title: Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.
abstract: An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.
authors.affiliation: Department of Medical and Clinical Psychology, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA. mfeuerstein@usuhs.mil
authors.forename: Michael
authors.initials: M
authors.lastname: Feuerstein
authors.forename: Grant D
authors.initials: GD
authors.lastname: Huang
authors.forename: Jose M
authors.initials: JM
authors.lastname: Ortiz
authors.forename: William S
authors.initials: WS
authors.lastname: Shaw
authors.forename: Virginia I
authors.initials: VI
authors.lastname: Miller
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Wood
mesh_terms: D000328:Adult; D019090:Case Management; D004496:Education, Continuing; D006804:Ergonomics; D035082:Federal Government; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011340:Problem Solving; D012050:Rehabilitation, Vocational / Q000379:methods*; D011795:Surveys and Questionnaires; D014481:United States; D034941:Upper Extremity / Q000503:physiopathology*; D014942:Workers' Compensation