Cutler Robert B, Fishbain David A, Steele-Rosomoff Renee, Rosomoff Hubert L
Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Comprehensive Pain and Rehabilitation Center, South Shore Hospital, Miami, Florida, USA.
J Occup Rehabil. 2003 Dec;13(4):249-58. doi: 10.1023/a:1026220704974.
The extent to which baseline psychological measures, pain, and compensation status are related to admission and posttreatment functional capacity and employment outcome was investigated. Four pass/fail functional capacity tests based on the DOT (Dictionary of Occupational Titles) classification system and previously shown to be predictive of treatment outcome in chronic pain patients were analyzed in relation to baseline measures of depression, state and trait anxiety, and perceived stress. Statistical tests of all measures with employment level at admission to treatment, 1 month follow-up and at long-term follow-up were also performed. The results showed that pain level and/or compensation status were the primary predictors of functional capacity and employment status at follow-up. Admission functional capacity measures were also predictors of employment outcome. Depression scores at admission predicted some admission functional capacity results, however, psychological scores were not as significantly related to discharge functional capacity tests. One functional capacity test, the crouching test, was an independent predictor of short- and long-term employment outcome. Trait anxiety was the only psychological factor that was independently predictive of long-term employment outcome. In conclusion, these results suggest that psychological variables are related to measures of functional capacity measured at admission. However, psychological measures at admission are not good predictors of later functional capacity measures. Functional capacity measures are important predictors of follow-up employment outcome, but return to work cannot be predicted without taking pain into account.
研究了基线心理测量、疼痛和补偿状态与入院时及治疗后功能能力和就业结果之间的关联程度。分析了四项基于《职业名称词典》(DOT)分类系统的通过/失败功能能力测试,这些测试先前已被证明可预测慢性疼痛患者的治疗结果,并将其与抑郁、状态和特质焦虑以及感知压力的基线测量进行关联分析。还对治疗入院时、1个月随访和长期随访时所有测量指标与就业水平进行了统计检验。结果表明,疼痛程度和/或补偿状态是随访时功能能力和就业状态的主要预测因素。入院时的功能能力测量指标也是就业结果的预测因素。入院时的抑郁评分可预测一些入院时的功能能力结果,然而,心理评分与出院时的功能能力测试相关性并不显著。一项功能能力测试,即蹲伏测试,是短期和长期就业结果的独立预测因素。特质焦虑是唯一能独立预测长期就业结果的心理因素。总之,这些结果表明心理变量与入院时测量的功能能力指标相关。然而,入院时的心理测量指标并不能很好地预测后期的功能能力指标。功能能力测量指标是随访就业结果的重要预测因素,但不考虑疼痛就无法预测能否重返工作岗位。