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Psychological morbidity and return to work after injury: multicentre cohort study

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posted on 2017-04-04, 11:03 authored by Denise Kendrick, P. Dhiman, Blerina Kellezi, Carol Coupland, J. Whitehead, Kate Beckett, Nicola Christie, Jude Sleney, Jo BarnesJo Barnes, Stephen Joseph, Richard Morriss
Background: The 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. Aims: To quantify the role of psychological factors including anxiety, depression and post-traumatic distress on RTW following unintentional injuries. Design and Setting: Longitudinal multi-centre prospective study in Nottingham, Bristol, Leicester and Guildford, UK Method: Participants (n=273) were 16-69 year olds admitted to hospital following unintentional injury and, in paid employment prior to injury. They were surveyed at baseline, 1, 2, 4 and 12 months following injury on demographic and injury characteristics, psychological morbidity and RTW status. Associations between demographic, injury and psychological factors and RTW status were quantified using random effects logistic regression. Results: The odds of RTW reduced as depression scores one month post-injury increased (OR 0.87, 95%CI 0.79, 0.95) and as length of hospital stay increased (OR 0.91, 95%CI 0.86, 0.96). Those experiencing threatening life events following injury (OR 0.27, 95%CI 0.10, 0.72) and with higher scores on the crisis social support scale (OR 0.93, 95%CI 0.88, 0.99) had a lower odds of RTW. Multiple imputation analysis found similar results except crisis social support did not remain significant. Conclusion: Primary care professionals can identify patients at risk of delayed RTW who may benefit from management of psychological morbidity and support to RTW. How this fits in Injuries are common in working age-adults; resulting in a delayed return to work (RTW) for many. The benefits of work for physical, psychological and financial wellbeing are well documented. Depression occurring early in the recovery period, threatening life events after the injury and a longer stay in hospital significantly reduce the odds of RTW in the first year after injury. Primary care professionals can identify patients at risk of delayed RTW, detect and manage psychological morbidity and provide support to RTW.

Funding

This study was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Nottinghamshire Derbyshire and Lincolnshire.

History

School

  • Design

Published in

British Journal of General Practice

Volume

67

Issue

661

Pages

e555-e564

Citation

KENDRICK, D. ...et al., 2017. Psychological morbidity and return to work after injury: multicentre cohort study. British Journal of General Practice, 67(661): e555-e564.

Publisher

© Royal College of General Practitioners

Version

  • AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Acceptance date

2017-01-24

Publication date

2017-07-27

Notes

This paper was accepted for publication in the journal British Journal of General Practice and the definitive published version is available at https://doi.org/10.3399/bjgp17X691673

ISSN

1478-5242

Language

  • en

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