Objective . This study identified predictors (clinical, demographic, economic, job, psychosocial, and organizational) of a change in self-efficacy which, at two months post surgery, along with organizational policies and practices (OPPs) have been shown to be a significant predictor of successful work role function following carpal tunnel release surgery (CTRS). The role of these same variables in accommodation of the employee in the workplace was also explored.
Methods . A community based cohort (N=148) of persons meeting selection criteria for CTRS were followed for one year post surgery. Predictors of a change in self-efficacy were analyzed using linear regression. Logistic regression was used to determine those variables associated with accommodation.
Results . Employee's perception of organizational policies and practices predicted the change in self-efficacy (p=.001) with R2 =0.291. Significant covariates included personal health status and force times repetition, a measure estimating the physical work load which increased the R2 of the model to 0.419. No significant variables, including OPPs, were associated with accommodation at baseline.
Conclusion . The work environment and specifically the organizational level OPPs are important in predicting a change in self efficacy following CTS. This research supports the role of the environment as described in the social cognitive theory and provides a mechanism or link between OPPs and SE. Primary and secondary models for disability should be multidimensional, temporal and include workplace policies and practices. These OPPs should include disability management, safety, ergonomics and a people oriented culture. OPPs were not associated with accommodation. To better understand the behavior of an employee following an illness or injury, the work environment and its influence on the employee needs further evaluation.
