Psychosocial Factors Impacting Workplace Injury Rehabilitation: Evaluation of a Concise Screening Tool

Jan 17, 2019

Psychosocial factors such as social support at home and in the workplace can impact both the causation and rehabilitation of workplace injuries. Previous evidence has found that workers with poorer perceived social supports often demonstrate prolonged workplace injury recovery time following simple acute musculoskeletal injuries. Another important factor is expectations of regarding return to work, those who have negative expectations take a more prolonged actual time to recover than those with positive expectations about return to work.  Overall, there is a strong body of evidence supporting the correlation between poor work domain social support and prolonged return to work.

To identify factors that impact workplace injury recovery there are a number of screening tools that have been developed throughout the world. There is no one screening tool that exists which can capture all factors that may be contributing to persistent pain in musculoskeletal injury in a time efficient manner with tools taking anywhere from a few minutes to 30 min to administer. The prolonged time to administer a screening tool is reported by physiotherapists to be the largest barrier for implementing available screening tools.

The current study aims to determine whether a concise four-question psychosocial screening tool taking less than 1 minute administer is effective at predicting simple musculoskeletal injury recovery time. The authors co-designed a tool called the ‘How are you Coping Gauge?’ (HCG). The tool requires the therapist to read a brief paragraph explaining the purpose and how to use the tool. The tool consists of four questions asking patients how they are coping.  The four questions of the HCG are:
1. How well are you coping with your symptoms?
2. How supported do you feel by your workplace, coworkers and managers?
3. How safe and supported do you feel by your family, friends and finances?
4. How confident are you that you will return to your normal work duties?

The patient verbally responds with a score from ‘0’ to ‘10’, indicating ‘very well’ or ‘not at all’. The scores for each of the four questions were then compared to the number of days between the workers first contact with the treating physiotherapist (the initial assessment) and the day of certification to full work capacity deemed by the worker’s treating medical practitioner.

Partial correlations were conducted to identify whether relationships existed between variables of interest: work support (social support received from work colleagues and supervisors); home support (support received from family, friends, and financial situation); and days to return to full capacity as certified by the treating medical practitioner. Age, gender, and injured body area were all controlled for in the analysis. Indicating that there may be an effect between social supports and return to full capacity. The results of the study suggests that simple musculoskeletal injuries which take longer than the normal pathophysiological healing timeframe to recover could potentially be explained by poor workplace or home social support.

This qualitative research lends support for the rationale behind the creation and implementation of the HCG screening tool, as a method of identifying the presence of poor social support for the individual’s recovery.  Furthermore, based on the study improving workplace and home domain social supports may be an effective way to assist with the return to work process. It is important that both workers compensation environments and employers understand the strategies that are available to them to improve these psychosocial factors.

Reference: McLinton, S., McLinton, S. S., & Van Der Linden, M. (2018). Psychosocial Factors Impacting Workplace Injury Rehabilitation: Evaluation of a Concise Screening Tool. Journal Of Occupational Rehabilitation, 28(1), 121–129. https://doi.org/10.1007/s10926-017-9701-6