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Bah MG, Chen AY, Hart K, Vahidy Z, Coles J, Mahas R, Eden SV. Racial Disparities in Employment Status After Moderate/Severe Traumatic Brain Injuries in Southeast Michigan. Arch Phys Med Rehabil 2023; 104:1173-1179. [PMID: 37178951 PMCID: PMC10524608 DOI: 10.1016/j.apmr.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/26/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To examine the progress made in recent decades by assessing the employment rates of Black and non-Hispanic White (NHW) patients after traumatic brain injury (TBI), controlling for pre-TBI employment status and education status. DESIGN Retrospective analysis in a cohort of patients treated in Southeast Michigan at major trauma centers in more recent years (February 2010 to December 2019). SETTING Southeastern Michigan Traumatic Brain Injury Model System (TBIMS): 1 of 16 TBIMSs across the United States. PARTICIPANTS NHW (n=81) and Black (n=188) patients with moderate/severe TBI (N=269). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Employment status, which is separated into 2 categories: student plus competitive employment and noncompetitive employment. RESULTS In 269 patients, NHW patients had more severe initial TBI, measured by percentage brain computed tomography with compression causing >5-mm midline shift (P<.001). Controlling for pre-TBI employment status, we found NHW participants who were students or had competitive employment prior to TBI had higher rates of competitive employment at 2-year (P=.03) follow-up. Controlling for pre-TBI education status, we found no difference in competitive and noncompetitive employment rates between NHW and Black participants at all follow-up years. CONCLUSIONS Black patients who were students or had competitive employment before TBI experience worse employment outcomes than their NHW counterparts after TBI at 2 years post TBI. Further research is needed to understand better the factors driving these disparities and how social determinants of health affect these racial differences after TBI.
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Affiliation(s)
- Momodou G Bah
- Michigan State University College of Human Medicine, East Lansing, MI
| | - Alex Y Chen
- Department of Neurology, Case Western Reserve University, University Hospital Cleveland Medical Center, Cleveland, OH
| | - Kristina Hart
- Wayne State University School of Medicine, Detroit, MI
| | - Zara Vahidy
- Wayne State University School of Medicine, Detroit, MI
| | - Jasmine Coles
- Wayne State University School of Medicine, Detroit, MI
| | - Rachel Mahas
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
| | - Sonia V Eden
- Department of Neurosurgery, Semmes Murphey Clinic, Memphis, TN; University of Tennessee Health Sciences Center, Memphis, TN.
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2
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Chen PY, Hsieh SH, Lin CK, Wei L, Su YK, Tsai PS, Chiu HY. Mental fatigue mediates the relationship between cognitive functions and return to productive activity following traumatic brain injury: a mediation analysis. Brain Inj 2022; 36:32-38. [PMID: 35099340 DOI: 10.1080/02699052.2022.2034044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE We performed a mediation analysis to investigate how mental fatigue mediates the relationship between cognitive functions and the return to productive activity following TBI. METHODS One hundred and one people (≥20 years) with first-time TBI more than 3 months who completed a series of cognitive tasks followed by Chinese versions of the Mental Fatigue Scale and Community Integration Questionnaire-Revised. Mediation analysis was used to test our hypotheses. RESULTS Recognition memory and information processing speed were the only cognitive functions correlated with mental fatigue (B = -0.56 and -0.37, P = .04 and < 0.001) and the return to productive activity (B = 0.69 and 0.19, both P < .001) after controlling for confounders. Mental fatigue partially mediated the associations of recognition memory and information processing speed with the return to productive activity (B = 0.15 and 0.08, P = .001 and < 0.001, proportion of mediation = 22% and 46%) after the adjustment of confounders. CONCLUSIONS The findings suggest that mental fatigue can partially mediate the relationship between cognitive deficits and return to productive activity. Mental fatigue can be considered a crucial, treatable mediator of the adverse effects of cognitive impairment upon return to productive activity following TBI.
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Affiliation(s)
- Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Community Medicine Research Center Chang Gung Memorial Hospital, Keelung branch, Keelung, Taiwan
| | - Shu-Hua Hsieh
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Che-Kuang Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Li Wei
- Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yu-Kai Su
- Department of Neurosurgery, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
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3
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Raukola-Lindblom M, Ljungqvist L, Kurki T, Tenovuo O, Laasonen M. Cognitive-Linguistic outcome in moderate to severe diffuse axonal injury and association with fatigue. Brain Inj 2022; 35:1674-1681. [PMID: 35015614 DOI: 10.1080/02699052.2021.2012824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Individuals with traumatic brain injury (TBI) often have persistent cognitive-linguistic deficits that negatively influence their life. Our objective was to examine the cognitive-linguistic outcome in individuals with moderate to severe diffuse axonal injury (DAI) with a novel test battery. As fatigue is a common symptom affecting the lives of individuals with DAI, we also wanted to assess whether the self-reported fatigue was associated with cognitive-linguistic abilities. METHODS Selected cognitive-linguistic subtests of the Finnish KAT test and The Mental Fatigue Scale (MFS) were applied to 48 adults with moderate to severe DAI and 27 healthy controls. The majority of the participants with DAI were in the chronic stage. The groups were compared using ANCOVA. Linear regressions were used to analyze the association between MFS and cognitive-linguistic outcomes. RESULTS The participants with DAI had significantly poorer scores than the controls in most cognitive-linguistic variables and reported significantly more fatigue. Two of the four cognitive-linguistic composite variables were associated with the degree of self-reported fatigue. CONCLUSIONS Cognitive-linguistic deficits are common in individuals with moderate to severe DAI, and The Finnish KAT test is a valuable tool to detect those. Fatigue was associated with linguistic working memory and language production.
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Affiliation(s)
- Marjaana Raukola-Lindblom
- Department of Psychology and Speech-Language Pathology, Department of Social Sciences, University of Turku, Turku, Finland
| | | | - Timo Kurki
- Department of Radiology, University of Turku, Turku, Finland.,Terveystalo Medical Center, Turku, Finland
| | - Olli Tenovuo
- Department of Clinical Neurosciences, University of Turku, Turku, Finland.,Turku Brain Injury Center, Neurocenter, Turku University Hospital, Turku, Finland
| | - Marja Laasonen
- Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Department of Phoniatrics, Helsinki University Hospital and University of Helsinki, Finland
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4
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Managing fatigue at work after traumatic brain injury. Int J Rehabil Res 2021; 45:93-97. [DOI: 10.1097/mrr.0000000000000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fortune DG, Walsh RS, MacConaill S, Harte M, Richards HL. Facilitating a return to productive roles following acquired brain injury: The impact of pre-injury work level, current abilities, and neuropsychological performance. Neuropsychol Rehabil 2020; 31:914-934. [PMID: 32223509 DOI: 10.1080/09602011.2020.1746674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The primary aim of this study was to examine predictors of Return to Productive Roles (RTPR) in individuals with ABI following participation in a community-based RTPR intervention. One hundred and thirty participants were inducted to an ABI-specific RTPR programme. At induction, information on clinical and social demographics, previous education and employment roles were collected. Participants underwent a comprehensive neuropsychological assessment at baseline and completed assessments of disability, mental health and community integration. Participants were followed up at the end of their programme to assess RTPR. Three out of four participants who entered the RTPR programme returned to productive roles. Despite the relatively high levels of anxiety and depression in the sample, people who returned to productive roles were not significantly less anxious or depressed than those who did not. Logistic regression suggested that participants who returned to productive roles following the programme had higher levels of pre-ABI work engagement, less disability and performed better on neuropsychological assessment in terms of their language skills. Results suggest that these factors which cut across specific prior experience, cognitive performance, and social and disability areas of functioning represent barriers to an effective return to productive roles for people with ABI accessing RTPR intervention.
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Affiliation(s)
- Dónal G Fortune
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - R Stephen Walsh
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | | | | | - Helen L Richards
- Department of Clinical Psychology, Mercy University Hospital Cork, Cork, Ireland
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6
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Manoli R, Delecroix H, Daveluy W, Moroni C. Impact of cognitive and behavioural functioning on vocational outcome following traumatic brain injury: a systematic review. Disabil Rehabil 2019; 43:2531-2540. [DOI: 10.1080/09638288.2019.1706105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Romina Manoli
- PSITEC Lab (EA 4072), Department of Psychology, University of Lille, Lille, France
| | - Helene Delecroix
- PSITEC Lab (EA 4072), Department of Psychology, University of Lille, Lille, France
- UEROS, UGECAM Hauts-de-France, Lille, France
| | - Walter Daveluy
- UEROS, UGECAM Hauts-de-France, Lille, France
- Service de Rééducation Neurologique Cérébrolésion, Hopital Swynghedauw, CHRU de Lille, Lille, France
| | - Christine Moroni
- PSITEC Lab (EA 4072), Department of Psychology, University of Lille, Lille, France
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Spitz G, Mahmooei BH, Ross P, McKenzie D, Ponsford JL. Characterizing Early and Late Return to Work after Traumatic Brain Injury. J Neurotrauma 2019; 36:2533-2540. [PMID: 30924716 DOI: 10.1089/neu.2018.5850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Facilitating successful return to work (RTW) is a key rehabilitation objective following traumatic brain injury (TBI). This study modelled early (within 6 months) and late (7-34 months) RTW by leveraging a large and comprehensive compensation database. The sample comprised 666 participants with TBI, the majority of whom sustained a moderate or severe injury caused by a motor vehicle accident. Early RTW was more likely for individuals who were pre-morbidly employed in a managerial or professional occupation (odds ratio [OR] = 2.1, confidence interval [CI] = 1.29-3.37), and those who experienced shorter post-traumatic amnesia (PTA) (OR = 0.96, CI = 0.94-0.98). RTW was less likely in the late phase for individuals who were older (hazard ratio [HR] = 0.99, CI = 0.98-1.00), experienced longer PTA (HR = 0.98, CI = 0.97-0.99), had an abdominal injury (HR = 0.90, CI = 0.67-1.21) and used more specialist practitioner (HR = 0.99, standard error [SE] = 0.98-1.00) and analgesic services (HR = 0.91, CI = 0.82-1.00). Conversely, RTW in the late phase was more likely for individuals using a greater number of specialist RTW supports (HR = 1.03, CI = 1.01-1.05). Patterns of early service utilization may therefore contribute to prediction of RTW outcome. It is encouraging that RTW was more likely for individuals using vocational supports.
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Affiliation(s)
- Gershon Spitz
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Behrooz Hassani Mahmooei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Pamela Ross
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Dean McKenzie
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Jennie L Ponsford
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
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Radford K, Sutton C, Sach T, Holmes J, Watkins C, Forshaw D, Jones T, Hoffman K, O'Connor R, Tyerman R, Merchán-Baeza JA, Morris R, McManus E, Drummond A, Walker M, Duley L, Shakespeare D, Hammond A, Phillips J. Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT. Health Technol Assess 2019; 22:1-124. [PMID: 29863459 DOI: 10.3310/hta22330] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Up to 160,000 people incur traumatic brain injury (TBI) each year in the UK. TBI can have profound effects on many areas of human functioning, including participation in work. There is limited evidence of the clinical effectiveness and cost-effectiveness of vocational rehabilitation (VR) after injury to promote early return to work (RTW) following TBI. OBJECTIVE To assess the feasibility of a definitive, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early, specialist VR plus usual care (UC) compared with UC alone on work retention 12 months post TBI. DESIGN A multicentre, feasibility, parallel-group RCT with a feasibility economic evaluation and an embedded mixed-methods process evaluation. Randomisation was by remote computer-generated allocation. SETTING Three NHS major trauma centres (MTCs) in England. PARTICIPANTS Adults with TBI admitted for > 48 hours and working or studying prior to injury. INTERVENTIONS Early specialist TBI VR delivered by occupational therapists (OTs) in the community using a case co-ordination model. MAIN OUTCOME MEASURES Self-reported RTW 12 months post randomisation, mood, functional ability, participation, work self-efficacy, quality of life and work ability. Feasibility outcomes included recruitment and retention rates. Follow-up was by postal questionnaires in two centres and face to face in one centre. Those collecting data were blind to treatment allocation. RESULTS Out of 102 target participants, 78 were recruited (39 randomised to each arm), representing 39% of those eligible and 5% of those screened. Approximately 2.2 patients were recruited per site per month. Of those, 56% had mild injuries, 18% had moderate injuries and 26% had severe injuries. A total of 32 out of 45 nominated carers were recruited. A total of 52 out of 78 (67%) TBI participants responded at 12 months (UC, n = 23; intervention, n = 29), completing 90% of the work questions; 21 out of 23 (91%) UC respondents and 20 out of 29 (69%) intervention participants returned to work at 12 months. Two participants disengaged from the intervention. Face-to-face follow-up was no more effective than postal follow-up. RTW was most strongly related to social participation and work self-efficacy. It is feasible to assess the cost-effectiveness of VR. Intervention was delivered as intended and valued by participants. Factors likely to affect a definitive trial include deploying experienced OTs, no clear TBI definition or TBI registers, and repatriation of more severe TBI from MTCs, affecting recruitment of those most likely to benefit/least likely to drop out. LIMITATIONS Target recruitment was not reached, but mechanisms to achieve this in future studies were identified. Retention was lower than expected, particularly in UC, potentially biasing estimates of the 12-month RTW rate. CONCLUSIONS This study met most feasibility objectives. The intervention was delivered with high fidelity. When objectives were not met, strategies to ensure feasibility of a full trial were identified. Future work should test two-stage recruitment and include resources to recruit from 'spokes'. A broader measure covering work ability, self-efficacy and participation may be a more sensitive outcome. TRIAL REGISTRATION Current Controlled Trials ISRCTN38581822. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 33. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Radford
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Chris Sutton
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Tracey Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jain Holmes
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Denise Forshaw
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Trevor Jones
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen Hoffman
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | - Rory O'Connor
- Academic Department of Rehabilitation Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Ruth Tyerman
- Community Head Injury Service, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | | | - Richard Morris
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emma McManus
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Avril Drummond
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Marion Walker
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Lelia Duley
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Alison Hammond
- Health Sciences Research Centre, University of Salford, Salford, UK
| | - Julie Phillips
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
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9
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Abstract
BACKGROUND Whilst post traumatic brain injury fatigue (PTBIF) and sleep disturbance are common sequelae following brain injury, underlying mechanisms, and the potential for targeted interventions remain unclear. OBJECTIVE To present a review of recent studies exploring the epidemiology of PTBIF and sleep disturbance, the relationship and neuropsychological correlates of these issues, potential approaches to intervention, and implications for neurorehabilitation. METHODS A review of relevant literature was undertaken, with a focus on PTBIF relating to sleep disturbance, the neuropsychological correlates of these issues and implications for neurorehabilitation. This paper does not set out to provide a systematic review. RESULTS Multidimensional approaches to assessment and treatment of sleep disturbance and PTBIF are required. CONCLUSIONS There is a need for more robust findings in determining the complex nature of relationships between PTBIF, sleep disturbance, and correlates. Longitudinal prospective data is required to increase our understanding of the nature and course of PTBIF and sleep disturbance post TBI. Large scale clinical trials are required in evaluating the potential benefits of interventions.
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Affiliation(s)
- Heather Cronin
- National Rehabilitation Hospital, Dun Laoghaire, Dublin, Ireland
| | - Emer O'Loughlin
- Health Service Executive Ireland, Blanchardstown, Dublin, Ireland
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Simpson GK, McRae P, Hallab L, Daher M, Strettles B. Participation in competitive employment after severe traumatic brain injury: New employment versus return to previous (pre-injury) employment. Neuropsychol Rehabil 2018; 30:995-1012. [DOI: 10.1080/09602011.2018.1531769] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Grahame K. Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney Australia
- John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney Australia
| | - Philippa McRae
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney Australia
- Brain Injury Rehabilitation Directorate, NSW Agency for Clinical Innovation, Sydney, Australia
| | - Lisa Hallab
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney Australia
- Brain Injury Rehabilitation Directorate, NSW Agency for Clinical Innovation, Sydney, Australia
| | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney Australia
- Brain Injury Rehabilitation Directorate, NSW Agency for Clinical Innovation, Sydney, Australia
| | - Barbara Strettles
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney Australia
- Brain Injury Rehabilitation Directorate, NSW Agency for Clinical Innovation, Sydney, Australia
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Abstract
Objective: Adults are at risk for unemployment following a moderate-severe traumatic brain injury (TBI). Less is known about employment patterns following mild TBI. This study aims to examine patterns of return to pre-injury job in adults following mild TBI over a 12-month post injury period, and to investigate factors associated with return to work. Methods: It is a prospective longitudinal study of 205 adults (aged ≥16 years at injury) identified as part of a larger population-based incidence study in the Waikato, New Zealand. In-person assessments were completed at baseline (within 14 days) and 1-, 6-, and 12-month post-injury. Results: A total of 159 (77.6%) adults returned to their pre-injury job at baseline and 185 (90.2%) returned within 12 months. Of those who did not return to their pre-injury job at baseline (n= 46), younger age at injury (≤30 years,p= .02) and poor overall neurocognitive functioning at 1-month (p= .02) was associated with non-return to pre-injury job at 12 months. Conclusion: In a sample of employed adults, the majority returned to their pre-injury job shortly after injury. Cognitive functioning and younger age at time of injury may be associated with delayed return to work. Interventions to support younger workers may facilitate their return to work.
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Wardlaw C, Hicks AJ, Sherer M, Ponsford JL. Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury. Front Neurol 2018; 9:563. [PMID: 30061858 PMCID: PMC6054998 DOI: 10.3389/fneur.2018.00563] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/22/2018] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) causes physical and cognitive-behavioral impairments that reduce participation in employment, leisure, and social relationships. Demographic and injury-related factors account for a small proportion of variance in participation post-injury. Personal factors such as resilience may also impact outcomes. This study aimed to examine the association of resilience alongside demographic, injury-related, cognitive, emotional, and family factors with participation following TBI. It was hypothesized that resilience would make an independent contribution to participation outcomes after TBI. Participants included 245 individuals with mild-severe TBI [Mage = 44.41, SDage = 16.09; post traumatic amnesia (PTA) duration M 24.95 days, SD 45.99] who completed the Participation Assessment with Recombined Tools-Objective (PART-O), TBI Quality of Life Resilience scale, Family Assessment Device General Functioning Scale, Rey Auditory Verbal Learning Test, National Adult Reading Test, and Hospital Anxiety and Depression Scale an average 4.63 years post-injury (SD 3.02, R 0.5-13). Multiple regression analyses were used to examine predictors of PART-O scores as the participation measure. Variables in the model accounted for a significant 38% of the variability in participation outcomes, F(13, 211) = 9.93, p < 0.05, R2 = 0.38, adjusted R2 = 0.34. Resilience was a significant predictor of higher participation, along with shorter PTA duration, more years since injury, higher education and IQ, and younger age. Mediation analyses revealed depression mediated the relationship between resilience and participation. As greater resilience may protect against depression and enhance participation this may be a focus of intervention.
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Affiliation(s)
- Carla Wardlaw
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Amelia J. Hicks
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Mark Sherer
- TIRR Memorial Hermann, Houston, TX, United States
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, United States
| | - Jennie L. Ponsford
- Monash-Epworth Rehabilitation Research Centre, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, VIC, Australia
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Libeson L, Downing M, Ross P, Ponsford J. The experience of return to work in individuals with traumatic brain injury (TBI): A qualitative study. Neuropsychol Rehabil 2018; 30:412-429. [DOI: 10.1080/09602011.2018.1470987] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Lauren Libeson
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Marina Downing
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Department of Rehabilitation, Psychology and Psychotherapy, Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | | | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Department of Rehabilitation, Psychology and Psychotherapy, Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
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Feasibility of a Cognitive Behavioral Intervention to Manage Fatigue in Individuals With Traumatic Brain Injury: A Pilot Study. J Head Trauma Rehabil 2018; 31:E41-9. [PMID: 26580691 DOI: 10.1097/htr.0000000000000196] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the feasibility of conducting a randomized clinical trial of an Internet-based manualized intervention to teach individuals with traumatic brain injury to manage their fatigue. SETTING Community dwelling. PARTICIPANTS Forty-one participants randomized to Maximizing Energy (MAX) intervention group (n = 20) and Health Education group (n = 21). INTERVENTION The experimental group (MAX intervention) received an 8-week program that combined education and Problem-Solving Therapy to teach individuals to manage fatigue-related problems. The attention control group received health education. MEASURES Primary outcome measures pertained to the feasibility of conducting the trial. Secondary outcomes were fatigue impact and fatigue severity assessed at baseline and postintervention. RESULTS Of the 65 participants referred, 41 were enrolled (63% recruitment rate), of which 3 withdrew (92% retention rate). Participants in the experimental and control groups completed their homework 75% and 85% of the time, respectively, and were equally engaged in the sessions. Participants in the experimental group were able to learn and implement the MAX intervention steps. Effect sizes for all measures ranged from small (-0.17) to medium (-0.58) in favor of the intervention group. CONCLUSION Findings from the study suggest that the MAX intervention is feasible to administer to individuals with post-traumatic brain injury fatigue.
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Paniccia A, Colquhoun H, Kirsh B, Lindsay S. Youth and young adults with acquired brain injury transition towards work-related roles: a qualitative study. Disabil Rehabil 2018; 41:1331-1342. [PMID: 29334802 DOI: 10.1080/09638288.2018.1425743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this research was to explore the experiences of youth and young adults with acquired brain injury as they transition towards work-related roles. Little is known about employment experiences among this age group. Understanding their perspectives can inform programs and clinical practice. MATERIALS AND METHODS A descriptive qualitative design, including semi-structured interviews with 14 participants (8 females; 6 males) was used. Interviews were transcribed verbatim and analyzed using an open-coding, thematic approach. RESULTS Three major themes emerged related to the experience of work-related roles: (1) getting to know the new me; (2) navigating support systems; and (3) taking control of my experience. Some participants used coping strategies to acquire and/or maintain work-related roles, while others felt limited by their condition. CONCLUSIONS A variety of work-related roles, people, and environments directly and indirectly influenced the work-related transition of youth and young adults with acquired brain injury. Individuals expressed the importance of acquired brain injury awareness in informing others about their impairments. In fact, a lack of acquired brain injury awareness was often a main reason for receiving less than adequate support and accommodations. Without an understanding of acquired brain injury, people in the lives of these individuals were unable to perceive the legitimacy of acquired brain injury-related impairments. Implications for rehabilitation The purpose of this study is to understand the experiences of youth and young adults with acquired brain injury as they transition into work-related roles. Using these experiences as a guideline can promote acquired brain injury awareness, and contribute to how current interventions are designed and delivered. Clinicians should ensure that youth and young adults with acquired brain injury have access to the resources they need to maximize their independence. Healthcare professionals can play a pivotal role in relaying important acquired brain injury-related education, implementing suitable treatment plans, and providing them with effective tips to help them through their transition. A healthy transition to work-related roles should include ample social support and communication, acquired brain injury-related information that informs the community of acquired brain injury impairments, needs, and recovery trajectory, as well as adequate and consistent coordination within and between the person and the environment.
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Affiliation(s)
- Alicia Paniccia
- a Rehabilitation Science Institute , University of Toronto , Toronto , Canada.,b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada
| | - Heather Colquhoun
- c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
| | - Bonnie Kirsh
- c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
| | - Sally Lindsay
- a Rehabilitation Science Institute , University of Toronto , Toronto , Canada.,b Bloorview Research Institute , Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.,c Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada
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Mitrushina M, Tomaszewski R. Factors associated with return to work in patients with long-term disabilities due to neurological and neuropsychiatric disorders. Neuropsychol Rehabil 2017; 29:1313-1331. [DOI: 10.1080/09602011.2017.1395746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maura Mitrushina
- Department of Psychology, California State University, Northridge, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Robert Tomaszewski
- Department of Psychology, California State University, Northridge, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Chesnel C, Jourdan C, Bayen E, Ghout I, Darnoux E, Azerad S, Charanton J, Aegerter P, Pradat-Diehl P, Ruet A, Azouvi P, Vallat-Azouvi C. Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study. Clin Rehabil 2017; 32:692-704. [DOI: 10.1177/0269215517734294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.
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Affiliation(s)
- Camille Chesnel
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Claire Jourdan
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eleonore Bayen
- Laboratoire d’Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Université Paris-Dauphine, Paris, France
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Idir Ghout
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - Emmanuelle Darnoux
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
- UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Pascale Pradat-Diehl
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Claire Vallat-Azouvi
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
- Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
- EA 2027: Laboratoire de Psychopathologie et Neuropsychologie, Université Paris 8, Saint-Denis, France
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Reciprocal Causation Between Functional Independence and Mental Health 1 and 2 Years After Traumatic Brain Injury. Am J Phys Med Rehabil 2017; 96:374-380. [DOI: 10.1097/phm.0000000000000644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Cogné M, Wiart L, Simion A, Dehail P, Mazaux JM. Five-year follow-up of persons with brain injury entering the French vocational and social rehabilitation programme UEROS: Return-to-work, life satisfaction, psychosocial and community integration. Brain Inj 2017; 31:655-666. [PMID: 28406316 DOI: 10.1080/02699052.2017.1290827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Social and vocational reintegration of persons with brain injury is an important element in their rehabilitation. AIMS To evaluate the 5-year outcome of persons with brain injury included in 2008 in the Aquitaine Unit for Evaluation, Training and Social and Vocational Counselling programme (UEROS). METHOD 57 persons with brain injury were recruited from those who completed the 2008 UEROS programme. Five years later, an interview was done to assess family and vocational status, autonomy and life satisfaction. These results were compared with those from persons completing the 1997-1999 programme. RESULTS The typical person entered the 2008 UEROS programme 6 years after a severe brain injury (42%) and was male, single and 35 years. At the 5-year follow-up, more persons lived with a partner (+23%) and lived in their own home (+21%). 47% were working vs 11% on entering the programme. Approximately half were satisfied or very satisfied with their quality of life. Having a job in 2013 was associated with a high education level, less cognitive sequelae, having a job in 2008 and no health condition. CONCLUSIONS The UEROS programme is effective with regard to return-to-work and improvement of autonomy in persons with brain injury, irrespective of length of time from injury.
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Affiliation(s)
- M Cogné
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
| | - L Wiart
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,c UEROS Aquitaine , Bordeaux , France
| | - A Simion
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,c UEROS Aquitaine , Bordeaux , France
| | - P Dehail
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
| | - J-M Mazaux
- a Rehabilitation Medicine Unit, Centre Hospitalier Universitaire of Bordeaux , Bordeaux , France.,b EA4136, University of Bordeaux , Bordeaux , France
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Chien DK, Hwang HF, Lin MR. Injury severity measures for predicting return-to-work after a traumatic brain injury. ACCIDENT; ANALYSIS AND PREVENTION 2017; 98:101-107. [PMID: 27716491 DOI: 10.1016/j.aap.2016.09.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 06/30/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
This study compared the ability of five injury severity measures, namely the Abbreviated Injury Scale to the Head (AIS-H), Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), Extended Glasgow Outcome Scale (GOSE), and Injury Severity Score (ISS), to predict return-to-work after a traumatic brain injury (TBI). Furthermore, factors potentially associated with return-to-work were investigated. In total, 207 individuals aged ≤65 years newly diagnosed with a TBI and employed at the time of injury were recruited and followed-up for 1year by telephone every 3 months. A bivariate proportional hazards model analysis revealed that all five injury severity measures were significantly associated with return-to-work after a TBI. The AIS-H and non-head ISS explained 23.8% of the variation in the duration of returning to work from discharge after hospitalization for a TBI; similarly, the GCS, GOS, GOSE, and ISS respectively accounted for 4.7%, 21.4%, 12.9%, and 48.4% of the variation. A multivariable analysis revealed that individuals with higher injury severity as measured by the ISS (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.92-0.97), a lack of autonomy in transportation (HR, 2.55; 95% CI, 1.23-5.32), cognitive impairment (HR, 0.47; 95% CI, 0.28-0.79), and depression (HR, 0.97; 95% CI, 0.95-0.99) were significantly less likely to be employed after a TBI. In conclusion, of the five injury severity measures, the ISS may be the most capable measure of predicting return-to-work after a TBI. In addition to injury severity, autonomy in transportation, cognitive function, and the depressive status may also influence the employment status during the first year after a TBI.
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Affiliation(s)
- Ding-Kuo Chien
- Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hei-Fen Hwang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Mau-Roung Lin
- Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan; Master's Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Lequerica AH, Botticello AL, Lengenfelder J, Chiaravalloti N, Bushnik T, Dijkers MP, Hammond FM, Kolakowsky-Hayner SA, Rosenthal J. Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study. Neuropsychol Rehabil 2016; 27:1019-1030. [PMID: 27633955 DOI: 10.1080/09602011.2016.1231120] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Post-traumatic brain injury fatigue (PTBIF) is a major problem in the years after traumatic brain injury (TBI), yet little is known about its persistence and resolution. The objective of the study was to identify factors related to PTBIF remission and resolution. TBI Model System registrants at five centres participated in interviews at either one and two years post-injury (Y1-2 Cohort), or two and five years post-injury (Y2-5 Cohort). Characteristics of participants with PTBIF remission were compared to those with PTBIF persistence. Variables studied included the presence of and changes in disability, sleep dysfunction, mood, and community participation. The Functional Independence Measure did not differ significantly between groups or over time. In the Y1-2 Cohort the Fatigue Resolved group scored significantly better on the Disability Rating Scale and Pittsburgh Sleep Quality Index. In the Y2-5 Cohort the Fatigue Resolved group scored significantly higher on a measure of community participation. It was concluded that fewer than half of the sample in each cohort experienced a remission of PTBIF between time points. Persistence of PTBIF 1-2 years post-injury is associated with disability, sleep disturbance, and depression while persistence of fatigue beyond 2 years post-injury appears to be related to participation level, underscoring the potential impact of effective surveillance, assessment, and treatment of this condition in optimising life after TBI. Differences in fatigue progression may point to the presence of different types of PTBIF.
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Affiliation(s)
| | | | | | | | | | - Marcel P Dijkers
- c Department of Rehabilitation Medicine , Mount Sinai School of Medicine , New York , USA
| | - Flora M Hammond
- d Department of Physical Medicine and Rehabilitation , Indiana University School of Medicine , Indianapolis , IN , USA
| | | | - Joseph Rosenthal
- f Department of Physical Medicine and Rehabilitation , Ohio State University, Wexer Medical Center , Columbus , OH , USA
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Colantonio A, Salehi S, Kristman V, Cassidy JD, Carter A, Vartanian O, Bayley M, Kirsh B, Hébert D, Lewko J, Kubrak O, Mantis S, Vernich L. Return to work after work-related traumatic brain injury. NeuroRehabilitation 2016; 39:389-99. [DOI: 10.3233/nre-161370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Colantonio
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Sara Salehi
- Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, ON, Canada
| | - Vicki Kristman
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
- Institute for Work & Health, Toronto, ON, Canada
| | - J. David Cassidy
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - Angela Carter
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Oshin Vartanian
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
| | - Debbie Hébert
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - John Lewko
- Centre for Research in Human Development, Laurentian University, Sudbury, ON, Canada
| | - Olena Kubrak
- Public Services Health & Safety Association, Toronto, ON, Canada
| | - Steve Mantis
- Research Action Alliance on the Consequences of Work Injury, Thunder Bay, ON, Canada
| | - Lee Vernich
- Research Service Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Holloway M, Tyrrell L. Acquired Brain Injury, Parenting, Social Work, and Rehabilitation: Supporting Parents to Support Their Children. ACTA ACUST UNITED AC 2016; 15:234-259. [DOI: 10.1080/1536710x.2016.1220883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Scaratti C, Leonardi M, Sattin D, Schiavolin S, Willems M, Raggi A. Work-related difficulties in patients with traumatic brain injury: a systematic review on predictors and associated factors. Disabil Rehabil 2016; 39:847-855. [DOI: 10.3109/09638288.2016.1162854] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chiara Scaratti
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Davide Sattin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Michelle Willems
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute Carlo Besta IRCCS Foundation, Milan, Italy
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Abstract
OBJECTIVE To examine the stability of employment between 1 and 3 years following traumatic brain injury (TBI) and to identify the variables associated with continued employment throughout this time span. PARTICIPANTS This study included 236 individuals with predominantly moderate to very severe TBI, who had received rehabilitation in the context of a no-fault accident compensation system. Participants were eligible for the current study if they were employed before injury and reported their employment status at 1, 2, and 3 years following their injury as part of a longitudinal head injury outcome study. RESULTS Only 44% of participants remained employed at each of the 3 years following TBI. There was also substantial transition into and out of employment across the 3 years. Significantly greater instability in employment was reported by individuals who were machinery operators or laborers before injury, had a longer duration of posttraumatic amnesia, reported more cognitive difficulties, and were less mobile 1 year following their injury. CONCLUSION A number of important factors determine the likelihood of achieving stability in employment following TBI. Findings from the current study support the continued need to identify ways in which physical as well as cognitive changes contribute to employment following TBI. Further examination is needed to identify possible compensatory strategies or job modifications to maximize the likelihood of job retention.
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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Factors associated with return to work in men and women with work-related traumatic brain injury. Disabil Health J 2015; 9:439-48. [PMID: 26817582 DOI: 10.1016/j.dhjo.2015.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 11/03/2015] [Accepted: 12/04/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Symptoms that persist subsequent to a work-related traumatic brain injury (wrTBI) influence the ability to return to work (RTW) and indicate areas of functional disability, as classified in the International Classification of Functioning, Disability and Health (ICF) framework. OBJECTIVE The purpose of this study was to describe the relationship between RTW status and ICF framework domains in men and women with a wrTBI. METHODS A retrospective chart review of 209 consecutive workers with TBI (mild TBI: 71.8%; mean age: 40.2 ± 11.1, men: 71.3%) was conducted. Workers were assessed during the chronic post-injury phase, at the neurology service of a large rehabilitation hospital in Ontario, Canada in 2003. Frequency distributions were calculated and chi-square tests performed. RESULTS At the point of assessment, 78.0% of workers were in receipt of disability benefits, while the remainder had returned to work on a full- or part-time basis. Significant differences were observed in the Body Functions and Structures domain of the ICF model, specifically clinical diagnoses of depression, anxiety, pain disorders; self-perceived cognitive disturbance, and certain psychosocial factors (p < 0.05), between workers who had returned to work and those who had not. When stratified according to sex, these associations remained significant only in men. CONCLUSIONS The factors outlined above should be subject to further TBI research, as indicators for RTW. The lack of significant findings in women warrants further exploration of variables within the physical and social environmental domains of the ICF.
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Willmott C, Spitz G, Ponsford JL. Predictors of productivity outcomes for secondary and tertiary students following traumatic brain injury. Brain Inj 2015; 29:929-36. [DOI: 10.3109/02699052.2015.1022882] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Meulenbroek P, Turkstra LS. Job stability in skilled work and communication ability after moderate-severe traumatic brain injury. Disabil Rehabil 2015; 38:452-61. [PMID: 25958999 PMCID: PMC5308217 DOI: 10.3109/09638288.2015.1044621] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Communication deficits may play a critical role in maintaining employment after traumatic brain injury (TBI), but links between specific communication deficits and employment outcomes have not been determined. This study identified communication measures that distinguished stably employed versus unstably employed adults with TBI. METHODS Participants were 31 adults with moderate-severe TBI who were employed full-time for at least 12 consecutive months before injury in skilled jobs and had attempted return to skilled jobs after injury. Sixteen had achieved stable employment (SE) post-injury, defined as full-time employment for ≥12 consecutive months; and 15 had unstable employment (UE). Participants completed a battery of communication tests identified in a prior qualitative study of communication skills required for skilled work. RESULTS Measures of spoken language comprehension, verbal reasoning, social inference, reading and politeness in spoken discourse significantly discriminated between SE and UE groups. Two nested models were completed and compared. The first model excluded discourse data because of missing data for two UE and one SE participant. This model revealed that measures of verbal reasoning speed (β = -0.18, p = 0.05) and social inference (β = 0.19, p = 0.05) were predictive independent of the overall model. The second model included discourse politeness data and was a better overall predictor of group membership (Likelihood ratio test, Model 1: 3.824, Model 2: 2.865). CONCLUSION Communication measures were positively associated with SE in skilled jobs after TBI. Clinicians should include assessment of communication for adults attempting return to work after TBI, paying specific attention to social inference and speed of verbal reasoning skills. IMPLICATIONS FOR REHABILITATION Traumatic brain injury (TBI) often results in communication impairments associated with the cognitive skills underlying interpersonal skills. Communication impairment after TBI has been anecdotally associated with job instability. This research associate communication functioning with work stability after TBI in skilled jobs. These findings indicate that communication impairment should be assessed in persons with TBI returning to skilled employment after injury.
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Affiliation(s)
- Peter Meulenbroek
- Northwestern University, Department of Physical Medicine and Rehablitation, Feinberg School of Medicine, Chicago, IL, USA
- The Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - Lyn S. Turkstra
- University of Wisconsin – Madison, Department of Communication Sciences and Disorders, Madison, WI, USA
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Zimmermann N, Pereira N, Hermes-Pereira A, Holz M, Joanette Y, Fonseca RP. Executive functions profiles in traumatic brain injury adults: Implications for rehabilitation studies. Brain Inj 2015; 29:1071-81. [DOI: 10.3109/02699052.2015.1015613] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A systematic review of fatigue in patients with traumatic brain injury: The course, predictors and consequences. Neurosci Biobehav Rev 2014; 47:684-716. [DOI: 10.1016/j.neubiorev.2014.10.024] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/18/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022]
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Leigh AJ, O'Hanlon K, Sheldrick R, Surr C, Hare DJ. Care mapping in clinical neuroscience settings: Cognitive impairment and dependency. Neuropsychol Rehabil 2014; 25:574-92. [PMID: 25233395 DOI: 10.1080/09602011.2014.951366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Person-centred care can improve the well-being of patients and is therefore a key driver in healthcare developments in the UK. The current study aims to investigate the complex relationship between cognitive impairment, dependency and well-being in people with a wide range of acquired brain and spinal injuries. Sixty-five participants, with varied acquired brain and spinal injuries, were selected by convenience sampling from six inpatient clinical neuroscience settings. Participants were observed using Dementia Care Mapping - Neurorehabilitation (DCM-NR) and categorised based on severity of cognitive impairment. A significant difference in the behaviours participants engaged in, their well-being and dependency was found between the severe cognitive impairment group and the mild, moderate or no cognitive impairment groups. Dependency and cognitive impairment accounted for 23.9% of the variance in well-ill-being scores and 17.2% of the variance in potential for positive engagement. The current study highlights the impact of severe cognitive impairment and dependency on the behaviours patients engaged in and their well-being. It also affirms the utility of DCM-NR in providing insights into patient experience. Consideration is given to developing DCM-NR as a process that may improve person-centred care in neuroscience settings.
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Foy CML. Long term efficacy of an integrated neurological and vocational rehabilitation programme for young adults with acquired brain injury. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:533-542. [PMID: 24347006 DOI: 10.1007/s10926-013-9488-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To characterise and determine the pre-injury, injury and post-injury factors associated with vocational outcome 1-9 years post-discharge from a mixed therapy/educational/vocational rehabilitation (VR) residential programme. METHODS 119 clients of working age when they acquired their brain injury and who had attended the centre between 2002 and 2011 were followed up at least 1 year post-discharge to determine their vocational outcome as part of an ongoing review/audit of the service. All clients had had a severe/very severe brain injury. Clients were classified as having a positive vocational outcome (working-paid/voluntary, full/part-time or undertaking full or part-time vocationally related education) or negative vocational outcome (undertaking neither work nor education). RESULTS Over half of the clients attained a positive vocational outcome. Length of time since discharge did not differ between those clients with a positive or negative vocational outcome. Vocational outcome was predicted by cognitive and motor ability at discharge, and gender. Together these variables correctly classified the vocational outcome of 76 % of the clients. CONCLUSION Clients with severe/very severe brain injury can attain a positive vocational outcome following intensive neurorehabilitation consisting of traditional therapies in addition to educational and VR.
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Affiliation(s)
- Catherine M L Foy
- QEF Neuro Rehabilitation Services, Banstead Place, Park Road, Banstead, Surrey, SM7 3EE, UK,
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Nourollahi S, Wille J, Weiß V, Wedekind C, Lippert-Grüner M. Quality-of-life in patients with post-traumatic hypopituitarism. Brain Inj 2014; 28:1425-9. [PMID: 24911541 DOI: 10.3109/02699052.2014.917201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE Hypopituitarism is a frequent complication in patients after traumatic brain injury (TBI). Both TBI and hypopituitarism can lead to complex cognitive and affective deficits. This study was intended to examine the quality-of-life in patients with post-traumatic hypopituitarism (PTH) and to discern the effect of this endocrinological disorder on general outcome of patients after TBI including earning capacity. Research type: Retrospective analysis of clinical data. METHODS AND PROCEDURES Ninety-seven symptomatic patients were screened after TBI for PTH. Their results were examined in the SF-36 [a standardized questionnaire for quality of life (QoL)] comparing the groups with or without PTH. After 6 months of hormone substitution (if necessary), patients were asked to repeat the SF-36. MAIN OUTCOMES AND RESULTS Forty-six patients were diagnosed with PTH (47.5%). All patients included had a significantly lower QoL compared to the standard population. QoL was significantly worse in patients with PTH. There was no significant difference with regard to earning capacity. After hormone substitution, patients achieved better SF-36-results, albeit the difference was lacking statistical significance. CONCLUSIONS PTH is frequent after TBI. PTH turns out to further diminish QoL, without affecting earning capacity. Hormone substitution might improve QoL in patients with PTH, but future research is needed to confirm this hypothesis.
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Prognostic Importance of Self-Reported Traits/Problems/Strengths and Environmental Barriers/Facilitators for Predicting Participation Outcomes in Persons With Traumatic Brain Injury: A Systematic Review. Arch Phys Med Rehabil 2014; 95:1162-73. [DOI: 10.1016/j.apmr.2014.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/30/2014] [Accepted: 02/02/2014] [Indexed: 11/18/2022]
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Diaz AP, Schwarzbold ML, Thais ME, Cavallazzi GG, Schmoeller R, Nunes JC, Hohl A, Guarnieri R, Linhares MN, Walz R. Personality changes and return to work after severe traumatic brain injury: a prospective study. ACTA ACUST UNITED AC 2014; 36:213-9. [PMID: 24770655 DOI: 10.1590/1516-4446-2013-1303] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/27/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate predictors of non-return to work (nRTW) among social, demographic, clinical, and psychiatric variables after severe traumatic brain injury (TBI) in a cohort of Brazilian patients. METHODS Prospective study. Forty-three community-dwelling individuals treated at a Level I trauma center at the time of TBI were evaluated 18 months after trauma. Measures included DSM-IV-TR criteria for personality changes after TBI and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to assess psychiatric diagnosis. Hospitalization variables included Glasgow Coma Scale scores, pupil examination findings, associated limb trauma, Marshall computed tomography classification, and blood glucose levels. RESULTS After multiple logistic regression analysis, only the diagnosis of personality changes was found to be independently associated with nRTW, with an adjusted odds ratio of 10.92 (p = 0.02, 95% confidence interval 1.41-84.28). CONCLUSIONS In this study, personality changes were an independent predictor of nRTW after severe TBI. Ways to predict risk factors associated with personality changes after severe brain injury could aid in identification of early and effective interventions that might ease the burden associated with this condition.
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Affiliation(s)
- Alexandre P Diaz
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Marcelo L Schwarzbold
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Maria E Thais
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Gisele G Cavallazzi
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Roseli Schmoeller
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Jean C Nunes
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Alexandre Hohl
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Ricardo Guarnieri
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Marcelo N Linhares
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
| | - Roger Walz
- Center of Applied Neurosciences (CeNAp), Hospital Universitário da Universidade Federal de Santa Catarina (HU-UFSC), Florianópolis, SC, Brazil
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Belio C, Prouteau A, Koleck M, Saada Y, Merceron K, Dayre E, Destaillats JM, Barral C, Mazaux JM. Participation restrictions in patients with psychiatric and/or cognitive disabilities: preliminary results for an ICF-derived assessment tool. Ann Phys Rehabil Med 2013; 57:114-37. [PMID: 24364986 DOI: 10.1016/j.rehab.2013.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 11/19/2013] [Accepted: 11/24/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED Participation in community life is a major challenge for most people with psychiatric and/or cognitive disabilities. Current assessments of participation lack a theoretical basis. However, the new International Classification of Functioning, Disability and Health (ICF) provides a relevant framework. AIMS The present study used an ICF-derived assessment tool to activity limitations and participation restrictions in two groups of participants with disabilities linked to schizophrenia or traumatic brain injury respectively. METHODS Twenty-six items (related to six ICF sections) were selected by reviewing the literature and gathering the clinician's opinions and representatives of patient associations. These items, yielded an ordinal rating of activity limitations, participation restrictions and contextual factors (social support, attitudes and, systems & politics). Special attention was paid to contextual and environmental factors. The final checklist (called the Grid for Measurements of Activity and Participation, G-MAP) was administered to 16 participants with traumatic brain injury (the TBI group) and 15 participants with schizophrenic disorders (the SD group). Psychometric assessments of cognition and, neurobehavioural, psychological and psychosocial functioning were also performed. RESULTS The internal consistencies for activity limitations (Cronbach's alpha coefficient=0.89) and participation restriction (Cronbach's alpha coefficient=0.89) were satisfactory. We did not observe any significant differences between the two groups in terms of the psychometric test results. The G-MAP scores demonstrated that the two groups were confronted with the same limitations in self care, domestic life, leisure and community life (i.e., the intergroup differences were not statistically significant in Mann-Whitney tests). However, interpersonal relationships and economic and social productivity appeared to be more severely limited in the SD group than in the TBI group. Similarly, participation restrictions in domestic life, interpersonal relationships and economic and social productivity were more severe in the SD group than in the TBI group. CONCLUSION G-MAP is a useful, feasible, relevant tool for performing a detailed, individualized assessment of participation restrictions in people with psychiatric and/or cognitive disabilities.
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Affiliation(s)
- C Belio
- EA4136 handicap et système nerveux, institut de formation en ergothérapie, université Bordeaux-Segalen, IMS rue F.-Ferrer, 33076 Bordeaux cedex, France.
| | - A Prouteau
- EA4139 santé et qualité de vie, université Bordeaux-Segalen, 33076 Bordeaux, France; Centre hospitalier de Jonzac, 17500 Jonzac, France
| | - M Koleck
- EA4139 santé et qualité de vie, université Bordeaux-Segalen, 33076 Bordeaux, France
| | - Y Saada
- EA4139 santé et qualité de vie, université Bordeaux-Segalen, 33076 Bordeaux, France
| | - K Merceron
- EA4139 santé et qualité de vie, université Bordeaux-Segalen, 33076 Bordeaux, France
| | - E Dayre
- EA4136 handicap et système nerveux, institut de formation en ergothérapie, université Bordeaux-Segalen, IMS rue F.-Ferrer, 33076 Bordeaux cedex, France
| | - J M Destaillats
- EA4136 handicap et système nerveux, institut de formation en ergothérapie, université Bordeaux-Segalen, IMS rue F.-Ferrer, 33076 Bordeaux cedex, France; Centre hospitalier de Jonzac, 17500 Jonzac, France
| | - C Barral
- EHESP MSSH, 35043 Rennes, France
| | - J M Mazaux
- EA4136 handicap et système nerveux, institut de formation en ergothérapie, université Bordeaux-Segalen, IMS rue F.-Ferrer, 33076 Bordeaux cedex, France
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Goverover Y, Chiaravalloti N. The impact of self-awareness and depression on subjective reports of memory, quality-of-life and satisfaction with life following TBI. Brain Inj 2013; 28:174-80. [PMID: 24304140 DOI: 10.3109/02699052.2013.860474] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the relationship between self-awareness and depressive symptomatology with self-reports of memory, Quality-of-Life (QoL) and satisfaction with life in individuals with traumatic brain injury (TBI). METHODS Cross-sectional survey of 30 community dwelling adults, who sustained a TBI at least 1 year prior to study enrolment. Participants completed questionnaires to assess the constructs of depression, self-awareness, QoL, satisfaction with life and memory. RESULTS Symptoms of depression were significantly associated with self-reports of poor memory abilities, lower QoL and lower satisfaction with life. Additionally, higher levels of self-awareness were associated with lower ratings of QoL and reduced memory abilities and better strategy use regarding memory. However, when examining the contribution of each construct individually, depressive symptomatology, and not self-awareness, was significantly associated with subjective self-reports of memory, QoL and satisfaction with life. CONCLUSIONS This pattern of relationships illustrates that, when a person has a low level of depressive symptoms, his/her reports of QoL, memory and satisfaction with life will be more positive; however, he/she will demonstrate more difficulty with self-awareness. Thus, psychological aspects of recovery must, therefore, be taken into account when using self-reported measures in the evaluation of persons who have sustained TBI.
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Affiliation(s)
- Yael Goverover
- Department of Occupational Therapy, New York University , New York, NY , USA
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Interest of workplace support for returning to work after a traumatic brain injury: A retrospective study. Ann Phys Rehabil Med 2013; 56:652-62. [DOI: 10.1016/j.rehab.2013.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 10/02/2013] [Accepted: 10/03/2013] [Indexed: 11/23/2022]
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Saltychev M, Eskola M, Tenovuo O, Laimi K. Return to work after traumatic brain injury: Systematic review. Brain Inj 2013; 27:1516-27. [DOI: 10.3109/02699052.2013.831131] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The differential contributions of posttraumatic amnesia duration and time since injury in prediction of functional outcomes following moderate-to-severe traumatic brain injury. J Head Trauma Rehabil 2013; 28:48-58. [PMID: 22333678 DOI: 10.1097/htr.0b013e31823c9317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relative contributions of preinjury, injury severity, and acute postinjury variables in predicting outcomes at 1 year following moderate-severe traumatic brain injury (TBI). DESIGN Secondary analysis of a prospective longitudinal cohort study. SETTING Four Veterans Affairs Medical Center acute inpatient rehabilitation programs. PARTICIPANTS Active duty military or veterans with a nonpenetrating moderate-to-severe TBI. MAIN OUTCOME MEASURES Independent living status (N = 280) and work status (N = 248) at one year postinjury. RESULTS Preinjury characteristics as a group accounted for the largest amount of variance in independent living status at 1 year; however, posttraumatic amnesia (PTA) uniquely explained the largest amount of variance (8.8%). Those with less than 60 days PTA were 9 times more likely to be independent; those with less than 30 days PTA were 3 times more likely to be independent. In contrast, acute postinjury characteristics accounted for the largest amount of variance in work status, with time to rehabilitation explaining the most unique variance (10.4%). Those with less than 48 days time to rehabilitation were 2.4 times more likely to be productive. CONCLUSIONS This study highlights the differential contribution of variables in the prediction of 2 specific functional outcomes in a military sample, adding to our current body of knowledge to assist clinicians, patients and their families following TBI.
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Radford K, Phillips J, Drummond A, Sach T, Walker M, Tyerman A, Haboubi N, Jones T. Return to work after traumatic brain injury: Cohort comparison and economic evaluation. Brain Inj 2013; 27:507-20. [DOI: 10.3109/02699052.2013.766929] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hooson JM, Coetzer R, Stew G, Moore A. Patients' experience of return to work rehabilitation following traumatic brain injury: A phenomenological study. Neuropsychol Rehabil 2013; 23:19-44. [DOI: 10.1080/09602011.2012.713314] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mesurer la participation et l’environnement dans le handicap psychique et cognitif : validation préliminaire de la G-MAP. ALTER 2012. [DOI: 10.1016/j.alter.2012.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Juengst S, Skidmore E, Arenth PM, Niyonkuru C, Raina KD. Unique contribution of fatigue to disability in community-dwelling adults with traumatic brain injury. Arch Phys Med Rehabil 2012; 94:74-9. [PMID: 22885286 DOI: 10.1016/j.apmr.2012.07.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 07/26/2012] [Accepted: 07/31/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To examine the unique contribution of fatigue to self-reported disability in community-dwelling adults with traumatic brain injury (TBI). DESIGN A cross-sectional cohort design. SETTING Community dwellings. PARTICIPANTS Adults (N=50) with a history of mild to severe TBI were assessed. INTERVENTION Not applicable. MAIN OUTCOME MEASURES This study assessed the contribution of fatigue (Modified Fatigue Impact Scale) to disability (Mayo-Portland Adaptability Inventory), controlling for executive functions (Frontal Systems Behavior Scale), depression status (major depression in partial remission/current major depression/depressive symptoms or no history of depression), and initial injury severity (uncomplicated mild, complicated mild, moderate, or severe). RESULTS Fatigue was found to contribute uniquely to the variance in self-reported disability (β=.47, P<.001) after controlling for injury severity, executive functions, and depression status. The overall model was significant (F(4,45)=17.32, P<.001) and explained 61% of the variance in self-reported disability, with fatigue alone accounting for 12% of the variance in self-reported disability (F(1,45)=13.97, P<.001). CONCLUSIONS Fatigue contributes uniquely to disability status among community-dwelling adults with chronic TBI, independent of injury severity, executive functions, and depression. Addressing fatigue through targeted interventions may help to improve self-perceived disability in this population.
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Affiliation(s)
- Shannon Juengst
- Department of Occupational Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA.
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García-Molina A, Tormos JM, Bernabeu M, Junqué C, Roig-Rovira T. Do traditional executive measures tell us anything about daily-life functioning after traumatic brain injury in Spanish-speaking individuals? Brain Inj 2012; 26:864-74. [PMID: 22583177 DOI: 10.3109/02699052.2012.655362] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To examine the relationship between traditional executive function measures and everyday competence in Spanish-speaking individuals with moderate-to-severe traumatic brain injury (TBI). METHODS AND PROCEDURES Thirty-two TBI patients (24 men, eight women) with an age range of 17-59 years (mean age = 30.73 years; SD = 13.34) were administered a battery of performance-based executive function measures. Such measures included the Trail Making Test part B, Wisconsin Card Sorting Test, Stroop Colour Word Interference Test, Controlled Oral Word Association Test and Letter-Number Sequencing. Behavioural manifestations of executive deficits were assessed by the Behaviour Rating Inventory of Executive Function-Adult version (BRIEF-A). Patient's everyday functioning was examined with the Patient Competency Rating Scale (PCRS). MAIN OUTCOMES AND RESULTS Traditional performance-based executive measures correlated significantly, although moderately, with the PCRS; this relationship was more significant in the Controlled Oral Word Association Test and Trail Making Test part B. A significant correlation was obtained between the BRIEF-A clinical scales and patient's everyday competence as measured by the PCRS. CONCLUSIONS The current findings suggest that traditional performance-based executive measures reveal some degree of ecological validity or real-world relevance, providing relevant information for predicting everyday competence after moderate-to-severe TBI.
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Affiliation(s)
- A García-Molina
- Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, Spain.
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Stergiou-Kita M, Dawson D, Rappolt S. Inter-professional clinical practice guideline for vocational evaluation following traumatic brain injury: a systematic and evidence-based approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:166-181. [PMID: 21968612 DOI: 10.1007/s10926-011-9332-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION This paper introduces an inter-professional clinical practice guideline for vocational evaluation following traumatic brain injury. This guideline aims to explicate the processes and factors relevant to vocational evaluation to assist evaluators (i.e. health care teams, individuals and employers) in collaboratively determining if clients are able to work and to make recommendations for work entry, re-entry or vocational planning. METHODS Methods in the Canadian Medical Association's (CMA) Handbook on Clinical Practice Guideline and the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument were utilized to ensure rigour. Steps in the CMA handbook were followed and included: (1) identifying the guideline's objective and questions; (2) systematic literature review; (3) study selection and quality appraisal; (4) development of clear recommendations by key stakeholders; (5) guideline pilot testing and endorsement. RESULTS The resulting guideline includes 17 key recommendations within the seven domains: (1) evaluation purpose and rationale; (2) initial intake process; (3) assessment of the personal domain; (4) assessment of the environment; (5) assessment of occupational/job requirements; (6) analysis and synthesis; (7) evaluation recommendations. CONCLUSIONS The guideline may be useful to individually practicing clinicians, health care teams, employers and individuals with TBI. Future research will formally examine the success of the guideline's implementation.
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Affiliation(s)
- Mary Stergiou-Kita
- Graduate Department of Rehabilitation Science, University of Toronto, 160-500 University Ave., Toronto, ON M5G 1V7, Canada.
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Spanish, French, and British cross-cultural validation of the European Brain Injury Questionnaire. J Head Trauma Rehabil 2012; 26:478-88. [PMID: 21169861 DOI: 10.1097/htr.0b013e3181fc042c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore the factor structure of the European Brain Injury Questionnaire and to assess the cross-cultural and construct validity of this questionnaire by using Rasch analysis. PARTICIPANTS A total of 366 individuals with traumatic brain injury or stroke were recruited from 3 different countries: Spain (116 participants), the United Kingdom (110 participants), and France (140 participants). ANALYSES We first performed a factor analysis and then applied Rasch analysis to the resulting factors to examine construct and cross-cultural validity. RESULTS Three subscales labeled Depressive Mood, Cognitive Dysfunction, and Poor Social and Emotional Self-regulation were extracted using the factor analysis. In the Rasch analyses, 8 items were removed because of misfit and 7 items showed differential item functioning by country. CONCLUSION Rasch analyses showed good fit to the model, unidimensionality, construct validity, and good reliability of the 3 European Brain Injury Questionnaire subscales. However, only the Depressive and Cognitive subscales showed cross-cultural validity.
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The temporal relationship between depression, anxiety, and functional status after traumatic brain injury: a cross-lagged analysis. J Int Neuropsychol Soc 2011; 17:781-7. [PMID: 21729404 DOI: 10.1017/s1355617711000701] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Poor functional status and high rates of anxiety and depression have been reported in individuals who have sustained a traumatic brain injury (TBI). However, it is unclear whether psychiatric disorders after TBI are a cause or a consequence of functional limitations. The current study aimed to investigate the temporal relationship between anxiety, depression and functional impairment following TBI. The study has a prospective, longitudinal single-group design. Anxiety and depression, assessed using the Structured Clinical Interview for DSM-IV, and functional changes, assessed with the Glasgow Outcome Scale-Extended, were measured six and 12 months post-injury in 122 individuals who had sustained a TBI (79% male, mean age 35 years, mean duration of post-traumatic amnesia 24 days, mean Glasgow Coma Scale score 9.2). Cross-lagged analyses were conducted within a structural equation modelling framework. Functional changes six months post-injury predicted depression and anxiety one year after the injury. Anxiety and depression, in turn, were not predictive of later functional status. This study adds to our understanding of the temporal relationship between depression, anxiety and functional status after TBI. The results indicate the importance of supporting brain injured individuals in coping with the functional consequences of their injury in order promote psychological well-being.
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