Citation

Kadzielski JJ, Bot AG, Ring D. J. Hand Surg. Am. 2012; 37(9): 1812-1819.

Affiliation

Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.

Copyright

(Copyright © 2012, American Society for Surgery of the Hand, Publisher Elsevier Publishing)

DOI

10.1016/j.jhsa.2012.05.023

PMID

22763059

Abstract

PURPOSE: Motivation, job satisfaction, burnout, and secondary gain are factors that can influence return to work and disability after orthopedic injuries. The current study evaluated the separate effects of job satisfaction, burnout, and secondary gain on arm-specific disability after a finger injury. METHODS: Ninety-three employed patients with finger injuries were enrolled in this prospective study, and 51 completed the follow-up. Burnout (measured with Shirom-Melamed's Burnout Measure), job satisfaction (measured with the Job Descriptive Index questionnaire), and demographics were assessed at the initial visit. After 6 months, arm-specific disability was measured with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and general health status was measured with the Short Form-36 (SF-36) survey, mental component summary (MCS) and physical component summary (PCS). RESULTS: In the 51 patients with complete follow-up, the mean DASH score was 12, the mean SF-36 PCS was 48, the mean SF-36 MCS was 49, and the mean pain was 2.1. In multivariable analysis, pain and workers' compensation status explained 52% of the variability in DASH scores (pain alone accounted for 49%); pain accounted for 14% of the variability in SF-36 PCS scores; and workers' compensation accounted for 11% of the variation in the SF-36 MCS scores. CONCLUSIONS: The majority of variation in the SF-36 PCS and MCS scores remained unaccounted for by the models, but pain and workers' compensation were more important than job burnout or job satisfaction. Pain and workers' compensation were also significant predictors of the DASH. CLINICAL RELEVANCE: Workers' compensation and pain were more important than job satisfaction and burnout in explaining variations in arm-specific disability in patients with finger injuries. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.

Language: en