Determinants of limitations in unpaid work after major trauma: a prospective cohort study with 15 months follow-up

Injury. 2014 Mar;45(3):629-34. doi: 10.1016/j.injury.2013.10.019. Epub 2013 Oct 26.

Abstract

Objective: To identify determinants of limitations in unpaid work (household work, shopping, caring for children and odd jobs around the house) in patients who had suffered major trauma (ISS≥16) and who were in full-time employment (≥80%) at the time of injury.

Design: Prospective cohort study.

Setting: University Medical Centre Utrecht, a level 1 trauma centre in the Netherlands.

Method: All severely injured (ISS≥16) adult (age≥16) trauma survivors admitted from January 1999 to December 2000 who were full-time employed at time of the injury were invited for follow-up (n=214). Outcome was assessed with the 'Health and Labour Questionnaire' (HLQ) at a mean of 15 months (SD=1.5) after injury. The HLQ was completed by 211 patients.

Results: Response rate was 93%. Logistic regression analyses identified the percentage of permanent impairment (% PI), level of participation (RtW), co-morbidity, lower extremity injury (LEI) and female gender as determinants of limitations in unpaid work. Patients with a post-injury status of part-time or no return to work experienced more limitations in unpaid work than those who returned to full-time employment.

Conclusions: Resuming paid work after major trauma is not associated with reductions in unpaid activities. To assess the long-term outcome of rehabilitation programmes, we recommend a measure that combines patient's satisfaction in their post-injury jobs with a satisfactory level of activities in their private lives.

Keywords: Household; Injury severity score; Limitations; Major trauma; Permanent impairment; Return to work; Unpaid work.

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Comorbidity
  • Disability Evaluation*
  • Employment
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Patient Satisfaction / statistics & numerical data*
  • Prospective Studies
  • Surveys and Questionnaires
  • Volunteers / statistics & numerical data*
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / rehabilitation