Employment stability in the first 5 years after moderate to severe traumatic brain injury

Publication date: Available online 26 July 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Dominic DiSanto, Raj Kumar, Shannon B. Juengst, Tessa Hart, Therese M. O'Neil-Pirozzi, Nathan Zasler, Thomas A. Novack, Christina Dillahunt-Aspillaga, Kristin M. Graham, Bridget A. Cotner, Amanda Rabinowitz, Sureyya Dikmen, Janet Niemeier, Matthew R. Kesinger, Amy K. Wagner

Abstract

Objective

To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate to severe traumatic brain injury (TBI) that may be clinically addressed.

Design

Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.

Setting

Inpatient rehabilitation centers with telephone follow-up.

Participants

Individuals enrolled in the TBIMS-NDB since 2001, aged 18 to 59, with employment data at two or more follow-up interviews at years 1, 2, and 5 (N=5,683).

Interventions

Not applicable.

Main Outcome Measure

Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.

Results

Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, pre-injury employment, higher annual earnings, male sex, higher education, transportation independence post-injury, and no anxiety or depression at 1-year post-TBI.

Conclusions

Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2uQR71V
via IFTTT