Injuries occur and outcomes vary dependent on a variety of factors. One such factor is anxiety/stress.
Workers’ compensation injuries are a fact of doing business. While injuries will occur, a frustrating consideration for employers, workers and payers alike, is that clinical outcomes “among workers’ compensation patients have traditionally been found to be worse than those of non-workers’ compensation patients. In addition, workers’ compensation patients take significantly longer to return to their jobs, and they return to their preinjury levels of employment at a lower overall rate.1” Since it’s routinely confirmed that this patient population has poorer outcomes, it becomes critical for healthcare providers and stakeholders to implement strategies to minimize variables complicating return to work. One such variable is stress. While perhaps outside the normal considerations for employers/payers, pursuing a strategy to minimize stress to the injured worker will result in better functional outcomes, faster return to work, and reductions in medical claim costs.2
After an injury has occurred on the job, a worker may experience an abundance of emotions, ranging from fear and disbelief, to anxiety about what lies ahead. In addition to the obvious concerns regarding their injury, a worker may also have the following fears and concerns3:
Considering that a recent survey4 suggest that only 39% of Americans could cover an unplanned expense of $1,000, you can imagine that the idea of not working for a prolonged period of time could significantly stress an injured worker as “rainy-day” funds may quickly become depleted. Even with worker’s compensation benefits providing a fraction of the worker’s normal pay, it may not be enough to cover bills. And that’s not all, an injured worker may be stressed by an inability to assist with non-work-related tasks. Whether aiding in child care, maintaining a home, or helping an aging family member, the injured worker’s ability to assist may be significantly impacted. While workplace injuries do occur at work, the injury itself often impacts all aspects of the injured worker’s day … and this can create lots of stress.
So why is stress a problem? In short, it impacts multiple systems of the body, and when prolonged, will negatively impact healing. But how? Let’s first begin by examining a system of the body that many of us have heard about, but may not understand well: the Sympathetic Nervous System (SNS). This is the body’s “fight or flight” system, and stimulation of the SNS engages/modifies a variety of body systems, all in response to a release of adrenaline.
This systems is designed to be an on/off system, but pain, stress, lack of sleep, and other considerations can lead to prolonged stimulation of the SNS, keeping the individual in a perpetual state of excitability. Understanding that this “fight or flight” system is all “brain driven and occurs in response to […] thoughts, beliefs, perceptions, moods and memories5” is crucial, as perceived or actual stress can facilitate the injured worker remaining in this excitable state. This is a huge problem for an injured worker, as the body heals, recovers, and experiences restful sleep when the SNS is “off.” When the SNS is “off” the Parasympathetic Nervous System (PNS)) can become more active, and subsequently allow for improved rest and healing.
Additionally, because the brain is the controller of bodily systems, perceived or actual stresses also stimulate an endocrine response (releasing another chemical, cortisol – a stress hormone). If a stress is persistent, cortisol levels will increase and this has been “linked to slow healing, poor healing, loss of memory, loss of libido, depression, despair and a decline in physical performance.5” Furthermore, this prolonged endocrine response stimulates the immune system to release pro-inflammatory cytokines. This can further impact healing in a negative fashion, as the body remains in a state of inflammation.
As outlined above, prolonged stress, whether actual or perceived, has a myriad of negative consequences. So what are employers to do about it? “Current research shows that the employers who include empathy in their workers’ compensation practices can experience better outcomes. An employee-first approach fosters trust and confidence, which results in greater employee engagement and motivation, as well as a decrease in costs.2” So how can employers improve their practice of empathy? Communication!
! It’s crucial for the employer to learn about the unique concerns of their injured employees – “This open communication helps alleviate employee worries, misperceptions about being injured and what to expect during the workers’ compensation process.3” By facilitating one-on-one communication, there is a “opportunity to build trust and put the employee at ease. The clear message employers need to convey is: “I’m sorry that this happened to you. You’re a valuable member of the team and, together, we’ll get through this.2″ Put another way, “the reality is that positive outcomes depend more on a company’s value system, such as whether an organization views its employees as assets rather than liabilities.6”
While employers can do their part to reduce stress to their injured workers, physical therapists can also serve as emphatic educators and providers of customizable healthcare interventions to improve the probability of good outcomes. Physical therapists, by means of the time spent with injured workers (often 2-3 hours/week for several weeks), have a unique opportunity to treat, educate, and follow-up with injured workers to ensure concerns, stressors, and anxiety are appropriately addressed. This may include education on:
Additionally, Results Physiotherapy Physical Therapists are trained on a biopsychosocial approach to patient interaction. This approach, which focuses on treating the whole person vs. the diagnosis, will be discussed further in an upcoming blog post. This biopsychosocial approach emphasizes education/communication and is an excellent approach to reducing stress for injured workers.
Employers and healthcare providers have an opportunity to improve outcomes for injured workers. While the approach outlined above (which focuses on education, empathy, and communication) may demonstrate a deviation away from current practices, it’s worth highlighting that “studies have found that employers who consistently utilized an empathetic approach have experienced the following:
Those numbers are very encouraging. Not only do the numbers above illustrate that managing an employee’s stress yields meaningful change, it’s also worth noting that those numbers are likely to reduce the stress of the employer as well. It’s a win-win!
To learn more about how Physical Therapy can help anxious or stressed workers, contact Results Physiotherapy at https://resultspt.com/request-info
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