COMPARISON OF NURSE VERSUS NON-NURSE CASE MANAGEMENT ON WORK DAYS LOST AMONG PERSONS WITH WORK-RELATED INJURIES.
Contributors: University of Cincinnati.
Published: 1994
Number of pages: 180
Subjects: Health Sciences, Nursing.; Health Sciences, Occupational Health and Safety.; Business Administration, Management.
Description: The purpose of this descriptive study was to distinguish differences in lost days among injured workers based on type of case management provider. The 118 subjects, drawn from 43 facilities of a manufacturing company, had sustained work-related injuries from 1988 to 1992, had received workers' compensation, and had returned to work. The sample was 59 pairs matched on type and mechanism of injury, age within six years, and gender. One member of each pair was in a facility with a nurse case manager; the matched case was in a facility with a non-nurse case manager. Data were collected on variables of demographics, medical condition, workers' compensation claims history, job satisfaction, facility characteristics, and case management activities.

Using the Cox Interaction Model of Client Health Behavior as a framework, it was hypothesized that nurse-client relationships in case management would facilitate prompt recovery and return to work. A matched pairs t-test on lost days performed on 47 pairs supported the null hypothesis that there was no significant difference (p = 0.418; one-tailed) between lost days in the nurse group (49.75 days; SD = 51.22) versus non-nurse group (51.70 days; SD = 54.22).

Regression analysis identified five factors associated with lost days: multiple physicians; non-union membership; conversion of claim from personal medical to workers' compensation, complications of injury, and strain injuries. These factors accounted for 32.75% of the variance in lost days. Factors that were not significant in lost days were: pre-existing conditions, previous claims, time from injury to filing claim, and attorney involvement.

Limitations of the study were those inherent in retrospective records review, and those related to missing data. In addition, the matching procedure did not result in pairs with high correlation of lost days (r = 0.259); therefore, power was inadequate to detect a statistically significant difference.

Implications of the study point to adopting a strong theoretical basis for practicing case management. The Cox interaction model offers a potential foundation for structuring a comprehensive program to guide individual clients to positive health outcomes. Recommendations for future study include both qualitative and quantitative approaches to better understand the process of nurse-client interaction in case management.
Notes: Source: Dissertation Abstracts International, Volume: 55-09, Section: B, page: 3818.

Thesis (PH.D.)--UNIVERSITY OF CINCINNATI, 1994.

School code: 0045.