What influences positive return to work expectation? Examining associated factors in a population-based cohort of whiplash-associated disorders

Abstract

Study design: 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.

Summary of background data: 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.

Conclusion: 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.