Variables that predict successful outcome for a hospital-based work hardening program

Barbara Pearson (1998)

Work hardening programs provide a highly structured, multi-disciplinary treatment approach to assist injured workers in improving their physical strength, their endurance, and their psychosocial skills, thus enabling them to return to gainful employment. This study identified variables that predicted a successful outcome for clients in a work hardening program. Nine variables predicted a staff recommendation that the person was ready to return to work at the completion of the program. These included: male gender, a comparatively shorter time lapse between injury and entry into the treatment program, the absence of a back injury at the time of treatment, the absence of other previous injuries, relatively lower scores on the Beck Depression Inventory, and various scores on subscales 6,7,8 and 9 of the West Haven Multidimensional Pain Assessment Inventory (MPI). Two variables predicted improvement in physical capacity. These included: the absence of a back injury at the time of treatment, and shorter lengths of stay in the program. Four variables predicted client status (i.e., completion of the program or premature exit for medical reasons, non-compliance, referral to vocational rehabilitation or workman's compensation settlement) at the time they left the program. These included: the Beck Depression Inventory, subscales 2 and 6 of the MPI, and the absence or presence of a back injury. Implications of these findings are examined. The results suggest treatment recommendations including developing a program component for women, developing a program component for a spouse/significant other, assessment of depression in all phases of the program, and substance-abuse screening.