The utility of measuring sexual disability for predicting 1-year return to work

Gross DP, Knupp H, Esmail S. The utility of measuring sexual disability for predicting 1-year return to work.

Objective

To explore sexual disability in injured workers undergoing rehabilitation. Specifically, we investigated (1) factors associated with high ratings of sexual disability, (2) factors associated with noncompletion of the sexual disability questionnaire, and (3) the association between sexual disability and future recovery.

Design

Historical cohort study with 1-year follow-up.

Setting

Workers' compensation rehabilitation facility.

Participants

Workers' compensation claimants (N=1078) undergoing return-to-work assessment. Ratings of sexual disability were measured using the Sexual Behavior item of the Pain Disability Index. Other demographic, clinical, and occupational factors also were collected.

Intervention

Not applicable.

Main Outcome Measures

Outcomes included administrative indicators of timely and sustained recovery and return to work.

Results

Of subjects included in analysis, 18.5% did not complete the Sexual Behavior item. Claimants were less likely to complete if they were women, older, and single; had lower salaries, injury diagnoses other than sprain/strain, and fewer health visits before assessment; and reported lower recovery expectations. Higher levels of sexual disability were associated with higher levels of overall pain and disability, as well as being in a married/common law relationship. After adjusting for injury duration, the Sexual Behavior item was not associated significantly with any recovery measure or claims outcome.

Conclusions

A response bias exists in Canadian injured workers asked to complete a sexual disability rating. In those completing the questionnaire, higher sexual disability was associated most closely with higher pain severity and higher disability. Perceptions of sexual disability did not contribute to predicting recovery, which supports replacement of this item for use within this and related contexts.