Lin Fa-Chen, Lin Chia-Pin, Chuang Hung-Yi, Wu Tse-Wei, Huang Peng-Ju, Yang Chen-Cheng, Kuo Chao-Hung
Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Saf Health Work. 2025 Mar;16(1):90-96. doi: 10.1016/j.shaw.2024.12.003. Epub 2025 Jan 3.
Rates of return to work (RTW) after an occupational injury vary considerably according to a range of factors. Limited studies have been conducted on the specific correlation between RTW and functional assessments, including activities of daily living (ADL) and instrumental activities of daily living (IADL). This prospective cohort study aims to determine if a relationship exists between ADL/IADL and RTW among injured workers in Taiwan.
We recruited 162 workers who reported work-related injuries from January 2023 to May 2024. The assessment of ADL was evaluated using the Barthel Index, whereas IADL was evaluated using the Lawton Instrumental Activities of Daily Living scale. ADL/IADL were assessed immediately after the injury, at 3 and 6 months postinjury. Logistic regression models were used for the connections between ADL, IADL, and RTW while considering various confounding factors.
The mean ADL and IADL improved significantly at both 3 and 6 months postinjury. Logistic regression analysis indicated that IADL scores at 3 and 6 months postinjury were significantly linked to RTW. ADL scores lost significance after adjustment. Age was negatively associated with RTW, whereas sex and labor insurance status showed no significant association.
Short-term improvements in IADL are linked to successful RTW, rather than ADL for occupationally injured workers. Evaluations of IADL should be incorporated into rehabilitation plans to predict and improve RTW. Thorough rehabilitation approaches that address various aspects of functional abilities may be crucial to support successful RTW. Further studies are required to validate these results.
职业伤害后的重返工作岗位（RTW）率因一系列因素而有很大差异。关于RTW与功能评估之间的具体相关性，包括日常生活活动（ADL）和工具性日常生活活动（IADL），所开展的研究有限。这项前瞻性队列研究旨在确定台湾受伤工人的ADL/IADL与RTW之间是否存在关联。
我们招募了162名在2023年1月至2024年5月期间报告了与工作相关伤害的工人。ADL的评估使用巴氏指数，而IADL的评估使用洛顿工具性日常生活活动量表。在受伤后、受伤后3个月和6个月时对ADL/IADL进行评估。在考虑各种混杂因素的情况下，使用逻辑回归模型分析ADL、IADL和RTW之间的联系。
受伤后3个月和6个月时，平均ADL和IADL均有显著改善。逻辑回归分析表明，受伤后3个月和6个月时的IADL得分与RTW显著相关。调整后ADL得分失去了显著性。年龄与RTW呈负相关，而性别和劳工保险状况无显著关联。
对于职业受伤工人来说，IADL的短期改善与成功的RTW相关，而非ADL。IADL评估应纳入康复计划，以预测和改善RTW。全面的康复方法应对功能能力的各个方面，这对于支持成功的RTW可能至关重要。需要进一步的研究来验证这些结果。
