Worker recovery expectations and fear-avoidance predict work disability in a population-based workers' compensation back pain sample
Worker recovery expectations and fear-avoidance predict work disability in a population-based workers' compensation back pain sample
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DOI：
10.1097/01.brs.0000202762.88787.af
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发表时间：
2006-03-15
期刊：
影响因子：
3
通讯作者：
Egan, K
中科院分区：
文献类型：
--
作者：
Turner, JA;Franklin, G;Egan, K
研究设计.前瞻性、基于人群的队列研究。研究工人的人口统计学、疼痛、残疾和心理社会变量，在工作相关性背痛残疾发作后不久进行评估，是否可以预测6个月的工作残疾。较大的年龄，疼痛，身体残疾，以及某些社会心理特征可能是长期背痛相关的工作能力障碍的危险因素，虽然许多研究一直很小，结果一直不一致，一些社会心理变量尚未进行前瞻性研究。工人（N = 1，068）在提交工人赔偿背痛残疾索赔后18天（中位数）完成了评估人口统计学、疼痛、残疾和心理社会变量的电话访谈。结果：1.在提交索赔后6个月获得工作残疾的行政措施。在6个月时，196名工人（18.4%）正在领取工伤伤残补偿。年龄、种族、教育、基线疼痛和残疾是6个月残疾的重要预测因素。调整基线人口统计学、疼痛、残疾和其他心理社会变量后，高工作恐惧回避（比值比，4.6; 95%置信区间，1.6-13.7）和极低的恢复期望（比值比，3.1，95%置信区间，1.5-6.5）是显著的独立预测因子。在患有急性工作相关背痛的人中，高疼痛和残疾，低恢复期望以及担心工作可能会增加疼痛或造成伤害是慢性工作残疾的风险因素。
Study Design. Prospective, population-based cohort study.Objectives. To examine whether worker demographic, pain, disability, and psychosocial variables, assessed soon after work-related back pain disability onset, predict 6-month work disability.Summary of Background Data. Greater age, pain, and physical disability, and certain psychosocial characteristics may be risk factors for prolonged back pain-related work disability, although many studies have been small, findings have been inconsistent, and some psychosocial variables have not been examined prospectively.Methods. Workers (N = 1,068) completed telephone interviews assessing demographic, pain, disability, and psychosocial variables 18 days (median) after submitting Workers' Compensation back pain disability claims. Administrative measures of work disability 6 months after claim submission were obtained.Results. At 6 months, 196 workers (18.4%) were receiving work disability compensation. Age, race, education, and baseline pain and disability were significant predictors of 6-month disability. Adjusting for baseline demographics, pain, disability, and other psychosocial variables, high work fear-avoidance (odds ratio, 4.6; 95% confidence interval, 1.6-13.7) and very low recovery expectations (odds ratio, 3.1, 95% confidence interval, 1.5-6.5) were significant independent predictors.Conclusions. Among individuals with acute work-related back pain, high pain and disability, low recovery expectations, and fears that work may increase pain or cause harm are risk factors for chronic work disability.