Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
Pain Med. 2009 Nov;10(8):1378-88. doi: 10.1111/j.1526-4637.2009.00738.x.
Predict long-term adjustment (pain intensity, pain-related catastrophizing, and pain-related disability) from socio-demographic, claim process, and post-settlement adjustment variables in a cohort of 374 Workers' Compensation low back claimants.
Age- and gender-matched subsamples of African Americans and Caucasians were randomly selected for long-term follow-up (6 years post-settlement) from a larger, existing cohort of Workers' Compensation low back claimants in Missouri. Computer-assisted telephone interviews were used to assess pain, catastrophizing, and disability. Path analysis and logistic regression analysis were used to predict long-term adjustment from socio-demographic variables (race, gender, age, and socioeconomic status), Workers' Compensation claim process variables (surgery, diagnosis, claim duration, treatment costs, settlement awards, and disability rating), and adjustment at baseline.
Poorer long-term adjustment (higher levels of pain, catastrophizing, and pain-related disability) was significantly predicted by relatively poorer adjustment at baseline, lower socioeconomic status, and African American race. African American race associations were also mediated through lower socioeconomic status. Higher levels of occupational disability, as measured by long-term rates of unemployment and social security disability, were also predicted by African American race (in addition to age and claim process factors).
Long-term adjustment to low back pain in this cohort of Workers' Compensation claimants was stable, relative to short-term adjustment soon after settlement. Long-term adjustment was worse for people of lower socioeconomic status, particularly for economically disadvantaged African Americans, suggesting the possibility of race- and class-based disparities in the Workers' Compensation system.
从社会人口统计学、理赔过程和理赔后调整变量中预测 374 名工人赔偿腰痛索赔者队列的长期调整（疼痛强度、与疼痛相关的灾难化和与疼痛相关的残疾）。
从密苏里州更大的工人赔偿腰痛索赔者现有队列中，按年龄和性别匹配，随机选择非裔美国人和白种人亚组进行长期随访（理赔后 6 年）。使用计算机辅助电话访谈评估疼痛、灾难化和残疾。路径分析和逻辑回归分析用于从社会人口统计学变量（种族、性别、年龄和社会经济地位）、工人赔偿理赔过程变量（手术、诊断、理赔期限、治疗费用、理赔裁决和残疾评级）以及基线调整预测长期调整。
相对较差的基线调整、较低的社会经济地位和非裔美国人种族显著预测了较差的长期调整（更高水平的疼痛、灾难化和与疼痛相关的残疾）。非裔美国人种族的关联也通过较低的社会经济地位中介。职业残疾程度较高，如长期失业率和社会保障残疾率较高，也被非裔美国人种族（除了年龄和理赔过程因素）预测。
在本工人赔偿腰痛索赔者队列中，与理赔后不久的短期调整相比，长期调整是稳定的。社会经济地位较低的人长期调整较差，特别是经济处于不利地位的非裔美国人，这表明工人赔偿制度中存在种族和阶级差异的可能性。
