What influences positive return to work expectation? Examining associated factors in a population-based cohort of whiplash-associated disorders.
METHODS
Cross-sectional study of population-based traffic cohort.


OBJECTIVE
To determine which factors are associated with both positive and negative expectations for returning to work after vehicle collision resulting in neck pain.


BACKGROUND
Positive expectations predict better outcomes for a variety of health conditions, including return to work from soft-tissue injury (including whiplash-associated disorders [WADs]). However, we know little about those with negative expectations who may be at risk for poor WAD outcomes.


METHODS
We assessed expectations for return to work in a population-based cohort of 2335 individuals with traffic-related WAD. We used logistic regression analysis to model factors associated with expecting to return to work (compared with not expecting to return to work or being unsure).


RESULTS
Depressive symptomatology, lower education, lower income, male sex, and greater initial pain (greater percentage of body in pain and greater intensity of neck pain) were associated with lower return-to-work expectation.


CONCLUSIONS
A number of demographic, socioeconomic, and injury-related factors were associated with expectations for return to work in WAD. Two of the strongest associated factors were depressive symptomatology and postcollision initial neck pain intensity. These results support using a biopsychosocial approach to evaluate expectancies and their influence on important health outcomes.
Ozegovic
Dejan
D
Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Alberta, Canada. ozegovic@ualberta.ca
Carroll
Linda J
LJ
Cassidy
J David
JD
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D012525:Saskatchewan; D014911:Whiplash Injuries / Q000150:complications*; D014937:Work / Q000523:psychology*; D055815:Young Adult