Determinants of limitations in unpaid work after major trauma: a prospective cohort study with 15 months follow-up.
OBJECTIVE
To identify determinants of limitations in unpaid work (household work, shopping, caring for children and odd jobs around the house) in patients who had suffered major trauma (ISS≥16) and who were in full-time employment (≥80%) at the time of injury.


METHODS
Prospective cohort study.


METHODS
University Medical Centre Utrecht, a level 1 trauma centre in the Netherlands.


METHODS
All severely injured (ISS≥16) adult (age≥16) trauma survivors admitted from January 1999 to December 2000 who were full-time employed at time of the injury were invited for follow-up (n=214). Outcome was assessed with the 'Health and Labour Questionnaire' (HLQ) at a mean of 15 months (SD=1.5) after injury. The HLQ was completed by 211 patients.


RESULTS
Response rate was 93%. Logistic regression analyses identified the percentage of permanent impairment (% PI), level of participation (RtW), co-morbidity, lower extremity injury (LEI) and female gender as determinants of limitations in unpaid work. Patients with a post-injury status of part-time or no return to work experienced more limitations in unpaid work than those who returned to full-time employment.


CONCLUSIONS
Resuming paid work after major trauma is not associated with reductions in unpaid activities. To assess the long-term outcome of rehabilitation programmes, we recommend a measure that combines patient's satisfaction in their post-injury jobs with a satisfactory level of activities in their private lives.
Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, The Netherlands.
Susan
S
van Erp
Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands. Electronic address: h.r.holtslag@umcutrecht.nl.
Herman R
HR
Holtslag
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Ed F
EF
van Beeck
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014838:Volunteers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000534:rehabilitation
Household; Injury severity score; Limitations; Major trauma; Permanent impairment; Return to work; Unpaid work