Work Disability Among Injured Workers with Chronic Upper Extremity Disorders: Measurement and Determinants

Work disability represents an important source of the burden for individuals recovering from a work-related upper-extremity disorder (WRUED). Historically, a small subset of injured workers has shown to experience a prolonged recovery course characterized by poor health and work outcomes, which are associated with high workers' compensation costs. Beyond achieving an initial return-to-work, the sustainability of work (i.e. staying at work) and health-related work limitations (i.e. "on-the-job" problems) are increasingly recognized as relevant concerns in this population. In this thesis, three quantitative studies were conducted to contribute insights to the measurement and determinants of work disability associated with WRUEDs, using survey data gathered from injured workers attending a Workplace Safety Insurance Board Upper-Limb Specialty Clinic in Ontario. Specifically, these studies investigated 1) the factorial validity of the Work Limitations Questionnaire (WLQ-25), 2) the predictive ability of the Upper-Limb Work Instability Scale (UL-WIS) for subsequent transitioning out of work (i.e. poor sustainability of work), and 3) the relationship between the work environment and health-related work limitations, among injured workers with a WRUED. Study findings suggest that: 1) due to a specific area of psychometric underperformance, some adaptations are needed for the WLQ-25 before it is suitable for use; 2) the UL-WIS is an independent predictor of transitioning out of work, although some limitations as a standalone prognostic tool were also revealed; and 3) against initial hypothesis, broad differences in the work environment (based on variations across 12 specific workplace characteristics) did not have significant associations with the extent of health-related work limitations experienced by injured workers with a WRUED. Study findings were discussed in terms of how they advance current understanding on the measurement and determinants of work disability, and potential implications in terms of the assessment and management of work disability among injured workers recovering from a WRUED. Future research directions were also proposed to build on current work.Ph.D.2016-11-30 00:00:0