RESUMO
Purpose: The objective of this study was to investigate the measurement properties of the Return-To-Work Self-Efficacy (RTWSE) scale in injured Canadian workers. Method: We assessed internal consistency, construct-convergent, and known-groups validity of the RTWSE scale's total score and the pain management and re-injury self-efficacy (PRSE), supervisor support self-efficacy (SSE), and coworkers support self-efficacy (CWSE) domains in workers who had participated in a multidisciplinary rehabilitation program. Disability was measured by using the Disabilities of the Arm, Shoulder and Hand (DASH) scale. Spearman's ρ, odds ratios, and the area under the receiver operating characteristic curve (AUC) were used to examine the strength of the associations. Results: The data of 57 injured workers (43 men [75%], mean age 52 [11] y) were used for analysis. Internal consistency of the domains was satisfactory, with Cronbach's αs of 0.81, 0.87, and 0.92 for the CWSE, PRSE, and SSE, respectively. The PRSE domain correlated with the DASH (r = 0.39) and relevant domains of the RTWSE scale (rs = 0.47-0.78). The PRSE was able to differentiate between working and non-working people (AUC = 0.72). Satisfaction with the actual support received at work and overall job satisfaction correlated significantly with the total score and CWSE and SSE domains (AUCs ≥ 0.70). Conclusions: The RTWSE showed satisfactory internal consistency and construct convergent and known-groups validity in workers with shoulder injuries.
Objectif : explorer les propriétés de mesure de l'échelle d'efficacité personnelle liée au retour au travail (EPRT) chez des travailleurs canadiens blessés. Méthodologie : les chercheurs ont évalué la cohérence interne, la validité du construit convergent et la validité du groupe connu du score total de l'EPRT, ainsi que les domaines de l'efficacité personnelle de la gestion de la douleur et des nouvelles blessures (EPGDNB), de l'efficacité personnelle du soutien du superviseur (EPSS) et de l'efficacité personnelle du soutien des collègues de travail (EPSC) chez les travailleurs qui avaient participé à un programme de réadaptation multidisciplinaire. Les chercheurs ont mesuré l'incapacité à l'aide de l'échelle des incapacités du bras, de l'épaule et de la main (DASH, d'après l'acronyme anglais). Ils ont examiné la force des associations au moyen de la corrélation de Spearman, des rapports de cotes et de l'aire sous la courbe (ASC) de la fonction d'efficacité du récepteur. Résultats : les chercheurs ont analysé les données relatives à 57 travailleurs blessés 43 hommes [75 %], âge moyen de 52 ans [11]). La cohérence interne des domaines était satisfaisante : le coefficient alpha de Cronbach était de 0,81 pour l'EPSC, de 0,87 pour l'EPGDNB et de 0,92 pour l'EPSS. Le domaine de l'EPGDNB était corrélé avec l'échelle DASH (r = 0,39) et les domaines pertinents de l'EPRT (r s = 0,47 à 0,78). L'EPGDNB a pu distinguer les personnes qui travaillent de celles qui ne travaillent pas (ASC = 0,72). La satisfaction à l'égard du soutien réel reçu au travail et à l'égard du travail global avait une corrélation significative avec le score total et avec les domaines d'EPSC et d'EPSS (ASC ≥ 0,70). Conclusion : L'EPRT démontrait une cohérence interne, une validité du construit convergent et une validité des groupes connus satisfaisantes chez les travailleurs victimes d'une blessure à l'épaule.
RESUMO
BACKGROUND: Work-related rotator cuff injuries are a common cause of disability and employee time loss. PURPOSE: To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status. RESULTS: One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) (P < .0001). Eighty-four percent (n = 122) of patients exceeded the MCID of 17 points. Individual factors that affected patient overall disability were preoperative ASES, work status prior to surgery, access to care, and autonomy at work. Achieving a minimal clinically meaningful change was influenced by perceived access to care, autonomy and stress at work, and overall satisfaction with the job. CONCLUSION: Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.