Workstyle as a predictor of pain and restricted work associated with upper extremity disorders: a prospective study.
OBJECTIVE
A patient's reaction to a perceived increase in work demand may be related to his or her upper limb symptoms. The purpose of this study was to determine whether a brief measure of a patient's perception of how they respond to perceived increases in demands at work predicts pain levels and work status 6 months after an initial consultation with a hand surgeon.


METHODS
Working patients with diverse upper extremity diagnoses completed a measure of response to job stress at their first clinic visit and were followed for 6 months during their prescribed treatment course. Controlling for age, gender, job type, diagnosis, patient perceptions of work-relatedness, baseline pain, grip strength, and treatment (surgery vs no surgery) analyses were conducted to determine whether self-reported response to perceived job stress was associated with pain and work status 6 months after the initial consultation.


RESULTS
Higher scores on the patient-reported job stress measure predicted higher levels of pain at 6 months. The measure was also a modest but significant predictor of work status at 6 months.


CONCLUSIONS
Evaluation of a working patient's self-reported cognitive and behavioral response to perceived increases in work demands, or what has been referred to as workstyle, predicts subsequent levels of upper extremity pain and work status. Generalization to other practice settings requires further study. This measure provides a brief evaluation of reaction to job stress that can be an important factor in certain patients with upper extremity symptoms. Future controlled studies addressing this aspect of the clinical picture are indicated.


METHODS
Prognostic IV.
Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Cherise B
CB
Harrington
Aamir
A
Siddiqui
Michael
M
Feuerstein
D000223:Adaptation, Psychological; D000328:Adult; D012090:Cumulative Trauma Disorders / Q000523:psychology* / Q000601:surgery; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D055809:Illness Behavior; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000523:psychology* / Q000601:surgery; D010146:Pain / Q000523:psychology* / Q000601:surgery; D010149:Postoperative Pain / Q000523:psychology; D012008:Recurrence; D012307:Risk Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications; D016526:Workload / Q000523:psychology*