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Characteristics and Prognostic Factors for Return to Work in Public Safety Personnel with Work-Related Posttraumatic Stress Injury Undergoing Rehabilitation
Journal of Occupational Rehabilitation ( IF 2.1 ) Pub Date : 2021-03-09 , DOI: 10.1007/s10926-021-09963-w
Douglas P Gross 1 , Geoffrey S Rachor 2 , Shelby S Yamamoto 3 , Bruce D Dick 4 , Cary Brown 5 , Ambikaipakan Senthilselvan 3 , Sebastian Straube 6 , Charl Els 7 , Tanya Jackson 6 , Suzette Brémault-Phillips 5 , Don Voaklander 3 , Jarett Stastny 8 , Theodore Berry 8
Affiliation  

Purpose

Public safety personnel (PSP) are at risk of developing posttraumatic stress injury (PTSI) due to exposure to traumatic experiences and accidents. Rehabilitation programs are available, but their success varies. We studied: (1) characteristics of PSP undergoing PTSI rehabilitation in comparison to non-PSP workers; and (2) predictive value of various factors for return to work. Methods A population-based cohort study was conducted using data on injured workers undergoing PTSI rehabilitation. Of the 488 workers included, 131 were PSP. Outcome measures were: (1) return to pre-accident work at rehabilitation discharge; (2) days receiving wage replacement benefits in the year following rehabilitation. Results PSP were mainly employed (90.8%), male (59.5%), paramedics/ambulance workers (58.0%); a minority (43.5%) returned to pre-accident work after rehabilitation. Compared to non-PSP workers, PSP were more likely to initially be diagnosed with psychological injuries (94.7% versus 59.4%, p < 0.001) rather than musculoskeletal injuries. Return to pre-accident work was predicted by shorter injury duration, having a primary mental health diagnosis, working at time of admission, and not having symptoms requiring treatment in a complex rehabilitation program. PSPs were slower to experience full recovery in the year after rehabilitation. Factors predicting fewer benefit days included not having a secondary psychological injury, being employed, and working at time of admission. Conclusions Most PSP did not return to work in full after PTSI rehabilitation. Outcomes are likely to improve by starting treatment earlier and maintaining connections with the workplace.



中文翻译:

因工作相关的创伤后应激性损伤正在康复的公共安全人员重返工作岗位的特征和预后因素

目的

由于暴露于创伤经历和事故,公共安全人员 (PSP) 有发生创伤后应激损伤 (PTSI) 的风险。康复计划是可用的,但它们的成功率各不相同。我们研究了:(1)与非 PSP 工作者相比,接受 PTSI 康复的 PSP 的特征;(2)复工各因素的预测价值。方法使用接受 PTSI 康复的受伤工人的数据进行了一项基于人群的队列研究。在包括的 488 名工人中,131 名是 PSP。结果措施是: (1) 在康复出院时返回事故前工作;(2) 康复后一年内领取工资替代福利的天数。结果PSP 主要就业(90.8%)、男性(59.5%)、护理人员/救护人员(58.0%);少数人(43.5%)在康复后重返事故前工作。与非 PSP 工人相比,PSP 更可能最初被诊断为心理损伤(94.7% 对 59.4%,p < 0.001)而不是肌肉骨骼损伤。通过较短的受伤持续时间、初步心理健康诊断、入院时工作以及在复杂的康复计划中没有需要治疗的症状,可以预测恢复事故前工作。PSP 在康复后的一年中完全恢复的速度较慢。预测福利天数减少的因素包括没有继发性心理伤害、就业和入院时工作。结论大多数 PSP 在 PTSI 康复后并没有完全恢复工作。通过更早开始治疗并保持与工作场所的联系,结果可能会得到改善。

更新日期:2021-03-09
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