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Factors Predicting Return-to-Work Outcomes in Workers with or without Comorbid Physical Injuries and Traumatic Psychological Injuries
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- Author / Creator
- Rachor, Geoffrey S
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Background: Physical injuries and psychological trauma frequently co-occur, and are associated with worse return-to-work outcomes. The Workers’ Compensation Board of Alberta (WCB-Alberta) offers psychologically-based occupational rehabilitation programs for workers having sustained traumatic psychological injuries (TPI) in the workplace. These programs have not been formally evaluated since their inception. As a result, it is not clear how successful these programs are in facilitating return-to-work. Additionally, factors associated with return-to-work in workers with or without TPI and pain resulting from physical injuries who have been referred to psychologically-based rehabilitation services have not been identified.
Objectives: The broad aim of this study was to identify factors associated with return-to-work in workers with or without comorbid physical injuries and TPI undergoing rehabilitation for TPI through WCB-Alberta.
Methods: The current study employed a population-based, retrospective, longitudinal design. A secondary analysis of data on 488 injured workers undergoing rehabilitation for TPI between the years of 2014 and 2016 was conducted. We also examined group differences between those with or without comorbid TPI and pain resulting from physical injuries on demographic/administrative and injury-related variables, as well as psychological variables. The TPI only group consisted of 318 injured workers, and the TPI + painful physical injury group consisted of 170 injured workers. To identify factors associated with return-to-work at the time of program discharge, we used chi-squared tests of independence and independent samples t-tests. Logistic regression analyses were conducted to model return-to-work prediction.
Results: Return-to-work was less likely among workers with comorbid injuries, primarily physical injuries, longer average treatment durations, and among those admitted to higher intensity interventions (i.e., multidisciplinary treatment). Return-to-work was also less likely among workers with greater levels of self-reported pain intensity, depression, and posttraumatic stress disorder (PTSD) symptoms; namely, defensive avoidance. Workers with greater levels of self-reported readiness to return-to-work were more likely to successfully return-to-work.
Conclusions: The current study provides evidence of factors associated with return-to-work in workers receiving psychologically-based rehabilitation services, which has not been extensively examined in the literature. The PTSD symptom domain of defensive avoidance was the only symptom domain significantly associated with return-to-work beyond the demographic/administrative and injury-related variables, appearing to be particularly important in relation to return-to-work outcomes. Further research with larger sample sizes is needed in order to delineate the relationships of psychological variables with return-to-work. Given power and sample size limitations, we were unable to examine whether factors associated with return-to-work differed in the TPI only and TPI + painful physical injury groups.
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- Graduation date
- Fall 2020
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.