Occupational Therapy Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Occupational Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Margo Kreger

Date of original Performance / Presentation

January 2025

Publication Date / Copyright Date

1-1-2025

Abstract

Complex regional pain syndrome (CRPS) is a secondary pain condition that occurs after an injury in the periphery and can be debilitating. This dissertation study explored The potential influences on quality of life in this population was explored in this dissertation study. Problem Statement: It is postulated that there is a bidirectional relationship between sleep and chronic pain, but minimal research has been focused specifically on the bidirectionality of sleep and CRPS. Additionally, a relationship is known between sleep disturbances and occupational engagement. Further, including occupational engagement in chronic pain interventions may influence sleep quality has been suggested by systematic reviews and meta-analyses. Although sleep disturbances in people diagnosed with CRPS has been identified, and relationships have been found between sleep and occupational engagement, there is little evidence available to help researchers understand the relationship of all three with each other related to quality of life. Furthermore, the role of occupational therapy in addressing sleep as an occupation and its influence on function in clients with CRPS has not been explored. The aim of this study was to analyze the predictive relationship of sleep, pain, and occupational engagement on quality of life in people diagnosed with CRPS. Methodology: The dissertation study is a prospective, cross-sectional survey design. Demographics were collected, and valid and reliable patient-reported outcome measures were used with participants. Descriptive statistics are reported, and linear regressions using SPSS 29.0 was used for the predictive analysis. Results: Findings show this sample was predominantly White, middle-aged, and female living in an urban area of the United States. Half of the sample reported a disability status, and almost 30% identified as being neurodivergent. For the primary research question, the coping and functional scales of the Patient-Reported Hamilton Inventory for CRPS (PR-HI-CRPS), the McGill-Short Form (MPQ-2) neuropathic subscale, and the PROMIS sleep subscale together significantly predicted quality of life. The secondary research question identified if each significant construct was predictive in isolation, and only function, coping, and neuropathic pain were significant. Conclusion: This investigator found that occupational engagement, pain, and sleep have an influence on each other and can predict the quality of life in people diagnosed with complex regional pain syndrome. The confluence of interventions addressing each of these predictor variables together may be an area of important future research in improving the quality of life in people diagnosed with CRPS.

Disciplines

Occupational Therapy

Keywords

complex regional pain syndrome; CRPS; occupational engagement; reflex sympathetic dystrophy; RSD; sleep

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