Association between financial distress and levels of discomfort and incapability after musculoskeletal injury.

Abstract

To determine whether self-reported financial stress is associated with levels of capability during recovery from musculoskeletal injury. Design: Cross-sectional survey SETTING: Multiple metropolitan musculoskeletal outpatient specialty offices PATIENT SELECTION CRITERIA: Adult outpatients seeking specialty care within 6 months of a musculoskeletal injury (fracture, tendon rupture, sprain, or dislocation). Capability was measured using the PROMIS Physical Function Computer Adaptive Test. Financial stress was measured using the FACIT-COST Version 2 questionnaire. Explanatory variables included levels of distress and unhelpful thoughts regarding sensations, social health, and sociodemographic characteristics. Associations with capability were examined using bivariate analyses and multivariable linear regression. Among 131 participants (56% men, mean age 42 ± 17 years), and an average of 8 ± 6 weeks had elapsed since injury. In multivariable analysis, higher capability was associated with longer time since injury (regression coefficient [RC] = 0.51, p < 0.01) and uninsured status (relative to Medicare coverage; RC = 13, p < 0.01). Lower capability was observed among unemployed participants (RC = -4.6, p = 0.033) and those with lower extremity injuries (RC = -4.5, p < 0.01). Financial stress demonstrated a modest inverse association with capability (RC = -0.20, p = 0.014). Measures of distress and unhelpful thinking were not independently associated with capability. LEVEL OF EVIDENCE: Level IIIb, Cross Sectional Observational study.