles at
home and work.
• Social isolation.
12 June 2011 4

5. What matters is the IMPACT of pain and
injury on…
Relationships
Function
Emotions
Roles
In the context of the person’s life.
12 June 2011 5

6. And the person’s responses to that
IMPACT…
And the INFLUENCE of those responses on
recovery, pain and disability.
20 May 2011 6

7. How do we measure IMPACT and
INFLUENTIAL factors
Self-report questionnaire:
 Evidence based questions
 Sliding scale (1 to 6 or 10) provides numerical
rating
 No need to re-tell story
 Informs treatment and rehabilitation needs
 Quantified, so can be re-measured.
12 June 2011 7

8. Abilita Assessment
ABILITA REHABILITATION INDEX (ARI)
• ARI: OMPSQ, PSEQ + 26 q.
• Secure website.
• Easy to use.
• 15 mins to complete.
• Self-report questionnaire.
• Confidential responses
• Triage - risk rating 1 to 4.
• Factors amenable to change.
• Immediate reports.
• Repeatable.
• Remote access available.
20 May 2011 8

9. Abilita Domains
Pain: ratings, expectations
Function: daily activities, exercise
Emotions: distress, pain focus, blame
Coping: active, passive, self-efficacy
Confidence: control, optimism, identity
Work Perceptions: expectations RTW, capacity
Occupational Factors: worker & work risk factors
1 June 2011 9

10. CASE STUDY 1: Sophie - 24 years old
• Referred 11 weeks post injury
• Thoracic spine strain
• Health professional
• RTW 3 days per week
• High reliance pain medication
• Physiotherapy
• Psychological counselling (distress and anger)
12 June 2011 10

11. 14 July 2011 11

12. BPS COACHING
Individual or group
Understanding pain
Managing distress
Skills and strategies
Goals and choice
12 June 2011 12

13. 1 June 2011 13

14. 14 July 2011 14

15. How did the Abilita Questionnaire and
Reports help Sophie?
• Her responses to the questions were confidential.
• Her responses were reported in meaningful domains.
• The Initial Report delivered Bio-Psycho-Social clarity
out of overwhelming confusion. (Insight & acceptance)
• Sophie was then keen to learn new knowledge and
strategies. (Engagement)
• The Impact Report confirmed her progress and
pathway forward.
• Empowerment!
12 June 2011 15

16. CASE STUDY 2: Jenny - 51 years old
• Referred 13 months post injury
• Lumbar facet joint strain
• Domestic Services Assistant
• Unsuccessful RTW
• Extensive work absence
• Pain medication
• Physiotherapy
12 June 2011 16

17. Initial Report: Jenny
1 June 2011 17

18. Impact Report: Jenny
20 May 2011 18

19. CASE STUDY 3: Chen - 47 years old
• Referred 15 months post injury
• Multiple injuries left leg
• Tool setter
• Unsuccessful RTW, job no longer
available.
• Extensive work absence.
• First language - Mandarin
12 June 2011 19

20. IMPACT REPORT: Chen
20

21. REVIEW REPORT: Chen
21

22. Work Outcomes
Average percentage reduction in Abilita score compared to average percent
increase in work hours.
100
90
80
70
60
50 Mean %reduction ARI
Mean %increase wk hrs
40
30
20
10
0
<26wks 26<wks<52 >52wks Attached Dettached
12 June 2011 22

23. We measure what matters.
The impact of pain and disability, as
reported by the person, matter.
The influence of responses to that
impact, matter.
This knowledge leads to acceptance
and empowerment.
20 May 2011 23

24. For further queries, discussion or
debate please
contact Pam Garton
08 89414200
pam.garton@abilita.net.au