Adams Jacqueline H, Williams Amanda C de C
Occupational Therapy, Human Focus Return To Work, Lancastrian Office Centre, Talbot Road, Old Trafford, Manchester M32 OFP, United Kingdom.
J Occup Rehabil. 2003 Jun;13(2):91-106. doi: 10.1023/a:1022599731391.
Chronic upper limb pain often causes work loss, and return to work after pain management is disappointingly low. This study aimed to identify patient characteristics and beliefs contributing to return to work or nonreturn. A total of 103 (66%) ex-patients with CULP, who had completed a pain management program, agreed to telephone interview. Participants were predominantly female and in middle years; 53.4% were working part- or full-time. Their responses were related to pre- and posttreatment psychological and disability variables. Those patients who had returned to work, compared to those who had not, were more likely to have been working shortly before treatment (chi 2 = 36.77, p < 0.00001). They were more psychologically robust and were more confident of managing pain (t = 4.55, p < 0.001), and catastrophized less (t = 2.21, p = 0.029). They were also more optimistic about being capable of work (u = 566, p < 0.0001) and of overcoming obstacles to work (u = 889, p = 0.0103). Workers and nonworkers were not differentiated by expectations of support from their immediate line manager, although nonworkers doubted support available from colleagues. Overall, despite generalization of pain management strategies in nonwork activity, return to work depended on specific beliefs concerning work-relevant strategies.
慢性上肢疼痛常常导致工作缺勤，而在疼痛管理后重返工作岗位的比例低得令人失望。本研究旨在确定有助于重返工作岗位或未能重返的患者特征和信念。共有103名（66%）完成疼痛管理项目的慢性上肢疼痛门诊患者同意接受电话访谈。参与者主要为中年女性；53.4%的人从事兼职或全职工作。他们的回答与治疗前后的心理和残疾变量有关。与未重返工作岗位的患者相比，重返工作岗位的患者在治疗前不久更有可能仍在工作（卡方=36.77，p<0.00001）。他们心理上更强健，对疼痛管理更有信心（t=4.55，p<0.001），灾难化程度更低（t=2.21，p=0.029）。他们对能够工作（u=566，p<0.0001）和克服工作障碍（u=889，p=0.0103）也更乐观。在职者和非在职者在对直属上级支持的期望方面没有差异，不过非在职者怀疑同事能提供的支持。总体而言，尽管疼痛管理策略在非工作活动中得到了推广，但重返工作岗位取决于与工作相关策略的特定信念。
