Article

OBJECTIVE: To examine whether motivational interviewing (MI) leads to more
sustainable return-to-work outcomes for injured workers undergoing
rehabilitation. DESIGN: Cluster randomized controlled trial. SETTING: Workers'
compensation rehabilitation facility. PARTICIPANTS: Claimants (N=728) undergoing
rehabilitation for musculoskeletal conditions, who were predominantly employed
(529, 72.7%) men (460, 63.2%) with chronic conditions (mean duration, 234d).
INTERVENTIONS: MI is a goal-oriented, client-centered counseling approach that
facilitates behavioral change through identifying and resolving ambivalence.
Treating clinicians at the facility were randomized into 2 groups. One group
included 6 clinicians who were trained to conduct MI interventions during
rehabilitation, while the control group included 6 clinicians who continued
standard procedures. MAIN OUTCOME MEASURES: Outcomes included compensation
outcomes over 1 year after discharge. This included reception of disability
benefits and recurrence rates. Analysis was stratified by admission employment
status and included chi-square test, t test, and multivariable regression.
RESULTS: Participants included 728 claimants, of whom 367 (50.4%) were treated
with MI. Unemployed claimants in the MI group received significantly more partial
temporary disability benefits (mean, 8.2d vs 0.2d; P=.02), indicating return to
modified work duties. Employed claimants in the control group had a higher
recurrence rate (9.1% vs 4.5%; P=.04). The adjusted odds ratio for benefit
recurrence was 2.7 (95% confidence interval, 1.1-6.5) after controlling for age,
sex, and number of previous claims. CONCLUSIONS: Use of MI appears to lead to
more sustainable return to work after rehabilitation and facilitates transition
to modified work duties.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS