Sandy Lee , J Yap, PP Chen Pain Management Centre,

1. Sick Leave in Patients with Chronic Pain due to Occupational Injury in an Employer-Financed Work-Injury Compensation System Sandy Lee, J Yap, PP Chen Pain Management Centre, Department of Anaesthesiology & Operating Services, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong

2. Introduction • Local surveys reported work-related injury was the most frequent cause of chronic pain: 21-36% Ng KF, Tsui SL, Chan WS. Clin J of Pain. 2002; 18: 275-81 Chen PP, Chen J, Gin T et al. Hong Kong Med J. 2004; 10: 150-55 • Chronic pain and the associated factors may prevent the worker from returning to work • Long sick leave has adverse impact on individual and social status Vingard E, Alexanderson, K, Norlund A. 2004; 63: 207-15 Johnson CJ, Croghan E, Crawford J. Journalof NursingManagement. 2003; 11: 336-42

3. Objective • This study examinedissues on • pain • sick leave & • return-to-work among work-injured patients with chronic pain at a regionalpain management centre in Hong Kong

4. Methodology • A cross-sectional survey • All patients attending Outpatient Pain Centre at AHNH • 1stMay - 31st Oct 2007 • Exclusion criteria • Informed consent

5. Methodology • Questionnaire • Demographic profiles & pain data • Sick leave including the duration and reasons • Reasons of failure to return to work after injury • Health related quality of life and psychological evaluation: • HADS, PCS, SF-36

6. Statistics Frequency: to measure descriptive data Mann-Whitney U test, chi square test: to evaluate any differences between work-injured chronic pain patients and those with non-work-related injury: data of demographics, pain, health related QOL and psychological evaluation Correlation, Mann-Whitney U test, Kruskal-Wallis test: to analyse factors affecting the respondents’ sick leave duration after work injury: data of demographics, pain, health related QOL and psychological evaluation All p-value less than 0.05 were considered significant

7. Result • 442 invited • 365 recruited • 207 work-related-injury causing chronic pain

8. Demographic profiles * Significant at p<0.05

9. Pain data * Significant at p<0.05

10. HRQOL & Psychometrics Scores * Significant at p<0.05

11. Sick Leave in Work-Injured Patients • 90.8% had taken or were on sick leave • Mean [SD] duration of sick leave: • 20 months [12.8] • Reasons for continuation of sick leave > 6 months: • Belief that their injury had not yet healed • Allow time to reach maximal medical improvement • Consider further or alternative treatment

12. Failure in Return-to-Workin Work-Injured Patients • Reasons • Pain-induced disability • Coexisting psychological or mood problem • Fear of pain aggravation or re-injury during work • Belief that they should not return to work if the condition had not completely healed

13. Factors Associated with Sick Leave Duration in Work-Injured Patients * Significant at p<0.05

14. Factors Associated with Sick Leave Duration in Work-Injured Patients * Significant at p<0.05

15. Conclusion • Local Chinese patients with chronic pain from work-related injury attending our pain management centre had long duration of sick leave • Sick leave duration was associated with perceived physical disability, psychological dysfunction, involvement of social welfare and litigation • Work-injured chronic pain patients were associated with more unfavourablepsychometric scores than in patients with chronic pain without work injury • Apart from perceived disability and psychosocial dysfunction, expectation of full recovery was common reason for long sick leave and failure in RTW

16. Thank you