title: Recovery from musculoskeletal injury: the role of social support following a transport accident.
abstract: BACKGROUND
  Social support can be an important coping resource for persons recovering from injury. In this study, we examined the effects of family structure and sources of social support on physical health, persistent pain and return to work (RTW) outcomes following musculoskeletal injury (MSI) sustained in a transport accident.
  
  
  METHODS
  Secondary analysis of Transport Accident Commission (TAC) cross-sectional surveys held in 2010 and 2011 was conducted. In total 1649 persons with MSI were identified and included. Family structure was determined by marital status and number of children. Sources of social support were measured as perceived help from family, friends, neighbours and employers. Physical health was measured with the Physical Component Summary (PCS) score of the Short-Form-12 Health Survey Version 2. Persistent pain was defined as self-reported persistent pain experienced in the last 3 months, and RTW was defined as being back at work for ≥3 months at time of interview. Multiple linear and logistic regressions were used for the analyses.
  
  
  RESULTS
  Family and friends' support was associated with better physical health among persons with >1 day hospital stay. Being married or in a de facto relationship was associated with greater PCS score among non-hospitalised persons. Being widowed/separated/divorced was associated with more self-reported persistent pain (odds ratio 1.62 [95 % confidence intervals 1.11-2.37]). Support from family (0.40 [0.24-0.68]), friends (0.29 [0.17-0.47]) and neighbours (0.59 [0.41-0.84]) was associated with less persistent pain. Among women, support from family (0.09 [0.01-0.78]) was negatively associated with RTW, whereas support from friends (3.03 [1.15-8.02]) was positively associated with RTW. These associations were not observed among men. For both men (5.62 [2.77-11.38]) and women (7.22 [2.58-20.20]), support from employers was positively associated with RTW.
  
  
  CONCLUSIONS
  Family structure and sources of social support had a positive impact on physical health, persistent pain and RTW following MSI. This study highlights the importance of identifying people who have limited access to a social support network. Those with limited access to social support after a transport accident could potentially benefit from the provision of formal sources of practical and psychological support.
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia. khic-houy.prang@monash.edu.
authors.forename: Khic-Houy
authors.initials: KH
authors.lastname: Prang
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia.
authors.forename: Janneke
authors.initials: J
authors.lastname: Berecki-Gisolf
authors.affiliation: Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Newnam
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000223:Adaptation, Psychological; D000328:Adult; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology* / Q000534:rehabilitation; D011788:Quality of Life / Q000523:psychology*; D062707:Return to Work / Q000523:psychology*; D012917:Social Adjustment; D012944:Social Support; D055815:Young Adult