EFFECT OF DISCHARGE RECOMMENDATIONS ON OUTCOME

被引:54
作者
HALL, H [1 ]
MCINTOSH, G [1 ]
MELLES, T [1 ]
HOLOWACHUK, B [1 ]
WAI, E [1 ]
机构
[1] CANADIAN BACK INST,330 FRONT ST W,SUITE 1200,TORONTO M5V 3B7,ON,CANADA
关键词
RECOMMENDATION; RESTRICTION; WORK; OUTCOME;
D O I
10.1097/00007632-199409150-00002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. The incidence of two common discharge recommendations, return to work unrestricted (RTWU) and restricted (RTWR) suggested that most restrictions were applied on the basis of patients' subjective reports of pain or therapists' unfounded fears that return to full duty would result in physical harm. Objectives. This prospective study compares the therapist's return to work recommendation to the patient's actual work status and analyzes the effect of that recommendation on outcome. Methods. There were 1438 consecutive patients reviewed by structured telephone interviews during the two halves of the study: the control group when pain was accepted as a reason for restriction and the study group when it was not. Summary of Background Data. In the control group, 44% of the patients were recommended to RTWU; for the study group, 81% received this recommendation. Compliance was 84% for the control subjects and 78% for the study group. Results. The absolute number of patients who returned to unrestricted work doubled in the study group. Conclusions. The probability of a successful return to normal duty increased with a recommendation of RTWU (P = 0.0001), whereas the probability of failure increased when restrictions were imposed (P = 0.0001).
引用
收藏
页码:2033 / 2037
页数:5
相关论文
共 35 条
[11]  
Estlander A., Mellin G., Vanharanta H., Hupli M., Effects and follow-up of a multimodal treatment program including intensive physical training for low back pain patients, Scand J Rehabil Med, 23, pp. 97-102, (1991)
[12]  
Fredrickson D.E., Trief T.M., Vanbeveren T., Yuan H.A., Baum G., Rehabilitation of the patient with chronic back pain, A Search for Outcome Predictors. Spine, 13, pp. 351-353, (1988)
[13]  
Gallagher R.M., Rauh V., Haugh L.D., Et al., Determinants of return-to-work among low back pain patients, Pain, 39, pp. 55-67, (1989)
[14]  
Greenough C.G., Fraser R.D., Assessment of outcome in patients with low back pain, Spine, 17, pp. 36-41, (1992)
[15]  
Hall H., Examination of the patient with low back pain, Bull Rheum Dis, 33, pp. 1-8, (1983)
[16]  
Hall H., Passive versus Active Conservative Treatment Options, (1992)
[17]  
Hazard R.G., Fenwick J.W., Kalisch S.M., Et al., Functional restoration with behavioral support, Spine, 14, pp. 157-161, (1989)
[18]  
Hemborg B., Moritz U., Hamberg J., Lowing H., Akesson I., Intraabdominal pressure and trunk muscle activity during lifting Effect of abdominal muscle training in healthy subjects, Scand J Rehabil Med, 15, pp. 183-196, (1983)
[19]  
Linton S.J., The relationship between activity and chronic pain, Pain, 21, pp. 289-294, (1985)
[20]  
Mayer T.G., Gatchel R.J., Kishino N.D., Et al., A prospective short term study of chronic low back patients utilizing novel objective functional measurement, Pain, 25, pp. 53-68, (1986)