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Determinants of work absence following surgery for carpal tunnel syndrome
Author(s) -
Katz Jeffrey N.,
Amick Benjamin C.,
Keller Robert,
Fossel Anne H.,
Ossman Janet,
Soucie Valerie,
Losina Elena
Publication year - 2005
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20127
Subject(s) - psychosocial , medicine , carpal tunnel syndrome , job control , cohort , physical therapy , logistic regression , multivariate analysis , workers' compensation , bivariate analysis , work (physics) , surgery , compensation (psychology) , psychiatry , psychology , social psychology , mechanical engineering , statistics , mathematics , engineering
Background The objective was to identify factors across multiple domains associated with return to work in a community‐based cohort of workers with carpal tunnel syndrome. Methods Workers scheduled for carpal tunnel release were recruited into this prospective study. Subjects completed questionnaires preoperatively and at 2, 6, and 12 months postoperatively. The questionnaires contained demographic, clinical, and psychosocial factors and physical and psychosocial workplace stressors. Predictors of work absence at 6 and 12 months were examined in bivariate and multivariate logistic regression analyses. Results Six months following surgery of 181 subjects, 29 (19%) were out of work. Twelve months postoperatively 33 subjects (22%) were out of work. In bivariate analyses, the factors associated with work absence at 6 months, at P ≤ 0.01, included preoperative physical functional status, change in self‐efficacy between preoperative assessment and 2 months, lower income, workers' compensation, representation by an attorney, work exposure to force and repetition, higher psychological job demands and lower control, lower social support by coworkers, lower job security and more supportive organizational policies and practices. The factors associated with work absence at 12 months in bivariate analyses included preoperative physical functional status, lower self‐efficacy at 2 months, workers' compensation, and less supportive organizational policies and practices. Multivariate analyses documented a multidimensional model, with predictors from multiple domains. Conclusions Clinical, demographic, economic, and workplace factors were associated with work absence. Strategies to reduce work absence following carpal tunnel release should address multiple dimensions of the worker and workplace. Am. J. Ind. Med. 47:120–130, 2005. © 2005 Wiley‐Liss, Inc.