Date of Award:

10-2011

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Psychology

Advisor/Chair:

Scott DeBerard, PhD

Abstract

Currently, rotator cuff injuries are the most common problem for the shoulder and accounted for 4.1 million physicians visits. Partial and full thickness tears are more common in people over the age of 50. The increased prevalence of rotator cuff injuries in the United States population certainly affects the working population and often represents a significant economic burden for employers. Few studies have examined outcomes in worker compensation patients or considered biopsychosocial predictive variables for rotator cuff repairs. The current study aimed to characterize injured workers who have undergone rotator cuff repairs across a number of pre- and postprocedural variables, evaluate multidimensional functional and quality of life outcomes, and examine biopsychosocial variables predictive of success and failure in this sample.

The current study examined 93 injured workers who had undergone at least one rotator cuff repair within the past five years. Participants were solicited through the Worker’s Compensation Fund of Utah (WCF) computerized database. The current study used a retrospective cohort design, patients’ medical charts were reviewed, and various preprocedural variables were coded for analysis including age at the time of the rotator cuff repair, lawyer involvement in the claim, prior shoulder surgery history, and quantity of other compensation claims. Of the total sample, 47 patients (50.5%) were contacted and completed outcome surveys that assessed patient satisfaction, shoulder functional impairment, disability status, and general physical and mental health functioning.

Findings revealed that approximately one third of the patients were totally disabled (29.8%), had poor shoulder specific functioning (36.2%), and were dissatisfied with their current shoulder condition (31.7%). A multivariate regression model was utilized in predicting patient outcomes. Specifically, the number of WCF claims of the patient was a robust predictor of multidimensional outcomes, while age and gender were less predictive of outcomes, and the presence of a prior shoulder surgery reflected no predictive power. Results of descriptive, correlational, and regression analyses are compared to existing data for rotator cuff repair patients when available or to other surgical procedures with similar populations. The study limitations are discussed, such as small sample size, the retrospective design, and lack of matched controls.

Comments

This work made publicly available electronically on November 21, 2011.

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