目的 探讨工人工伤后回归工作(RTW)的个案管理模式.方法 以523名在康复中心的工伤工人为回顾性队列,从病历记录中收集其社会人口学特征、医疗和RTW干预行为等信息,采用单因素分析和Cox回归分析检查个案管理及其他因素对RTW的影响.结果 在有效的335名调查对象中,275名(82.1%)在随访期间成功回归工作,平均休假期36.0 d.电脑技术培训促进RTW(P<0.01),而伤残适应小组则有抑制作用(P<0.05);教育程度、家庭成员对RTW的态度、伤残程度也与RTW结局有关.结论 特定技能的重建与培训是个案管理的重要组成部分.虽然伤残适应小组的活动未能显示为有利因素,但可能会改善工人的一般健康状况,应加强此方面的研究.%Objective To explore the case management model of return to work injured workers. Methods A retrospective cohort was formed with 523 injured workers in rehabilitation centre. The social demographic information, medical data and intervention process were extracted from the medical records. A Cox Regression Model was used to examine the effect of case management on work processes and other relevant factors affecting RTW. Results 275 cases (82.1％) out of the 335 subjects successfully returned to work after median absence duration of 36.0 days. Computer training prompted RTW outcomes (P＜ 0.01), while disability adjustment activity showed an opposite effect (P＜ 0.05). It showed that education level, family attitude to RTW and level of injury were significantly associated with outcomes of RTW.Conclusion Specific skills reconstruction and training would is one of the most important components of the case management intervention program on RTW. Although disability adjustment did not specifically benefit RTW, it might help in improving workers' general health status,and it should not be ignored in any case.
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