Return to Work After Hand Injury: the Role of Medical, Demographic and Psycho-Social Factors

May 29, 2008 updated by: Soroka University Medical Center

Return to Work After Hand Injury: The Role of Medical, Demographic and Psychosocial Factors

The purpose of this study is to investigate the extent of return to work (RTW) after traumatic hand injury and to identify factors that are related to RTW.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

RTW is one of the main rehabilitation outcomes after injury, the loss of the ability to work may have psychological as well as economic impact on the injured person. Time off work is also a burden to the economic system, associated with loss of work days, sick leave and national insurance payment. Hand injury can cause limitations in function, therefore influence the ability to work. Review of the literature reveals that time off work after hand injury ranges from a few days to a year and more. Factors associated with time off work include medical, socio-economic and psychosocial factors. Only a few studies have been conducted in Israel to investigate rate of RTW after hand injury and factors that affect RTW . The aim of this study is to explore the extent of RTW after traumatic hand injury and to examine the relationship between several factors - medical, demographic and psychosocial and RTW. This, in order to identify prognostic factors that can be treated during rehabilitation. There is no preliminary hypothesis made about the relationships between the factors and RTW. This study is also retrospective and prospective since it examine individuals under-going occupational therapy treatment and individuals who have been treated in the past.

Study Type

Observational

Enrollment (Anticipated)

75

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Israel
      • Beer - Sheba, Israel
        • Soroka University Medical Center, Occupational Therapy Department

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Individuals will be recruited from those referred to occupational therapy department at Soroka Medical Center.

Description

Inclusion Criteria:

  • The individual worked until he/she was injured
  • Traumatic hand injury including: wrist fractures, fingers fractures, tendon injury, nerve injury, Crush injury, finger amputation

Exclusion Criteria:

  • Non traumatic hand injury (such as CTS)
  • Mallet finger
  • Burns
  • Injury in several organs

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
A
Group A - 25 individuals or more, that start occupational therapy and agree to participate in the research.
Behavioral: Questionnaires and motor/sensitivity testing

Group A:

  1. Full assessment (using the various measures described) will be carried out 0-3 weeks since referral.
  2. Treatment will focus on the patient's needs and in accordance with the physicians requests.
  3. Three months post initial treatment re-assessment will be conducted.
Behavioral: Questionnaires and motor/sensitivity testing
Group B Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.
Behavioral: Questionnaires and motor/sensitivity testing
Group C Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.
B
Group B- 25 individuals or more, half a year after hand injury that were treated in occupational therapy at the same institute.
Behavioral: Questionnaires and motor/sensitivity testing

Group A:

  1. Full assessment (using the various measures described) will be carried out 0-3 weeks since referral.
  2. Treatment will focus on the patient's needs and in accordance with the physicians requests.
  3. Three months post initial treatment re-assessment will be conducted.
Behavioral: Questionnaires and motor/sensitivity testing
Group B Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.
Behavioral: Questionnaires and motor/sensitivity testing
Group C Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.
C
Group C - 25 individuals or more, a year after hand injury that were treated in occupational therapy at the same institute
Behavioral: Questionnaires and motor/sensitivity testing

Group A:

  1. Full assessment (using the various measures described) will be carried out 0-3 weeks since referral.
  2. Treatment will focus on the patient's needs and in accordance with the physicians requests.
  3. Three months post initial treatment re-assessment will be conducted.
Behavioral: Questionnaires and motor/sensitivity testing
Group B Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.
Behavioral: Questionnaires and motor/sensitivity testing
Group C Researcher will contact by phone previous patients that were treated in the occupational therapy department in the past half year and a year, in order to get their permission to participate (retrospectively) in this research. After getting their consent, a questionnaire concerning their RTW will be posted to the subjects.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
RTW vs no RTW
Time Frame: Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.

Secondary Outcome Measures

Outcome Measure
Time Frame
Medical, socio-demographic and work environment questionnaires
Time Frame: Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
psychosocial questionnaires including: Post Traumatic Stress Disorder questionnaire, McGill Pain Questionnaire, pain belief and self-efficacy questionnaires.
Time Frame: Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
Motor and sensitivity testing : hand grip and pinch strength measurements, Purdue Pegboard Test, Semmes-Weinstein Pressure Monofilaments, upper extremity rang of motion, Pain Visual Analogue Scale.
Time Frame: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .
within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .
Disabilities of Arm Shoulder and Hand questionnaire
Time Frame: Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.
Group A: within 0-3 weeks from referral to occupational therapy treatment and again three months later or at the end of treatment .Group B: half a year after injury. Group C: one year after injury.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Soroka University Medical Center

Investigators

  • Principal Investigator: Amiram Sagi, Professor, Hand Surgery Unit, Soroka University Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Bear - Lehman, J. (1983). Factors Affecting Return to Work After Hand Injury. American Journal of Occupational Therapy, 37 (3), 189 - 194. Chan, J., & Spencer, J. (2004). Adaptation to Hand Injury: An Evolving Experience. American Journal of Occupational Therapy, 58 (2), 128 - 139. Chan, J., & Spencer, J. (2005). Contrasting Perspectives on Pain following Hand Injury. Journal of Hand Therapy, Oct-Dec 18 (4),429 - 436. Chen, C.Y., Strecker Neufeld, P., Feely, C.H., & Skinner C.S. (1999). Factors Influencing Compliance With Home Exericise Programs Among Patients With Upper Extremity Impairment. American Journal of Occupational Therapy, 53 (2), 171 - 180. Deem, R. (1988). Work, Unemployment and Leisure. London: Routledge. DeGood, D.E., & Shutty, M.S. (1992). Assessment of Pain Beleifs, Coping, ans Self Efficancy. In D.C. Turk ,& R. Melzack (Eds), Hand Book of Pain Assessment, pp. 214 - 230. New York: The Guilford . Flood, A.B., Loernce, D.P., Ding, J., McPherson, K., & Black, N.A. (1993). The Role of Expectations in Patient's Reports of Post-Operative Outcomes and Improvement Following Therapy. Medical Care, 31 (11), 1043 - 1056. Franche R.L. & Krause N. (2002) Readiness for Return to Work Following Injury or Illness: Conceptualizing the Interpersonal Impact of Health Care, Workplace, and Insurance Factors. Journal of Occupational Rehabilitation,12 (4), 233 - 256. Gage, M. N., & Polatajko, H. (1994). Enhanching occupational performance through an understanding of percieved self-efficacy. American Journal of Occupational Therapy, 48, 452 - 461. Grunert, B.K., Matloub, H.S., Sanger, J.R., & Yousif, N.J. (1990). Treatment of Posttraumatic Stress disorder after work-related hand trauma. The Journal of Hand Surgery, 15A (3), 511 - 515. Jensen, P.J., Turner, J.A., Romano, J.M., & Lawler, B.K. (1994). Relationship of pain-specific beliefs to chronic pain adjustment. Pain , 57, 301 - 309. Johns, A.M. (1981). Time off work after hand injury. Injury ,Mar 12 (5), 417 - 424. Kasdan, M.L., & June, L.A. (1993). Returning to Work after Unilateral Hand Fracture. Journal of Occupational Medicine, 35(2), 132 - 136. Kelvin, P. & Jarret, J.E. (1985). Unemployment its social psychological effects. Cambridge University Press. Kilhofner, G. (2002). A Model of Human Occupation: Theory and Application (3 ed). Baltimore: Lippincott Williams & Wilkins. Krause, N., Frank, J.W., Dasinger, L.K., Sullivan. T.J., & Sinclair, S.J. (2001). Determinants of Duration of Disability and Return to Work after Work-Related Injury and Illness: Challenges for Future Research. American Journal of Industrial Medicine, 40, 464 - 484. Lai, C.H. (2004). Motivation in Hand-injured Patient with and without Work-related Injury. Journal of Hand Therapy, Jan-Mar 17 (1), 6 - 17. Melamed, S., Grosswasser, Z., & Stern, M.J. (1992). Acceptance of disability, work involvemnt and subjective rehabilitation status of traumatic brain injured (TBI) patients. Brain Injury, 6, 233 - 243. Mink Van Der Molen, A.B., Groothoff, J.W., Visser, J.P., Robinson, P.H., & Eisma, W.H. (1999). Time off Work due to Scaphoid Fracture and other Carpal Injuries in the Netherlands in the period 1990 to 1993. Journal of Hand Surgery (British and European Volume), 24b (2), 193-198. Pransky, G., Gatchel, R., Linton, S.J., & Loisel, P. (2005). Improving Return to Work Research. Journal of Occupational Rehabilitation, 15(4), 453 - 457. Rainwater, L. (1974). Work, Well-Being, and Family Life. In J. O'Toole (Ed), Work and the Quality of life, pp361-370. Cambridge Mass: Mit Press Rosberg, H.E., Steen-Carlsson, K., & Dahlin, L.B. (2005). Prospective study of patients with injuries to the hand and forearm: cost, function and genral health. Scandinavian journal of plastic and reconstructive surgery and hand surgey, 39 (6), 360-369. Rusch, M.D., Dzwierzynski, W.W., Sanger, J.R., Pruit, N.T., Siewert, A.D. (2003). Return to Work Outcomes after Work-Related Hand Trauma: The Role of Causal Attributions. The Journal of Hand Surgery, 28A, No. 4, 673 - 677. Schultz-Johnson, K. (1987). Assessment of Upper Extremity-injured persons' return to work potentail. Journal of Hand Surjery, 12A (5), 950 - 957. Skov, O., Jeune. B., Lauritsen J.M., & Barfred, T. (1999). Time off Work After Occupational Hand Injuries. Journal of Hand Surgery (British and European Volume), 24B (2): 187 - 189. Waylett-Rendall, J., & Niemeyer, L.O. (2004). Exploratory Analysis to Identify Factors Impacting Return-to-Work Outcomes in Cases of Cumulative Trauma Disorder. Journal of Hand Therapy, Jan-Mar, 17(1), 50 - 57.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2008

Study Completion (Anticipated)

December 1, 2008

Study Registration Dates

First Submitted

May 27, 2008

First Submitted That Met QC Criteria

May 29, 2008

First Posted (Estimate)

May 30, 2008

Study Record Updates

Last Update Posted (Estimate)

May 30, 2008

Last Update Submitted That Met QC Criteria

May 29, 2008

Last Verified

May 1, 2008

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • sor470708ctil

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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