The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68211

Benjamin C. Amick, PhD¹, Jeffrey N. Katz, MD, MS², and Janet Ossman, PhD¹. (1) School of Public Health, University of Texas-Houston Health Sciences Center, PO Box 20186, Houston, TX 77225, 713-500-9496, bamick@sph.uth.tmc.edu, (2) Division of Rheumatology, Brigham & Womens' Hospital, PBB-B3, 75 Francis St., Boston, MA 02115

A model was developed to predict and test successful return to work (RTW) following carpal tunnel release surgery (CTRS). Clinical, worker and economic/legal factors were hypothesized to predict successful RTW at 2 months following CTRS; job and organizational conditions were hypothesized as important at 6 months post-surgery. Successful RTW was measured using an ordered measure of work role functioning (not working, working with limitations, working well). Predictors were categorized a prior and included: Demographic, Clinical (e.g., hand/wrist symptom severity, upper extremity functional limitations, symptom duration, bilateral CTS symptoms, scar tenderness, endoscopic surgery, comorbidities, physical health, baseline work role functioning), Psychosocial (e.g., self-efficacy, depression, social support), Economic/legal (workers' compensation claimant, attorney involvement), Job conditions (e.g., high repetition hazardous exposure, psychosocial job demands and control, job security), and Organizational (e.g., job accommodation, employer size, union membership, organizational culture). Ordered logistic regression was used. Patients scheduled for CTRS from physician offices completed questionnaires preoperatively and postoperatively at two (n=128), six (n=122) and twelve months. At 2-months following CTRS, baseline work role functioning (OR 1.02; CI 1.01-1.04), depression, (OR 0.32; CI 0.14-0.74), and being a workers' compensation claimant, (OR 0.30; CI 0.14-0.66), predicted successful RTW. At 6-months following CTRS baseline work role functioning, (OR 1.04; CI 1.02-1.05), improved self-efficacy post-surgery, (OR 7.11; CI 2.47-20.46), and a supportive organization, (OR 5.20; CI 1.68-16.05), predicted successful RTW. While confirmation studies are needed, findings suggest interventions targeting improving self-efficacy and developing supportive organizational policies help promote successful RTW.

Learning Objectives:

At the conclusion of this presentation the participants will be able to: (
• describe the elements of a model to predict successful return to work following carpal tunnel release surgery, and (
• discuss which elements were significant predictors of successful return to work in this study of patients scheduled for carpal tunnel release surgery.

Keywords: Occupational Health Care, Disability Policy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.