Author:
Kendrick Denise,Dhiman Paula,Kellezi Blerina,Coupland Carol,Whitehead Jessica,Beckett Kate,Christie Nicola,Sleney Judith,Barnes Jo,Joseph Stephen,Morriss Richard
Abstract
BackgroundThe benefits of work for physical, psychological, and financial wellbeing are well documented. Return to work (RTW) after unintentional injury is often delayed, and psychological morbidity may contribute to this delay. The impact of psychological morbidity on RTW after a wide range of unintentional injuries in the UK has not been adequately quantified.AimTo quantify the role of psychological factors, including anxiety, depression, and post-traumatic distress, on RTW following unintentional injuries.Design and settingA longitudinal multicentre prospective study was undertaken in Nottingham, Bristol, Leicester, and Guildford, UK.MethodParticipants (n = 273) were 16–69-year-olds admitted to hospital following unintentional injury, who were in paid employment prior to injury. They were surveyed at baseline, then at 1, 2, 4, and 12 months following injury; demographic data were collected along with injury characteristics, psychological morbidity, and RTW status. Associations between demographic, injury and psychological factors, and RTW between 2 and 12 months after injury were quantified using random effects logistic regression.ResultsThe odds of RTW between 2 and 12 months after injury reduced as depression scores early in the recovery period (1 month after injury) increased (odds ratio [OR] 0.87, 95% confidence interval [CI] = 0.79 to 0.95) and as length of hospital stay increased (OR 0.91, 95% CI] = 0.86 to 0.96). For those experiencing threatening life events following injury (OR 0.27, 95% CI = 0.10 to 0.72) and with higher scores on the Crisis Support Scale (OR 0.93, 95% CI] = 0.88 to 0.99), the odds of RTW between 2 and 12 months after injury were lower. Multiple imputation analysis found similar results, but those relating to crisis support did not remain statistically significant.ConclusionPrimary care professionals can identify patients at risk of delayed RTW who may benefit from management of psychological morbidity and support to RTW.
Publisher
Royal College of General Practitioners
Reference59 articles.
1. Waddell G Burton AK (2006) Is work good for your health and well-being? An evidence review. (TSO, Norwich) https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being (accessed 16 May 2017).
2. Black C (2008) Working for a healthier tomorrow. Dame Carol Black’s review of the health of Britain’s working age population. (TSO, London) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209782/hwwb-working-for-a-healthier-tomorrow.pdf (accessed 16 May 2017).
3. NHS Digital Hospital Episode Statistics, Admitted Patient Care — England, 2014–15. http://content.digital.nhs.uk/searchcatalogue?productid=19420&q=title%3a%22Hospital+Episode+Statistics%2c+Admitted+patient+care+-+England%22&sort=Relevance&size=10&page=1#top (accessed 16 May 2017).
4. The impact of injuries on health service resource use and costs in primary and secondary care in the English NHS.;Kellezi;J Public Health (Oxf),2015
5. Getting back to work after injury: the UK Burden of Injury multicentre longitudinal study