Risk Factors For Functional Restoration Non-completion

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Title: Risk Factors For Functional Restoration Non-completion
Author: Howard, Krista J.
Abstract: Previous studies have shown that the one -year outcomes after an interdisciplinary functional restoration program for patients with chronic disabling occupational disorders vary significantly between those who complete the program and those who prematurely drop -out . Non -completers are 9 .7 times less likely to return -to -work at any time , and are 7 times less likely to retain work at one year , relative to those who complete the program . Non -completers are also 7 times more likely to have post -rehabilitation surgery to the original injured area , while also displaying higher levels of healthcare utilization . The present study focuses on identifying the risk factors for non -completion of a functional restoration program for these chronic patients . This was a prospective cohort study of consecutive patients undergoing functional restoration treatment in a regional rehabilitation referral center . The sample consisted of 3 ,052 consecutive patients , classified as either completers (C group , N= 2 ,367 ) or non -completers (NC group , N= 685 ) , who entered a functional restoration program . The measures used included medical evaluations , demographic data , DSM psychiatric diagnoses , the MMPI , and validated questionnaires evaluating pain , depression and occupational factors . Patients were admitted to a comprehensive interdisciplinary functional restoration program which provides medical and psychosocial support , along with quantitatively -directed exercise and disability management . A logistic regression analysis was utilized to further assess the significant univariate factors found to be associated with non -completion status . The findings revealed that patients who did not complete the program had a longer duration between injury and admission to treatment , a higher score on the MVAS , and were less likely to be working at the time of admission to treatment . Furthermore , patients who were opioid dependent were 1 .5 times more likely to drop out of rehabilitation , and patients diagnosed with a socially problematic cluster B Personality Disorder , especially Borderline , were 1 .6 times more likely to drop out . Although some risk factors associated with program non -completion may be addressed in treatment , socially maladaptive personality disorders , long -neglected disability and chronic opioid dependence are major barriers to successful treatment completion and social re -integration .
URI: http : / /hdl .handle .net /10106 /1052
Date: 2008-09-17


Risk Factors For Functional Restoration Non-completion. Available electronically from http : / /hdl .handle .net /10106 /1052 .

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