Return to work after hand injury

PhD ceremony: Ms. L. Opsteegh, 16.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Return to work after hand injury

Promotor(s): prof. C.K. van der Sluis, prof. K. Postema, prof. J.W. Groothoff

Faculty: Medical Sciences

Return to work after a hand injury frequently takes longer than medically necessary. The majority of studies on determinants of return to work focus solely on biomedical factors, while psychosocial and work-related determinants could also be important. Pain, symptoms of post-traumatic stress disorder, injury location, and aesthetics of the hand, were found as determinants in a survey among hand-injured patients. To estimate the working possibilities of patients it is important that the job demands are known. The Dictionary of Occupational Titles claims to categorize all functions based on work load. However, this categorization appeared to be invalid for assessing upper extremity work demands. To match work demands and work capacity, workplace assessments and functional capacity evaluations remain the standard. An iterative and interactive stepwise developmental process was developed as a novel group intervention aimed at facilitating return to work in hand-injured patients. Different stakeholders were included, i.e., therapists, physicians, and patients, and recent scientific insights were used. Solution-oriented therapy served as framework. The intervention was tested in a pilot study, and results were compared to a historical control cohort. No statistical significant differences were found between the groups, although economic and clinical outcomes were different. The median time to return to work decreased by 5 weeks. No differences were found on several psychosocial measurements. Possibly common factors have a significant role in determining the effectiveness of the intervention.