Numerous recent studies have shown that perceptions of injustice are prevalent following occupational injury and increase the risk of delayed recovery. The emerging pattern of findings suggests that perceived injustice triggers a cascade of cognitive (i.e., rumination), emotional (anger, depression) and behavioural (i.e., activity withdrawal, medication overuse) reactions that can impede recovery. The adverse outcomes associated with high levels of perceived injustice include more severe and prolonged symptoms of pain, depression and post-traumatic stress symptoms, medication overuse, pronounced disability, and prolonged absence from work. Guided by previous research on post-injury perceptions of injustice, we have developed a brief virtual intervention referred to as ‘Managing Post-Injury Challenges’ or MPIC. MPIC is delivered by a psychologist, and combines elements of validation, motivational interviewing, acceptance and problem-solving. It is delivered concurrently with other treatments. The aim of the proposed study is to evaluate the feasibility and acceptability of MPIC as an intervention to reduce postinjury perceptions of injustice.
(1) to determine the degree to which individuals who have sustained a work-related musculoskeletal injury are willing to enrol in MPIC,
(2) to determine the proportion of participants who complete all 4 sessions,
(3) to determine the degree to which participants adhere to MPIC procedures,
(4) to determine whether participants are satisfied with the intervention,
(5) to determine whether MPIC yields meaningful reductions in perceived injustice, and
(6) to determine whether treatment-related reductions in perceived injustice predict reductions in pain and disability.
Perceived injustice can contribute to a trajectory increasing distress and disability associated with discontinuation of life role activities, progressive decline toward a sedentary lifestyle, and social isolation. Since perceived injustice is potentially modifiable, the increased suffering and disability to which it contributes might be preventable. The expected outcome of the proposed research is that perceptions of injustice will decrease through the course of the intervention, and that treatment-related reductions in perceived injustice will predict reductions in disability. By targeting perceived injustice, the proposed intervention holds promise of improving recovery outcomes of individuals with musculoskeletal injuries that are complicated by elevated perceptions of injustice.