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Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for
N Krause1, J W Frank, L K Dasinger
1Division of Epidemiology, School of Public Health, University of California at Berkeley, 745 University Hall, Berkeley, CA 94720-7360, USA. nkrause@uclink4.berkeley.edu
Background:
The purpose of this review was to identify critical data and research needs in addressing the following question: What are the primary factors that affect the time lost from work, return-to-work (RTW), subsequent unemployment, and changes in occupation after disabling illness or injury?
Methods:
Review of the literature to identify research challenges originating from the multitude of disciplines, data sources, outcome measures, and methodological and analytical problems.
Results:
About 100 different determinants of RTW outcomes were identified. Their impact varies across different phases of the disablement process. Recommendations are provided for addressing five selected research challenges.
Conclusion:
Interdisciplinary research needs to develop a comprehensive conceptual framework. Priority should be given to studies on specific domains of risk factors meeting five selection criteria: amenability to change; relevance to users of research; generalizability across health conditions, disability phases, and settings; "degree of promise" as derived from qualitative exploratory studies; and capacity to improve measurement instruments. Combining qualitative and quantitative research methods is necessary to bridge existing knowledge gaps.
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