Monash Centre for Occupational and Environmental Health, Monash University, Melbourne/Burwood, Australia.
Department of Management, Deakin University, Burwood, Australia.
J Occup Rehabil. 2019 Sep;29(3):660-667. doi: 10.1007/s10926-018-09824-z.
Purpose This study investigated the association between return to work self-efficacy (RTW-SE) and sustained return to work (RTW) at two different time points, over a 12-month period. The primary objective of the study was to examine if the relationship between RTW-SE and a sustained RTW changed over the RTW timeline. Methods This study used survey responses from a longitudinal cohort of n = 410 workers' compensation claimants with either an upper-body musculoskeletal injury or a psychological injury. A path analysis tested the associations between RTW-SE and a sustained RTW at two time-points. A Wald χ test compared nested models to determine if the association changed over time. Results RTW-SE measured at time- point 1 (T1) was associated with a sustained RTW at time-point two (T2) (β = 0.24, P < 0.05) but no association was found between RTW-SE at T2 and a sustained RTW at time-point three (T3) (β = 0.017, n.s.). Model comparisons revealed significant differences in the associations between RTW-SE and a sustained RTW, with the relationship being stronger in the early phase of RTW compared to the latter phase (χ = 5.002, p = 0.03). Conclusions The results indicate that RTW-SE at 4-6 months post-injury is important for a sustained RTW 6-months later although RTW-SE at 10-12 months post-injury had a negligible association over the same duration. Further research should investigate whether these findings generalize to other populations and what factors other than RTW-SE are associated with RTW in the later stages of the RTW process.
本研究旨在探讨在 12 个月的时间内，两个不同时间点的恢复工作自我效能（RTW-SE）与持续恢复工作（SRTW）之间的关联。研究的主要目的是检验 RTW-SE 与 SRTW 之间的关系是否随 RTW 时间线而变化。
本研究使用了一项纵向队列研究的调查回复，该队列由 410 名工人赔偿索赔者组成，他们要么患有上肢肌肉骨骼损伤，要么患有心理损伤。路径分析检验了在两个时间点的 RTW-SE 与 SRTW 之间的关联。Wald χ检验比较嵌套模型，以确定关联是否随时间而变化。
在时间点 1（T1）测量的 RTW-SE 与时间点 2（T2）的 SRTW 相关（β=0.24，P<0.05），但在 T2 测量的 RTW-SE 与 T3 的 SRTW 之间未发现关联（β=0.017，n.s.）。模型比较显示，RTW-SE 和 SRTW 之间的关联存在显著差异，在 RTW 的早期阶段与后期阶段相比，这种关系更强（χ=5.002，p=0.03）。
结果表明，受伤后 4-6 个月的 RTW-SE 对于 6 个月后持续的 RTW 很重要，尽管受伤后 10-12 个月的 RTW-SE 在同一时间段内与 RTW 的关联微不足道。进一步的研究应该调查这些发现是否适用于其他人群，以及除了 RTW-SE 之外，哪些因素与 RTW 过程的后期阶段有关。
