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Lovette BC, Kanaya MR, Grunberg VA, McKinnon E, Vranceanu AM, Greenberg J. "Alone in the dark": A qualitative study of treatment experiences among young adults with a recent concussion and anxiety. Neuropsychol Rehabil 2024; 34:781-801. [PMID: 37497984 PMCID: PMC10818011 DOI: 10.1080/09602011.2023.2238950] [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: 02/07/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Young adults with anxiety are vulnerable to developing persistent symptoms following concussions. In order to develop psychosocial interventions to prevent persistent post-concussion symptoms, we need to understand patients' 1) experiences with treatments offered by health care providers; 2) experiences with attempted concussion management strategies; and 3) needs after their injury. METHODS We conducted in-depth interviews with 17 young adults with recent (≤ 10 weeks) concussions who have at least mild anxiety (Generalized Anxiety Disorder Assessment-7 ≥ 5). We used a hybrid deductive-inductive approach to thematic analysis. RESULTS Findings provide insight into recommended treatments (e.g., active/avoidant strategies, accommodations, referrals), attempted strategies (e.g., lifestyle changes, pacing, relationships, acceptance-based coping skills), and patient needs (e.g., education, accommodations, referrals for cognitive and emotional skills). Participants frequently expressed that treatment recommendations were confusing and difficult to implement. They initiated non-prescribed strategies that helped promote recovery and expressed a desire for more interdisciplinary treatment and education on concussions. CONCLUSION Patients' perceptions of health care provider recommendations after concussions did not fully meet patients' perceived needs. Young adults with concussions and anxiety would benefit from more education, guidance, and psychosocial and rehabilitation services. Addressing these gaps may help align treatments with patients' needs and therefore help optimize their recovery.
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Affiliation(s)
- Brenda C. Lovette
- MGH Institute of Health Professions, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Dr. Robert C. Cantu Concussion Center, Emerson Hospital,
Concord, MA, USA
| | - Millan R. Kanaya
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
| | - Victoria A Grunberg
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
- Division of Newborn Medicine, MassGeneral Hospital for
Children, Boston, MA, USA
| | - Ellen McKinnon
- Dr. Robert C. Cantu Concussion Center, Emerson Hospital,
Concord, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
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2
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Roberts M, Popovich M, Almeida A. The Evaluation and Management of Concussion to Optimize Safe Recovery. Prim Care 2024; 51:269-282. [PMID: 38692774 DOI: 10.1016/j.pop.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Concussion is a mild traumatic brain injury causing temporary neurologic dysfunction. Symptoms following concussion are variable and generally are expected to resolve within about 1 month, but some patients experience persistent and prolonged symptoms. An early return to safe, symptom-limited activity is now favored, using targeted rehabilitation and treatments. Accommodations may be needed to facilitate return-to-school and work following concussion. Athletes should not be cleared for a full return to sport until they have recovered from a concussion and completed a return-to-play progression, in addition to returning to work/school fully.
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Affiliation(s)
- Mark Roberts
- Department of Neurology, University of Michigan, 2901 Hubbard Road, Suite 2723, Ann Arbor, MI 48109, USA
| | - Michael Popovich
- Department of Neurology, University of Michigan, 2901 Hubbard Road, Suite 2723, Ann Arbor, MI 48109, USA.
| | - Andrea Almeida
- Department of Neurology, University of Michigan, 2901 Hubbard Road, Suite 2723, Ann Arbor, MI 48109, USA
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3
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Starik T, Huber M, Zeilig G, Wolff J, Ratzon NZ. Employment barriers questionnaire: Development and determination of its reliability and validity. Work 2024:WOR230736. [PMID: 38820058 DOI: 10.3233/wor-230736] [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: 06/02/2024] Open
Abstract
BACKGROUND The high unemployment rate among people with disabilities (PWDs) can be attributed to barriers found in the work environment and demands of the job itself. Given the lack of comprehensive tools to identify these barriers, we developed the Employment Barriers Questionnaire (EBQ). OBJECTIVE The objective of this study was to develop and examine the EBQ's reliability and validity for detecting employment barriers and possible modifications to overcome them. METHODS Two stages were conducted: stage I was a cross-sectional design. Stage II included a cross-sectional and prospective design. Thirty-nine people with physical disabilities (mean age 47.21±10.78 years) were recruited, 51% of which were employed during data collection. During stage I, we developed a first version of the EBQ (EBQ.I) and evaluated its internal reliability. The EBQ.I was filled twice, one week apart to assess test-re-test reliability. Predictive validity was tested using a regression model to predict the employment status of stage II based on EBQ.I's results from stage I. In stage II, we generated a second version (EBQ.II) and tested its internal-reliability and known-groups validity, by comparing the EBQ.II's results between employed and unemployed subjects. RESULTS The results showed that the EBQ.II has a high internal-reliability (α= 0.79-0.97) and a medium-large known-groups validity (-3.95≤Z≤-2.26, p < 0.05). Additionally, the EBQ.I has a high test re-test reliability (ICC = 0.85-0.94, p < 0.001) and predictive validity (β= 0.861, p = 0.033). CONCLUSION This study has illustrated that the EBQ.II is a unique, reliable and valid tool for identifying employment barriers and modifications to address them, expected to improve vocational rehabilitation efforts.
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Affiliation(s)
- Tal Starik
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Occupational Therapy, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Occupational Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Huber
- Department of Occupational Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Zeilig
- Division of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Julie Wolff
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Navah Z Ratzon
- Department of Occupational Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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4
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Cao S. Examining information systems use to facilitate the workplace accommodation process. Work 2024; 77:933-947. [PMID: 37807797 DOI: 10.3233/wor-220716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND The workplace accommodation process is often affected by ineffective and inefficient communications and information exchanges among disabled employees and other stakeholders. Information systems (IS) can play a key role in facilitating a more effective and efficient accommodation process since IS has been shown to facilitate business processes and effect positive organizational changes. OBJECTIVE Since there is little to no research that exists on IS use to facilitate the workplace accommodation process, this paper, as a critical first step, examines how IS have been used in the accommodation process. METHODS Thirty-six interviews were conducted with disabled employees from various organizations. Open, axial, and selective coding were part of the analysis. Fuzzy set qualitative comparative analysis was used to identify different levels of IS use based on participants' descriptions. RESULTS An IS used in the workplace accommodation process consists of electronic request form, accommodation checklist, special budget, specific role, ancillary service, formal policy and procedure. There are different levels of IS use in the current accommodation process. The high-level IS use often results in a better accommodation performance than the low-level IS use, including high efficiency, high effectiveness, and low emotional tolls. Nevertheless, the high-level IS use often uses a specific, inflexible template as well as disregards human elements in the accommodation process. CONCLUSION This work provides implications that future IS design should raise awareness of disability and accommodation, account for individual differences, involve multiple stakeholder inputs, as well as address the fundamental social issues in the accommodation process.
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5
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Craven K, De Dios Pérez B, Holmes J, Fisher R, Radford KA. Factors influencing employers' support for employees with acquired brain injuries or mental illness to return to- and stay in work: A qualitative systematic review. Work 2024; 79:93-121. [PMID: 38217562 DOI: 10.3233/wor-230214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND People with acquired brain injuries (ABIs) often experience residual limitations and co-morbid mental illnesses that restrict work participation. Employers are key in enabling successful return-to-work and job retention. OBJECTIVE This review aimed to explore employers' perspectives of factors influencing their support for people with ABIs and/or mental illness to return to- and stay in work. Review questions focused on barriers and facilitators to their support, and contextual characteristics present at the time. METHODS Five databases were searched from October 2010 until November 2023 for relevant qualitative studies published in English. Findings from included studies (N = 25) were synthesised using thematic synthesis. RESULTS Included studies focused on employees with ABI or mental illness, rather than dually diagnosed ABI and mental illness. Employers' support was influenced by their awareness/knowledge of- and attitudes towards the employee's condition/illness; their skills and experience in supportive strategies; factors related to provision of work accommodations; and stakeholder influence. Similarities and differences in influential factors were observed across the ABI and mental illness literature. Contextual characteristics related to organisational characteristics, cultural taboo, and involvement of certain stakeholders. CONCLUSIONS ABI survivors (with and without co-morbid mental illness) and their employers may benefit from specialist support and resources to guide them through the return-to-work process. Further research is needed to investigate employers' knowledge of ABI and mental illness and supportive strategies. Exploration of the influence of other stakeholders, socio-demographic characteristics, and contextual factors on employers' return-to-work and retention support for ABI survivors with co-morbid mental illness is warranted.
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Affiliation(s)
- Kristelle Craven
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, UK
| | - Blanca De Dios Pérez
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, UK
| | - Jain Holmes
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, UK
| | | | - Kathryn A Radford
- Centre for Rehabilitation & Ageing Research (CRAR), University of Nottingham, Nottingham, UK
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6
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Snell DL, Faulkner JW, Williman JA, Silverberg ND, Theadom A, Surgenor LJ, Hackney J, Siegert RJ. Fear avoidance and return to work after mild traumatic brain injury. Brain Inj 2023; 37:541-550. [PMID: 36856140 DOI: 10.1080/02699052.2023.2180663] [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: 02/24/2023]
Abstract
OBJECTIVES Fear avoidance is associated with symptom persistence after mild traumatic brain injury (mTBI). In this study, we investigated whether fear avoidance was associated with other outcomes such as return to work-related activity (RTW). MATERIALS AND METHODS We analyzed associations between fear avoidance and RTW 6-9 months after mTBI, in two merged prospective mTBI cohorts. Adult participants aged 16 or over (n=175), presenting to outpatient services in New Zealand within 3 months of their injury, who were engaged in work-related activity at the time of injury, were included. Participants completed the Fear Avoidance Behavior after Traumatic Brain Injury (FAB-TBI) questionnaire at enrollment and 6 months later. Associations between FAB-TBI scores and RTW outcome were analyzed using multivariate approaches. RESULTS Overall, 53% of participants had RTW by 6-9 months after mTBI. While early fear avoidance was weakly associated with RTW, persistent high fear avoidance between study assessments or increasing avoidance with time were associated with greater odds of still being off work 6-9 months after injury. CONCLUSIONS Pervasive and increasing avoidance of symptom triggers after mTBI were associated with lower rates of RTW 6-9 months after mTBI. Further research is needed to better understand transition points along the recovery trajectory where fear avoidance behaviors fade or increase after mTBI.
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Affiliation(s)
- Deborah L Snell
- Department of Orthopedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Josh W Faulkner
- School of Psychology, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | | | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Alice Theadom
- TBI Network, Department of Psychology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Lois J Surgenor
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Richard J Siegert
- TBI Network, Department of Psychology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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7
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Hanafy S, Colantonio A, Mollayeva T, Munce S, Lindsay S. Employment and accommodation needs and the effect of COVID-19 on men and women with traumatic brain injury. Work 2022; 75:41-58. [PMID: 36591690 DOI: 10.3233/wor-220437] [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: 12/31/2022] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) impacts an individual's workforce involvement post-injury. Support services and workplace accommodations that can help with work re-integration post-TBI may differ based on a person's sex and gender. The added impact of COVID-19 remains under-explored. OBJECTIVE We aimed to investigate the support services and workplace accommodation needs and the impact of COVID-19 on work and mental health for persons with TBI, considering sex and gender. METHODS A cross-sectional online survey was distributed. Descriptive and regression analyses were applied to uncover sex and gender differences, along with content analysis for open-ended responses. RESULTS Thirty-two persons with TBI (62% women, 38% men) participated. Physiotherapy, occupational therapy, and counselling services were indicated as the most needed services by women and men. Modified hours/days and modified/different duties were the most needed workplace accommodations. Mental challenges impacting well-being was a highlighted concern for both men and women. Women scored poorer on the daily activity domain of the Quality of Life after Brain Injury - Overall Scale (p = 0.02). Assistance with daily activities was highlighted by women for a successful transition to work, including housekeeping and caregiving. Men were more likely than women to experience change in employment status because of COVID-19 (p = 0.02). Further, a higher percentage of men expressed concern about the inability to pay for living accommodations, losing their job, and not having future job prospects. CONCLUSION Findings reveal important differences between men and women when transitioning to work post-TBI and emphasize the need for sex and gender considerations.
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Affiliation(s)
- Sara Hanafy
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Tatyana Mollayeva
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sally Lindsay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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8
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Spjelkavik Ø, Enehaug H, Klethagen P, Howe EI, Fure SC, Terjesen HCA, Løvstad M, Andelic N. Workplace accommodation in return to work after mild traumatic brain injury. Work 2022; 74:1149-1163. [PMID: 36442182 DOI: 10.3233/wor-211440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND: While a vast amount of research focuses on unmodifiable and individual factors that may impact return to work (RTW) for patients with traumatic brain injury (TBI), less knowledge exists of the relationship between specific workplace factors and work retention. OBJECTIVE: Identify types of accommodation in the workplace that influence the RTW process for employees with TBI and the challenges associated with them. METHODS: A multiple case study consisting of 38 cases and 109 interviews of employees with TBI and their managers conducted between 2017 and 2020 at two time points. RESULTS: Accommodation of both the organizational and psychosocial work environment influences RTW for employees with TBI. Social support and supportive management may have positive and negative effects. RTW is often not a linear process. Over time, maintaining and developing customized accommodation in the work organization is challenging. CONCLUSIONS: Uncertainty about accommodation in RTW for employees with TBI is closely linked to lack of knowledge in the workplace of how to handle complex and nonlinear RTW processes. Work-oriented rehabilitation should to a greater extent provide managers with relevant information and support to develop the person-environment fit over time.
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Affiliation(s)
| | - Heidi Enehaug
- Work Research Institute, Oslo Metropolitan University, Oslo, Norway
| | - Pål Klethagen
- Work Research Institute, Oslo Metropolitan University, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Silje C.R. Fure
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital Trust, Nesoddtangen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
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9
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Outlining the Invisible: Experiences and Perspectives Regarding Concussion Recovery, Return-to-Work, and Resource Gaps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138204. [PMID: 35805862 PMCID: PMC9266414 DOI: 10.3390/ijerph19138204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 02/01/2023]
Abstract
Appropriate supports and accommodations are necessary to ensure full concussion recovery and return-to-work (RTW). This research investigated barriers and facilitators to concussion recovery and RTW, and resource gaps reported by adults with concussion (‘workers’) and workplace and healthcare professionals (‘workplaces’). Semi-structured interviews and focus groups were conducted with workers (n = 31) and workplaces (n = 16) across British Columbia. Data were analyzed using inductive content analysis. Facilitators to workers’ concussion recovery and RTW included treatment, social support, and workplace and lifestyle modifications. To address barriers, both groups recommended: (a) widespread concussion and RTW education and training (b) standardized concussion recovery guidelines; (c) changing attitudes toward concussion; (d) mental health supports; and (e) increasing awareness that every concussion is unique. Findings can inform best practice for concussion recovery and RTW among professionals in workplaces, healthcare, occupational health and safety, and workers’ compensation boards.
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10
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Meulenbroek P, O'Neil-Pirozzi TM, Sohlberg MM, Lemoncello R, Byom L, Ness B, MacDonald S, Phillips B. Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:188-202. [PMID: 34929113 DOI: 10.1044/2021_ajslp-21-00129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. METHOD This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. RESULTS This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. CONCLUSIONS SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.
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Affiliation(s)
- Peter Meulenbroek
- Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Therese M O'Neil-Pirozzi
- Communication Sciences and Disorders, Northeastern University, Boston, MA
- Spaulding/Harvard Traumatic Brain Injury Model System, Boston, MA
| | | | - Rik Lemoncello
- School of Communication Sciences and Disorders, Pacific University, Forest Grove, OR
| | - Lindsey Byom
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of Chapel Hill, NC
| | - Bryan Ness
- Communication Sciences and Disorders, California Baptist University, Riverside
| | - Sheila MacDonald
- Sheila MacDonald & Associates, University of Toronto, Ontario, Canada
| | - Brian Phillips
- Special Education & Rehabilitation Counseling, Utah State University, Logan
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11
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Ditchman N, Thomas JA, Johnson K, Haak C, Rafajko S. The impact of employment on quality of life for adults with brain injury. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-211168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Employment is associated with greater quality of life (QOL) for people with disabilities. Yet, for individuals with traumatic brain injury (TBI), the benefits of work are not often realized given high rates of unemployment. OBJECTIVE: This study examined the unique impact of psychosocial variables and employment status (working vs. not working) on self-reported QOL among adults with TBI. METHODS: Participants included 116 adults with TBI between the ages of 18-65, recruited through state brain injury associations in the United States to complete an anonymous online survey. Hierarchical regression analysis was used to examine the incremental impact of psychosocial variables (sense of community, social support, social network, and problem-solving confidence) and employment status on QOL controlling for age and symptom severity. RESULTS: In the final model, employment status, informal and formal support network ties, problem-solving confidence, sense of community, and emotional support explained 59% of the variance in QOL, which is considered a large effect size. Employment status uniquely explained 5% of the variance in QOL. CONCLUSIONS: Findings support the positive benefits of work for adults with TBI. Rehabilitation services that emphasize vocational considerations and employment supports are needed to impact work status and ultimately QOL for individuals with TBI.
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Affiliation(s)
- Nicole Ditchman
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Julia A. Thomas
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Kristina Johnson
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Haak
- Center for Disabilities and Development, University of Iowa, Iowa City, IA, USA
| | - Sean Rafajko
- Gersten Center for Behavioral Health, Chicago, IL, USA
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12
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Wong J, Kallish N, Crown D, Capraro P, Trierweiler R, Wafford QE, Tiema-Benson L, Hassan S, Engel E, Tamayo C, Heinemann AW. Job Accommodations, Return to Work and Job Retention of People with Physical Disabilities: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:474-490. [PMID: 33479811 DOI: 10.1007/s10926-020-09954-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 05/26/2023]
Abstract
Purpose We aimed to identify job accommodations that help persons with physical disabilities maintain or return to work and explore the barriers and facilitators that influence the provision and reception of job accommodations. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in PROSPERO (CRD42019129645). The search strategy incorporated keywords describing physical disabilities, employer-approved job accommodations, and employment retention or return to work approaches. We searched MEDLINE, the Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, and ProQuest Theses and dissertations. Reviewers independently selected studies for inclusion. We used Hawker et al.'s method to assess study quality. Results We identified 2203 articles, of which 52 met inclusion criteria, developed a table of job accommodations commonly used by persons with physical disabilities, summarized the percentages of job accommodations used by persons with disabilities, synthesized evidence of the effectiveness of job accommodations, and identified the factors that influence job accommodation use. The most frequently reported accommodations were as follows: modification of job responsibilities, change of workplace policy, supportive personnel provision, flexible scheduling, and assistive technology. We summarized four types of facilitators and barriers that affect job accommodation use: employee-related factors, accommodation-related factors, job-related factors, and social workplace-related factors. Conclusion The absence of randomized controlled trials and prevalence of cross-sectional surveys provides inconclusive evidence regarding the effectiveness of specific job accommodations for people with particular functional limitations. Our system of categorizing job accommodations provides a guide to investigators seeking to evaluate the effectiveness of job accommodations using experimental methods.
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Affiliation(s)
- Jasin Wong
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA.
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA.
| | - Natasha Kallish
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Deborah Crown
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Pamela Capraro
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | | | - Q Eileen Wafford
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Shahzeb Hassan
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA
| | - Edeth Engel
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Christina Tamayo
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Allen W Heinemann
- Northwestern University Feinberg School of Medicine, 633 N. Saint Clair St., 20th Floor, Chicago, IL, 60611, USA
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
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13
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Graff HJ, Deleu NW, Christiansen P, Rytter HM. Facilitators of and barriers to return to work after mild traumatic brain injury: A thematic analysis. Neuropsychol Rehabil 2020; 31:1349-1373. [PMID: 32584206 DOI: 10.1080/09602011.2020.1778489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with mild traumatic brain injury (mTBI) may experience protracted symptoms affecting their ability to work. Several actors may facilitate or act as a barrier to a successful return to work (RTW). This qualitative study used semi-structured in-depth interviews with 22 adults with mTBI at 2-5 years post injury, targeting experiences of how different actors facilitated or acted as a barrier in the RTW process, and encompassed the mTBI trajectory from the acute phase to the post-acute phase. A thematic analysis with a hermeneutical phenomenological approach was used to analyse data. Three main themes emerged. (1) Worker-employer relationship: Workplace accommodations such as decreased working hours, modified working conditions, and support from co-workers were lacking. (2) The role of the general practitioner: The general practitioner was lacking treatment and referral opportunities and failed to provide the patient with relevant and individualized guidance. (3) Municipal case management: Participants perceived being met with distrust by social workers, follow-up assessments were too frequent, unnecessary, and did not target concussion, and rehabilitation was referred too late. Clinical practice guidelines to improve referral to relevant concussion rehabilitation in case of persistent symptoms are needed to inform clinicians, employers, and public institutions to facilitate a successful RTW.
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Affiliation(s)
- Heidi Jeannet Graff
- Department of Anaesthesia, Centre of Head and Orthopaedics, University Hospital Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Concussion Center, Copenhagen, Denmark
| | - Nicole W Deleu
- Centre for Rehabilitation of Brain Injury, Copenhagen, Denmark
| | | | - Hana Malá Rytter
- Danish Concussion Center, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, University Hospital Bispebjerg - Frederiksberg, Copenhagen, Denmark
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Eguchi H, Tsutsumi A, Inoue A, Kachi Y. Organizational justice and illness reporting among Japanese employees with chronic diseases. PLoS One 2019; 14:e0223595. [PMID: 31634347 PMCID: PMC6802873 DOI: 10.1371/journal.pone.0223595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/24/2019] [Indexed: 12/05/2022] Open
Abstract
Purpose This study examined the association between perceived organizational justice (i.e., procedural justice and interactional justice) and reporting of illness to one's company (illness reporting) among Japanese employees with chronic diseases. Methods This online cross-sectional survey included 1,134 employees (aged 18–65 years) who required workplace support to combine work with disease treatment. Participants were classified into tertiles of perceived organizational justice (low, moderate, and high). Multiple logistic regression analyses were conducted to examine sex differences in the associations between perceived justice and illness reporting. Results Males reporting perceived high levels of procedural and interactional justice had significantly higher odds of illness reporting than those with perceived low levels of procedural (odds ratio [OR] 2.62, 95% confidence interval [CI]: 1.47–4.66) and interactional justice (OR 4.34, 95% CI: 2.28–8.27). Females with perceived high levels of interactional justice had significantly higher odds of illness reporting than those with perceived low levels of interactional justice (OR 1.74, 95% CI: 1.08–2.80). There was no significant association between procedural justice and illness reporting among females. Conclusion The findings indicate that high perceived organizational justice is positively associated with illness reporting among Japanese employees who require workplace support to combine work and disease treatment.
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Affiliation(s)
- Hisashi Eguchi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
- * E-mail:
| | - Akizumi Tsutsumi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Yuko Kachi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
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