Association between workers' compensation and outcome following multidisciplinary treatment for XXXX : roles of mediators and moderators.

@entity1 @entity1118 @entity158
OBJECTIVE: To determine whether the tendency for @entity1118 @entity1 who receive Workers' Compensation to show a poorer response than non-compensated @entity1 to @entity158 treatment can be accounted for by mediating factors; to assess whether moderating factors can distinguish subgroups of Workers' Compensation recipients who react very poorly to treatment from compensated @entity1 who respond well. DESIGN: Outcome study based on archives. SETTING: @entity158 . @entity1 : Of 214 @entity1 , 158 had complete data. OUTCOME MEASURE: Blind ratings of narrative discharge summaries written by the Pain Treatment Center staff. RESULTS: A significant negative relationship between receiving Workers' Compensation and outcome was mediated by a pessimistic belief in the ability to return to former occupation. Moderator effects showed that Workers' Compensation recipients with high initial @entity158 and a history of @entity158 fared worse than any other group. Moreover, Workers' Compensation recipients not characterized by high @entity158 and a history of surgery responded as well as noncompensated @entity1 . CONCLUSIONS: The inadequate response to @entity158 programs shown by Workers' Compensation recipients may be partly understood in terms of well-defined mediating factors, which may admit to amelioration via clinical intervention. Moreover, Workers' Compensation @entity1 should not be considered high risks for failure by sole virtue of their compensation status. Multifactor assessment methods may be needed to identify that portion of compensation recipients who are actually at appreciable risk for treatment failure so that appropriate adjustments in treatment regimen may be made.
