Association between worker's compensation and outcome following multidisciplinary treatment for chronic pain : roles of mediators and moderators.
To determine whether the tendency for chronic pain patients who receive Workers'Compensation to show a poorer response than noncompensated patients to pain treatment can be accounted for by mediating factors ; to assess whether moderating factors can distinguish subgroups of Workers'Compensation recipients who react very poorly to treatment from compensated patients who respond well.
A significant negative relationship between receiving Workers'Compensation and outcome was mediated by a pessimistic belief in the ability to return to former occupation.
Moderator effects showed that Workers'Compensation recipients with high initial pain and a history of pain-related surgery fared worse than any other group.
Moreover, Workers'Compensation recipients not characterized by high pain and a history of surgery responded as well as noncompensated patients.
The inadequate response to pain programs shown by Workers'Compensation recipients may be partly understood in terms of well-defined mediating factors, which may admit to amelioration via clinical intervention.
Moreover, Workers'Compensation patients should not be considered high risks for failure by sole virtue of their compensation status.
Multifactor assessment methods may be needed to identify that portion of compensation recipients who are actually at appreciable risk for treatment failure so that appropriate adjustments in treatment regimen may be made.
Mots-clés Pascal : Evolution, Traitement, Homme, Dommages intérêts, Compensation, Douleur, Médiateur, Médecine travail, Chronique
Mots-clés Pascal anglais : Evolution, Treatment, Human, Compensatory damage, Compensation, Pain, Mediator, Occupational medicine, Chronic
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0446777
Code Inist : 002B30A03B. Création : 01/03/1996.