Return-to-work barriers among manual workers after hand injuries: one-year follow-up cohort study

Publication date: Available online 18 August 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Batia S. Marom, Navah Z. Ratzon, Rafael S. Carel, Moshe Sharabi

Abstract

Objective

To determine time of return to work (TRTW) in relation to multivariable predictors among male manual workers after hand injury (HI) over a 12-month follow-up.

Design

A cohort study with baseline medical information, functional evaluation, and three-, six-, nine-, and 12-month follow-up telephone interviews.

Setting

Seven physical rehabilitation community occupational therapy clinics.

Participants

178 subjects with acute HI aged 22 to 65. Two participants were lost to follow-up.

Intervention

Not applicable.

Main Outcome Measure

The dependent variable was TRTW. The independent variables originated from four domains: personal factors, environmental factors, body function and structure, and activity limitation and participation restriction. The proportion of RTW at each time point was calculated. Multiple Cox regressions established a predictive model for TRTW.

Results

At the end of the study, 75.3% participants returned to work. The median TRTW was 94 days. In the final model, only compensation factors and education contributed significantly to overall RTW, but when separate analyses were performed, decreased level of self-efficacy, higher workplace demands, level of pain, level of emotional response to trauma, reduced physical capability of the hand, and higher level of disability were significantly associated with delayed TRTW.

Conclusions

TRTW was determined by the physical capability of the hand, pain, and psychosocial factors, but it was also affected by legal factors. Subjects who did not RTW during the first nine months are at risk for long-term disability. Developing treatment programs for those who are at risk for not RTW, taking into consideration these factors, is recommended.

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