工伤患者的心理健康与其索赔状况之间的关系：来自改进试验的探索性发现

IF 2.7 3区医学 Q1 REHABILITATION

Journal of Occupational Rehabilitation Pub Date : 2026-06-28 DOI:10.1007/s10926-026-10422-7

Vera Camões-Costa, Karen Nolidin, Alex Collie, Samantha Chakraborty, Justin Kenardy, Bianca Brijnath, Duncan Mortimer, Joanne Enticott, Danielle Mazza

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引用次数: 0

摘要

目的：工人赔偿索赔过程可能会加剧与工作有关的精神健康状况（WR-MHCs）个体的精神健康症状。本研究考察了心理健康结果与同期索赔状况之间的关系。方法：这项队列研究的数据来自153名患有WR-MHCs的全科患者，提供了422项观察结果，这些患者参加了澳大利亚的IMPRovE试验。通过3个月的调查评估工人的赔偿索赔状态（接受、拒绝、正在评估或没有索赔）、工作状态和心理健康结果（抑郁、焦虑、压力量表21 （DASS-21）和简短健康调查）。使用混合效应线性回归模型评估索赔状态与结果之间的关系，调整干预状态、工作状态、时间点、州、诊所规模、地点、年龄和性别。结果：在DASS-21中，正在评估索赔申请的患者报告的总体心理健康结果明显低于接受索赔的患者（例如，压力：β = 5.73, 95% CI 1.69-9.77），拒绝索赔的患者（例如，抑郁症：β = 5.88, 95% CI 1.12-10.63）或没有索赔的患者（例如，总体心理健康：β = 6.14, 95% CI 2.87-9.42）。在接受、拒绝或没有索赔的患者之间没有发现显著差异。结论：在这个队列中，与其他索赔状态相比，正在评估工人赔偿索赔的与工作有关的精神健康状况的个体的心理健康状况较差。在接受、拒绝和没有索赔的组之间没有观察到差异。这些发现表明，索赔过程的裁决阶段可能对某些个人特别具有挑战性，需要有针对性的临床和系统层面的关注。需要进一步的研究来确定因果关系并设计能够解决因果机制的干预措施。

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Association Between Mental Health of Patients with Work-Related Injury and Their Compensation Claim Status: Exploratory Findings from the IMPRovE Trial.

Purpose: Workers' compensation claims processes may exacerbate mental health symptoms for individuals with work-related mental health conditions (WR-MHCs). This study examined associations between mental health outcomes and contemporaneous claim status.

Methods: Data of this cohort study were drawn from 153 general practice patients with WR-MHCs providing 422 observations, enrolled in the IMPRovE trial across Australia. Workers' compensation claim status (accepted, rejected, being assessed, or no claim), working status, and mental health outcomes (Depression Anxiety Stress Scale-21 (DASS-21) and Short-form health survey) were assessed via 3-monthly surveys. Mixed-effects linear regression models were used to assess the relationship between claim status and outcomes, adjusting for intervention status, working status, time-point, state, clinic size, location, age, and gender.

Results: On the DASS-21, patients with a claim application being assessed reported significantly poorer overall mental health outcomes than those with accepted claims (e.g. stress: β = 5.73, 95% CI 1.69-9.77), rejected claims (e.g. depression: β = 5.88, 95% CI 1.12-10.63), or no claim (e.g. overall mental health: β = 6.14, 95% CI 2.87-9.42). No significant differences were found between patients with accepted, rejected, or no claim.

Conclusion: In this cohort, poorer mental health outcomes were observed amongst individuals with work-related mental health conditions whose workers' compensation claims were being assessed, compared with other claim statuses. No differences were observed between accepted, rejected, or no-claim groups. These findings indicate that the adjudication phase of the claims process may be particularly challenging for some individuals and warrant targeted clinical and system-level attention. Further research is needed to establish causality and design interventions that can address causal mechanisms.

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来源期刊

Journal of Occupational Rehabilitation Multiple-

CiteScore

5.80

自引率

12.10%

发文量

期刊介绍： The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law. A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.