F-3-14-04
FACTORS AFFECTING RETURN TO WORK FOLLOWING BACK INJURY
P B Disler, N E Murray, P H Hart, A J Wearing, M J Norris & K Malinovskaya (University of Melbourne, Melbourne, Australia) (Supported by Victorian Workcover Authority)
Purpose: Back injuries are a major health care problem in terms of economic, social and rehabilitation costs. A substantial body of data indicates that return to work can not be predicted solely on the basis of physical diagnosis or impairment, but little research has systematically looked other factors which might influence the outcome. This research was based on a theoretical model which included as main variables: personality, pain levels, methods of coping with pain, perceptions of work environment and claims management, medical and physical therapy received, and impact of injury on lifestyle.
Method: We interviewed 281 subjects with work-related back injuries who were receiving workers compensation benefits. These comprised 3 groups: 62 who were off work for 4-8 weeks, 72 off work for 6-8 months & 147 who had returned to work at 4-12 weeks.
Results: Data was analysed using analysis of variance, discriminant function and structural equation modelling. Factors which were found to determine return to work and the numbers of days compensated included catastrophising as a way of coping, which influences the perception of pain severity and its impact on life; also the perception of claim management & the organisational climate of the employer. Primary diagnosis & the amount of physiotherapy received had no effect on outcome.
Conclusions: This study identifies areas for intervention and suggests that successful return to work is dependent on more than just the physical aspects being addressed.
F-3-14-05
Social and occupational outcome of the spinal cord injured patients in Rosai Hospitals in Japan.
Mikio Sumida (Kansai Rosai Hospital), Magara A. (Tsubame Rosai Hospital), Tokuhiro A. (Kibikogen Rehabilitation Center), Uchida R. (Kanto Rosai Hospital).
Purpose: To identify recent major problem of comprehensive treatment for the SCI patients in Rosai Hospitals managed by Japanese labor welfare corporation.
Method and Objects: A national wide questionnaire which consist of the age decade at the injury, hospitalization, gender, neurological level, social ability, employment rate, goal was done. From total 1,003 who admitted to Rosai Hospitals (29) and discharged during 2 years since April 1992, 644(male 531, female 113) were at random extracted.
Results: ?@ The degree of independence was the 1st independence at home, 2nd social independence, 3rd stay at home with some assists. ?A Total employment rate was 9.8%, but limiting to the group of social independence, the rate increased to 38.8%. ?B The group of discharge to another hospitals admitted to hospital earlier, and treated during 6 months and one year.
Conclusion: In order to promote better occupational results, we have to focus the difference between the employed and staying at home among social independent group.
