Determinants of limitations in unpaid work after major trauma: A prospective cohort study with 15 months follow-up

ObjectiveTo identify determinants of limitations in unpaid work (household work, shopping, caring for children and odd jobs around the house) in patients who had suffered major trauma (ISS ≥ 16) and who were in full-time employment (≥80%) at the time of injury.DesignProspective cohort study.SettingUniversity Medical Centre Utrecht, a level 1 trauma centre in the Netherlands.MethodAll severely injured (ISS ≥ 16) adult (age ≥ 16) trauma survivors admitted from January 1999 to December 2000 who were full-time employed at time of the injury were invited for follow-up (n = 214). Outcome was assessed with the 'Health and Labour Questionnaire' (HLQ) at a mean of 15 months (SD = 1.5) after injury. The HLQ was completed by 211 patients.ResultsResponse rate was 93%. Logistic regression analyses identified the percentage of permanent impairment (% PI), level of participation (RtW), co-morbidity, lower extremity injury (LEI) and female gender as determinants of limitations in unpaid work. Patients with a post-injury status of part-time or no return to work experienced more limitations in unpaid work than those who returned to full-time employment.ConclusionsResuming paid work after major trauma is not associated with reductions in unpaid activities. To assess the long-term outcome of rehabilitation programmes, we recommend a measure that combines patient's satisfaction in their post-injury jobs with a satisfactory level of activities in their private lives.