Impact of further injury on participation in work and activities among those previously injured: results from a New Zealand prospective cohort study

• Published in: Quality of life research 2018-12, Vol.27 (12), p.3167-3178
• Main Authors: Wilson, Suzanne J., Davie, Gabrielle, Harcombe, Helen, Wyeth, Emma H., Cameron, Ian D., Derrett, Sarah
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; CLINICAL AND POLICY APPLICATIONS; Cohort analysis; Cohort Studies; Female; Humans; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; New Zealand; Prevalence; Prospective Studies; Public Health; Quality of Life - psychology; Quality of Life Research; Sociology; Working hours; Young Adult
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-018-1970-9

Purpose To examine participation in paid work, unpaid work and activities 12 months after a sentinel (initial) injury, and to determine the impact of sustaining a subsequent injury (SI) on these participation outcomes. Methods Participants were recruited to the Prospective Outcomes of Injury Study following an Accident Compensation Corporation (ACC; New Zealand's no-fault injury insurer) entitlement claim injury. Outcomes were whether participants reported reduced paid work hours, reduced unpaid work (e.g. housework, gardening) or reduced activities (e.g. socialising, leisure pursuits) at 12 months compared to before the sentinel injury event. SIs were ACC claims of any type. Using multivariable models, characteristics of SIs were examined as potential predictors of reduced participation. Results At 12 months, 30% had reduced paid work hours, 12% had reduced unpaid work and 25% had reduced activities. Sustaining a SI predicted reduced paid work (RR 1.5; 95% CI 1.2, 1.8), but not unpaid work or activities. Participants who had sustained intracranial SIs were at highest risk of reduced paid work (RR 3.2, 95% CI 1.9, 5.2). Those sustaining SIs at work were less likely to have reduced paid work (RR 0.7; 95% CI 0.6, 1.0) than those with only non-work SIs. Participants sustaining assaultive SIs had higher risk of reduced unpaid work (RR 2.6, 95% CI 1.0, 6.8). Conclusions Reduced participation is prevalent after a substantive sentinel injury, and sustaining a SI impacts on return to paid work. Identification of SI characteristics that put people at high risk of participation restriction may be useful for focusing on rehabilitative attention.