Validity and Determinants of Clinicians’ Return to Work Judgments for Individuals Following Whiplash Injury
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Rehabilitation clinicians routinely make judgments about the capacity of individuals to return to work following whiplash injury, which can have serious implications for individuals’ continued access to salary indemnity benefits. The present study examined the validity and determinants of these judgments. During a standardized rehabilitation intervention, data regarding demographic factors, crash characteristics, pain severity, range of motion, pain-related psychological functioning, as well as change in the latter three factors over the course of treatment were collected for 104 whiplash-injured individuals (73 women, 31 men). Upon completion of the intervention, clinicians rated the number of hours each individual was capable of working per day. Follow-up data regarding the actual number of hours worked were collected 1 year later. Hierarchical regression analyses revealed that clinicians’ judgments added significant unique variance to the return to work prediction beyond other predictive factors, and that clinicians were particularly influenced by patients’ pain severity and treatment-related change in pain severity in making these judgments. Although clinicians were significantly able to predict return to work, the limited variance accounted for by their judgments (12%) warrants caution in the use of these judgments in decisions related to access to services or indemnity. Factors predictive of clinician judgment and actual return to work are compared, and recommendations to enhance the utility of these judgments are made.
KeywordsWhiplash injury Neck pain Disability Work readiness
The authors thank Nicole Davidson for her assistance data entry and database management. The authors also wish to thank Maria Milioto, Élyse Marois, Julie Piché and Isabelle Cournoyer for their collaboration. This research was supported by grants from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR).
Conflicts of Interest
The authors have no financial interests related to the content of this paper.
- Automobile Insurance Act (1989). In: Revised Statutes of Quebec, Chapter A-25. Publications Québec, Quebec.Google Scholar
- Beals, R. K., & Hickman, N. W. (1972). Industrial injuries of the back and extremities. Journal of Bone and Joint Surgery, 54-A, 1593–1611.Google Scholar
- Beck, A., Steer, R., & Brown, G. K. (1996). Manual for the Beck Depression Inventory–II. San Antonio: Psychological Corporation.Google Scholar
- French, D., Roach, P., & Mayes, S. (2002). Peur du mouvement chez des accidentés du travail: l’Échelle de Kinésiophobie de Tampa (EKT). Canadian Journal of Behavioural Science, 34, 40–45.Google Scholar
- French, D., Noel, M., Vigneau, F., French, J., Chantal, P., & Evans, R. (2005). L’Échelle de dramatisation face à la douleur PCS-CF: Adaptation canadienne en langue française de l’échelle “Pain Catastrophizing Scale”. Canadian Journal of Behavioural Science, 37, 181–192.Google Scholar
- Hoogendoorn, W. E., Bongers, P. M., de Vet, H. C., Ariens, G. A., van Mechelen, W., & Bouter, L. M. (2002). High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: Results of a prospective cohort study. Occupational and Environmental Medicine, 59, 323–328.CrossRefPubMedGoogle Scholar
- Kori, S., Miller, R., & Todd, D. (1990). Kinesiophobia: A new view of chronic pain behavior. Pain Management. pp 35-43.Google Scholar
- Morrow-Howell, N. (1994). The M word: Multicollinearity in multiple regression. Social Work Research, 18, 247–251.Google Scholar
- Suissa, S. (2003). Risk factors of poor prognosis after whiplash injury. Pain Research & Management, 8, 69–75.Google Scholar