Predictors of nonresponse in a questionnaire-based outcome study of vocational rehabilitation patients

Arch Phys Med Rehabil. 2009 Sep;90(9):1499-505. doi: 10.1016/j.apmr.2009.03.014.


Objective: To identify predictors of nonresponse to a self-report study of patients with orthopedic trauma hospitalized for vocational rehabilitation between November 15, 2003, and December 31, 2005. The role of biopsychosocial complexity, assessed using the INTERMED, was of particular interest.

Design: Cohort study. Questionnaires with quality of life, sociodemographic, and job-related questions were given to patients at hospitalization and 1 year after discharge. Sociodemographic data, biopsychosocial complexity, and presence of comorbidity were available at hospitalization (baseline) for all eligible patients. Logistic regression models were used to test a number of baseline variables as potential predictors of nonresponse to the questionnaires at each of the 2 time points.

Setting: Rehabilitation clinic.

Participants: Patients (N=990) hospitalized for vocational rehabilitation over a period of 2 years.

Interventions: Not applicable.

Main outcome measure: Nonresponse to the questionnaires was the binary dependent variable.

Results: Patients with high biopsychosocial complexity, foreign native language, or low educational level were less likely to respond at both time points. Younger patients were less likely to respond at 1 year. Those living in a stable partnership were less likely than singles to respond at hospitalization. Sex, psychiatric, and somatic comorbidity and alcoholism were never associated with nonresponse.

Conclusions: We stress the importance of assessing biopsychosocial complexity to predict nonresponse. Furthermore, the factors we found to be predictive of nonresponse are also known to influence treatment outcome and vocational rehabilitation. Therefore, it is important to increase the response rate of the groups of concern in order to reduce selection bias in epidemiologic investigations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Data Collection
  • Female
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Rehabilitation Centers
  • Rehabilitation, Vocational / methods*
  • Rehabilitation, Vocational / psychology*
  • Selection Bias
  • Socioeconomic Factors
  • Surveys and Questionnaires*
  • Wounds and Injuries / rehabilitation*
  • Young Adult