某机车制造企业工人工伤后回归工作的影响因素

Predictors of return to work after occupational injury in a locomotive enterprise

目的了解工人工伤后回归工作状况及其主要影响因素，为促进工伤工人回归工作岗位的干预提供依据。方法以某国有大型机车制造企业的工伤工人为对象进行回顾性队列研究。工伤工人的社会人口学信息、临床状况、经济水平来自于工厂文件档案，工人心理学资料由对工人的问卷调查获得。用单变量及Cox回归模型分析回归工作结局与可能的影响因素。结果323例工伤工人中有300名（92．9％）工人成功回归工作岗位，缺勤中位数为43d。单因素分析表明，社会人口学特征、临床状况、经济水平及心理学特征均影响回归工作结局。多因素分析结果表明，年龄、伤残程度、受伤部位和性质、伤处疼痛、自觉身体状况、伤前收入是回归工作结局的影响因素。结论多方面的因素影响工人工伤后回归工作，临床治疗和康复、公司就业政策是重要影响因素。未来研究应扩大样本资源，明确主要的影响因素，建立跨学科的干预措施，以促进工人工伤后回归工作。

Objective To identify the potential determinants of return to work （RTW） following work-related injury. Methods A historical cohort of workers with occupational injury in a state-owned locomotive vehicle company in central China was followed up for RTW. Demographic, employment and medieal information was retrieved from the company archival documents; and post-injury information was interviewed by questionnaires. Univariate analysis and Cox Regression Model were used to examine the associations be- tween potential determinants and outcomes of RTW. Results Three hundred of the 323 included cases （92.9%） eventually returned to work after the median absence of 43 days （average of 49.2 days）. Factors from socio-demographic, clinical, economie and psychological domains were found affecting RTW in the univariate analyses. The multivariate analysis indicated that age, injury severity, injury locus, injury nature, pain in the injui）, locus, self-reported health status and pre-injury monthly salary were significant determinants of RTW. Conclusions There are multidimensional factors affecting RTW after occupational injury＇. Proper clinical treatrnent and rehabilitation, as well as economic and social support to facilitate workers＇ RTW would he the priorities for intervention. Future studies shouhl he conducted in a larger representative sample to confirm the findings and to develop a muhidisciplinapy intervention strategy towards promoting RTW.