title: Determinants of work absence following surgery for carpal tunnel syndrome.
abstract: BACKGROUND
  The objective was to identify factors across multiple domains associated with return to work in a community-based cohort of workers with carpal tunnel syndrome.
  
  
  METHODS
  Workers scheduled for carpal tunnel release were recruited into this prospective study. Subjects completed questionnaires preoperatively and at 2, 6, and 12 months postoperatively. The questionnaires contained demographic, clinical, and psychosocial factors and physical and psychosocial workplace stressors. Predictors of work absence at 6 and 12 months were examined in bivariate and multivariate logistic regression analyses.
  
  
  RESULTS
  Six months following surgery of 181 subjects, 29 (19%) were out of work. Twelve months postoperatively 33 subjects (22%) were out of work. In bivariate analyses, the factors associated with work absence at 6 months, at P < or = 0.01, included preoperative physical functional status, change in self-efficacy between preoperative assessment and 2 months, lower income, workers' compensation, representation by an attorney, work exposure to force and repetition, higher psychological job demands and lower control, lower social support by coworkers, lower job security and more supportive organizational policies and practices. The factors associated with work absence at 12 months in bivariate analyses included preoperative physical functional status, lower self-efficacy at 2 months, workers' compensation, and less supportive organizational policies and practices. Multivariate analyses documented a multidimensional model, with predictors from multiple domains.
  
  
  CONCLUSIONS
  Clinical, demographic, economic, and workplace factors were associated with work absence. Strategies to reduce work absence following carpal tunnel release should address multiple dimensions of the worker and workplace.
authors.affiliation: Robert Brigham Arthritis and Musculoskeletal Clinical Research Center, Section of Clinical Sciences, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. Jnkatz@partners.org
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Amick
authors.forename: Robert
authors.initials: R
authors.lastname: Keller
authors.forename: Anne H
authors.initials: AH
authors.lastname: Fossel
authors.forename: Janet
authors.initials: J
authors.lastname: Ossman
authors.forename: Valerie
authors.initials: V
authors.lastname: Soucie
authors.forename: Elena
authors.initials: E
authors.lastname: Losina
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000601:surgery*; D018582:Sick Leave / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors