Heron-Delaney Michelle, Warren Jacelle, Kenardy Justin A
School of Psychology, Australian Catholic University, Brisbane, QLD, 4014, Australia.
Recover Injury Research Centre, The University of Queensland, Brisbane, Australia.
Injury. 2017 Jun;48(6):1120-1128. doi: 10.1016/j.injury.2017.03.012. Epub 2017 Mar 16.
Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC.
Participants were 194 claimants (63.4% female) within a common-law "fault-based" system from the UQ SuPPORT cohort who were working prior to their RTC. Participants were assessed at 6 months on a variety of physical and mental health measures and RTW status was determined at 2 years post-RTC. RTW rate was 78.4%.
Univariate predictors of NRTW included being the driver or passenger, having a prior psychiatric diagnosis, high disability level, low mental or physical quality of life, predicted non-recovery, high pain, low function, high expectations of pain persistency, low expectations about RTW, having a psychiatric diagnosis, elevated depression or anxiety. The final multivariable logistic regression model included only two variables: disability level and expectations about RTW. Seventy-five percent of individuals who will not RTW by 2 years can be identified accurately at an early stage, using only these two predictors.
The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW.
在道路交通事故(RTC)中受伤的个体面临长期健康问题和无法重返工作岗位(NRTW)的风险增加。确定NRTW的预测因素对于开发筛查工具以识别高危个体并提供早期针对性干预以成功重返工作岗位(RTW)是必要的。本研究的目的是确定能够预测哪些个体在RTC中受到轻度或中度损伤后无法RTW的因素。
参与者为来自昆士兰大学支持队列的普通法“基于过错”系统中的194名索赔人(63.4%为女性),他们在发生RTC之前有工作。在6个月时对参与者进行了各种身心健康测量,并在RTC后2年确定了RTW状态。RTW率为78.4%。
NRTW的单变量预测因素包括是司机或乘客、有先前的精神疾病诊断、残疾程度高、心理或生理生活质量低、预测无法康复、疼痛程度高、功能低、对疼痛持续性的高期望、对RTW的低期望、有精神疾病诊断、抑郁或焦虑程度升高。最终的多变量逻辑回归模型仅包括两个变量:残疾程度和对RTW的期望。仅使用这两个预测因素,75%在2年内无法RTW的个体可以在早期被准确识别。
结果很有前景,因为它们表明,掌握两个易于获得的因素的信息,可以准确预测哪些人需要额外支持以促进RTW。