O20-4 Modifiable factors associated with return-to-work self-efficacy; exploring early-claim differences between workers with a psychological or upper-body musculoskeletal injury

Objective Return-to-work (RTW) efforts for people with either a musculoskeletal or psychological injury has typically focussed on healthcare provision. However, the relationship between clinical improvements and RTW are weaker as duration of absence increases. Self-efficacy is psychosocial factor which is concerned with people’s beliefs in their abilities to RTW and has been associated with RTW outcomes among people with physical or psychological injuries. The objective of this study was to investigate modifiable early-injury factors which are associated with self-efficacy to RTW (RTW-SE) and explore whether these factors are different for people with psychological or upper-body musculoskeletal injuries (UB-MSK). Method The study used a prospective sample of workers with either an UB-MSK (N = 221) or psychological (N = 102) injury who had a claim for worker’s compensation accepted and were completely off work at the time of the baseline interview. Differences between injury types were investigated across variables related to: 1) the act of RTW (i.e. occupational rehabilitation); 2) communication with RTW parties (i.e. workplace contact); and 3) components of the job itself (i.e. job requirements). A stratified analysis was conducted using Structural Equation Models. Results The results show differences in the modifiable factors associated with RTW-SE for claimants with a psychological versus a UB-MSK injury. Higher job Autonomy was associated with greater RTW-SE for both injury types; however, the positive impact of low-stress contact from a return-to-work coordinator was unique among claimants with an UB-MSK injury. Increased stress when dealing with a health care provider (HCP), and inconsistent advice between HCP’s, resulted in lower RTW-SE among claimants with psychological injuries, but not UB-MSK conditions. Conclusions While job autonomy is associated with increased RTW-SE for both injury types, increasing RTW-SE among claimants with a psychological injury is characterised by the removal of stressful situations. These findings suggest injury-specific approaches to RTW-SE may be warranted.