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Are there differences in the return to work process for work-related psychological and musculoskeletal injuries? A longitudinal path analysis.

Authors
  • Smith, Peter1, 2, 3
  • LaMontagne, Anthony D4
  • Lilley, Rebbecca5
  • Hogg-Johnson, Sheilah6, 7
  • Sim, Malcolm8
  • 1 Institute for Work and Health, 481 University Ave, Suite 800, Toronto, ON, M5G 2E9, Canada. [email protected] , (Canada)
  • 2 Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. [email protected] , (Australia)
  • 3 Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. [email protected] , (Canada)
  • 4 Centre for Population Health Research, Deakin University, Victoria, Australia. , (Australia)
  • 5 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand. , (New Zealand)
  • 6 Institute for Work and Health, 481 University Ave, Suite 800, Toronto, ON, M5G 2E9, Canada. , (Canada)
  • 7 Canadian Memorial Chiropractic College, North York, ON, Canada. , (Canada)
  • 8 Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. , (Australia)
Type
Published Article
Journal
Social psychiatry and psychiatric epidemiology
Publication Date
Aug 01, 2020
Volume
55
Issue
8
Pages
1041–1051
Identifiers
DOI: 10.1007/s00127-020-01839-3
PMID: 32047973
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To examine differences in the return to work (RTW) process for workers' compensation claimants with psychological injuries compared to those with musculoskeletal (MSK) injuries. We collected data from 869 workers' compensation claimants in Victoria, Australia, at three time points over a 12-month period (21% with psychological injury claims). RTW was assessed through self-report. Potential mediators were identified at the personal, health-care provider, workplace and system levels. The relationships between injury type, mediating factors and RTW were assessed using path analysis, with adjustment for confounders through inverse probability weighting. We observed better RTW outcomes for claimants with MSK injuries (compared to those with psychological injuries) at T1 and T2, but not at T3. We also observed differences between psychological injuries and MSK injuries and all but two of the mediating factors examined. These differences, in particular related to supervisor response to injury, consultative RTW planning and offers of accommodation, as well as differences in mental health symptoms, explained approximately two-thirds of differences in RTW between injury types at T1. Differences in RTW at T2 were explained by mediating factors, and differences in RTW at T1. Claimants with work-related psychological injuries experience a variety of challenges in RTW compared to those with MSK injuries. While treating and preventing further exacerbation of psychological symptoms should remain an important part of the rehabilitation process, other modifiable factors, in particular supervisor response to injury and consultative RTW planning and modified duties, should be prioritised to reduce inequalities in RTW across injury types.

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