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Traumatic Brain Injury and Return to Work: A Review of Factors that have Negative, Positive, and No Relationship to Vocational Outcome in Brain Injured Individuals
1150-20 S 199?
(98FS-41)
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Issue: |
Identifying factors that may be used to predict ability to return-to-work for traumatic brain injured patients. |
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Agency: |
Simon Fraser University: Mental Health, Law and Policy Institute |
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Representative: |
Joti Samra-Grewal |
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Funding: |
$15,000.00 |
Context: Return-to-work (RTW) is an important endpoint in terms of measuring the effectiveness of rehabilitation among traumatic brain injured (TBI) patients. The ability to predict outcomes following injury influences decisions regarding diagnoses, prognoses, and treatment; as such, the ability to predict RTW rates following TBI is an integral part of understanding and improving rehabilitation of these patients.
Objective: To identify from the literature, factors that influence RTW for TBI patients, in order to understand and improve rehabilitation.
Design: A review of a wide body of literature was conducted to identify those factors reported to have either a negative, positive or no relationship to RTW for TBI patients. The factors are categorized as demographic, psychosocial, cognitive and neuropsychological deficits, workplace, and injury related.
Results: As all factors identified in the literature are classified as either having a negative, positive or no relationship, findings contradict each other in several incidents. A discussion of the limitations of the literature suggests that the contradicting findings may be the result of methodological variations. The absence of consistent operational definitions of successful employment is also identified as a major limitation of the research.
The study makes 19 practice recommendations for rehabilitation programming and future research directions regarding RTW for TBI patients. Some examples of the recommendations made are: Early post-injury intervention, multi-faceted rehabilitation, stabilizing neurological and/or psychiatric conditions prior to intervention and rehabilitation, individually tailoring rehabilitation to address specific patients’ needs, and taking into account individual patients’ pre-morbid characteristics.
Conclusion: It is suggested that RTW should not be the primary measure of social recovery. Other measures such as quality of personal relationships and leisure activities may be of primary importance to the TBI patient and may indirectly influence RTW for the patients. The summary also suggests that further research into the influence of workplace characteristics should also be considered. It is noted that some variables that may be useful for predicting RTW are not useful for predicting which patients will not return to work, suggesting that predictors should be examined separately for both successful and unsuccessful RTW.