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Gates TM, Daher M, McRae P, Simpson GK. Validation of the work-ability support scale in individuals seeking to return to work after severe acquired brain injury. Disabil Rehabil 2024; 46:3164-3175. [PMID: 37606282 DOI: 10.1080/09638288.2023.2243819] [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] [Received: 03/13/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE To assess the reliability and validity of the work-ability support scale (WSS) in a severe traumatic/acquired brain injury (TBI/ABI) population seeking to return to work (RTW). MATERIALS AND METHODS One hundred forty-four clients were enrolled in a vocational rehabilitation (VR) intervention trial through the Brain Injury Rehabilitation Program in New South Wales, Australia. Each client's primary brain injury clinician and VR provider completed the WSS pre- and post-intervention. Validating measures assessing dysexecutive behavior, disability, participation, and work instability were completed. Several aspects of reliability and validity were evaluated. RESULTS Internal consistency was excellent for Part A (Cronbach's αs > 0.9) but unacceptably low to questionable for Part B (αs < 0.6). Inter-rater reliability between clinicians and VR providers was generally fair to moderate for Part A (κw < 0.6) and worse for Part B (κw < 0.5), with both slightly improving at post-intervention. Strong support was found for predictive and convergent validity, but not divergent validity. Confirmatory factor analysis indicated a poor fit for Part A, whereas most Part B fit indices met criteria. CONCLUSIONS The WSS can play a useful role in assessing return to work (RTW) potential, planning and evaluation after severe TBI/ABI. Training could improve consistency of administration among staff working across health and VR service sectors.
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Affiliation(s)
- Thomas M Gates
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia
| | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation, NSW Health, Sydney, Australia
| | - Philippa McRae
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation, NSW Health, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia
- Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Sydney, Australia
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Guerrette MC, McKerral M. Predictors of Social Participation Outcome after Traumatic Brain Injury Differ According to Rehabilitation Pathways. J Neurotrauma 2023; 40:523-535. [PMID: 35974662 DOI: 10.1089/neu.2022.0232] [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: 11/13/2022] Open
Abstract
Social participation (SP) is one of many objectives in the rehabilitation of patients with traumatic brain injury (TBI). Studies on predictors of SP specific to post-acute universally accessible specialized rehabilitation pathways following TBI are scarce. Our objectives were to: 1) characterize SP, as well as a set of pre-injury, injury-related, and post-injury variables in individuals participating in inpatient-outpatient or outpatient rehabilitation pathways within a universally accessible and organized trauma continuum of care; and 2) examine the ability of pre-injury, injury-related, and post-injury variables in predicting SP outcome after TBI according to rehabilitation path. Participants (N = 372) were adults admitted to an inpatient-outpatient rehabilitation pathway or an outpatient rehabilitation pathway after sustaining a TBI between 2016 and 2020, and for whom Mayo-Portland Adaptability Intentory-4 (MPAI-4) outcomes were prospectively obtained at the start and end of rehabilitation. Additional data was collected from medical files. For both rehabilitation pathways, predicted SP outcome was MPAI-4 Participation score at discharge from outpatient rehabilitation. Multiple regression models investigated the predictive value of each variable for SP outcome, separately for each care pathway. Main findings show that for the inpatient-outpatient sample, three variables (education years, MPAI-4 Ability and Adjustment scores at rehabilitation intake) significantly predicted SP outcome, with the regression model accounting for 49% of the variance. For the outpatient sample, five variables (pre-morbid hypertension and mental health diagnosis, total indirect rehabilitation hours received, MPAI-4 Abilities and Adjustment scores at rehabilitation intake) significantly predicted SP outcome, with the regression model accounting for 47% of the variance. In conclusion, different pre-morbid and post-injury variables are involved in predicting SP, depending on the rehabilitation path followed. The predictive value of those variables could help clinicians identify patients more likely of showing poorer SP at discharge and who may require additional or different interventions.
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Affiliation(s)
- Marie-Claude Guerrette
- Department of Psychology, Université de Montréal, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal-IURDPM, Montreal, Quebec, Canada
| | - Michelle McKerral
- Department of Psychology, Université de Montréal, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal-IURDPM, Montreal, Quebec, Canada
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3
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The effectiveness of memory remediation strategies after traumatic brain injury: Systematic review and meta-analysis. Ann Phys Rehabil Med 2021; 64:101530. [PMID: 33957294 DOI: 10.1016/j.rehab.2021.101530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a steadily rising health concern associated with significant risk of emotional, behavioral and cognitive impairments. Cognitive memory impairment is one of the most concerning outcomes after TBI, affecting a wide range of everyday activities, social interactions and employment. Several comparative and comprehensive reviews on the effects of cognitive interventions in individuals with TBI have been conducted but usually with a qualitative rather than quantitative approach. Thus, evidence synthesis of the effects of TBI interventions on memory difficulties is limited. OBJECTIVE In this meta-analysis, we examined the memory-remediating effects of internal and external interventions, injury severity and the interaction of both factors for patients with TBI. METHODS Data were extracted from studies published between 1980 and 2020 that used objective memory measures (computerized or pencil-and-paper), and multiple meta-analyses were conducted to compare effectiveness across these interventions. Publication bias was assessed, as was quality of evidence using the Cochrane Risk of Bias tool for randomized controlled studies. Our final meta-analysis included 16 studies of 17 interventions classified into 3 categories: internal, external and mixed. RESULTS Mixed interventions demonstrated the highest average effect size for memory difficulties (Morris d=0.79). An evaluation of injury severity yielded 2 categories: mild-moderate and moderate-severe. Analyses demonstrated a homogenous medium effect size of improvement across injury severity, with moderate-severe injury with the largest average effect size (Morris d=0.65). Further evaluation of injury severity interaction with intervention type revealed a mediating effect for both factors, demonstrating the largest effect size for mixed interventions with moderate-severe injury (Morris d=0.81). CONCLUSION This study highlights the effectiveness of memory remediation interventions on memory impairment after TBI. A wide range of interventions are more effective because they address individual variability for severity and memory deficits. The study further supports and expands existing intervention standards and guidelines.
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Pellicciari L, Piscitelli D, Basagni B, De Tanti A, Algeri L, Caselli S, Ciurli MP, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Rinaldesi ML, Sozzi M, Abbruzzese L, Zettin M, La Porta F. 'Less is more': validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). Brain Inj 2020; 34:1741-1755. [PMID: 33180650 DOI: 10.1080/02699052.2020.1836402] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Previous analyses demonstrated a lack of unidimensionality, item redundancy, and substantial administrative burden for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs). OBJECTIVE To use Rasch Analysis to calibrate five short-forms of the BIRT-PQs, satisfying the Rasch model requirements. METHODS BIRT-PQs data from 154 patients with severe Acquired Brain Injury (s-ABI) and their caregivers (total sample = 308) underwent Rasch analysis to examine their internal construct validity and reliability according to the Rasch model. RESULTS The base Rasch analyses did not show sufficient internal construct validity according to the Rasch model for all five BIRT-PQs. After rescoring 18 items, and deleting 75 of 150 items, adequate internal construct validity was achieved for all five BIRT-PQs short forms (model chi-square p-values ranging from 0.0053 to 0.6675), with reliability values compatible with individual measurements. CONCLUSIONS After extensive modifications, including a 48% reduction of the item load, we obtained five short forms of the BIRT-PQs satisfying the strict measurement requirements of the Rasch model. The ordinal-to-interval measurement conversion tables allow measuring on the same metric the perception of the neurobehavioral disability for both patients with s-ABI and their caregivers.
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Affiliation(s)
- Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana , Rome, Italy
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University , Montreal, Canada.,School of Medicine and Surgery, University of Milano Bicocca , Milan, Italy.,School of Physical Therapy and Athletic Training, Pacific University , Hillsboro, OR, USA
| | - Benedetta Basagni
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Antonio De Tanti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Lorella Algeri
- UOC Psicologia, ASST Papa Giovanni XXIII , Bergamo, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria di Modena , Modena, Italy.,Scuola di Dottorato in Sanità Pubblica, Università degli Studi di Milano-Bicocca , Milano, Italy
| | | | - Jessica Conforti
- Cardinal Ferrari Centre, S. Stefano Rehabilitation , Fontanellato (PR), Italy
| | - Anna Estraneo
- Severe Brain Injury Department, IRCCS Don Gnocchi Institute , Florence, Italy.,Neurology Unit, Santa Maria della Pietà General Hospital , Nola, Italy
| | - Pasquale Moretta
- Maugeri Scientific and Clinical Institutes, IRCCS, Department of Neurorehabilitation, Institute of Telese Terme , Telese Terme, Italy
| | - Maria Grazia Gambini
- Dipartimento di Riabilitazione, Ospedale Sacro Cuore- Don Calabria , Verona, Italy
| | | | | | - Mauro Mancuso
- Department of Rehabilitation, National Health Service South-Est Tuscany , Grosseto, Italy.,Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Maria Luisa Rinaldesi
- Santo Stefano Riabilitazione, Istituto di Riabilitazione Santo Stefano , Porto Potenza Picena, Italy
| | - Matteo Sozzi
- Neurology Unit, "A. Manzoni" Hospital , Lecco, Italy
| | - Laura Abbruzzese
- Research Centre, Tuscany Rehabilitation Clinic , Montevarchi, Italy
| | - Marina Zettin
- Centro Puzzle , Turin, Italy.,Dipartimento di Psicologia, Università di Torino , Turin, Italy
| | - Fabio La Porta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurorehabilitation Unit , Bologna, Italy
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5
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Basagni B, Piscitelli D, De Tanti A, Pellicciari L, Algeri L, Caselli S, Formisano R, Conforti J, Estraneo A, Moretta P, Gambini MG, Inzaghi MG, Lamberti G, Mancuso M, Quinquinio C, Sozzi M, Abbruzzese L, Zettin M, La Porta F. The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics. Brain Inj 2020; 34:673-684. [PMID: 32126842 DOI: 10.1080/02699052.2020.1723700] [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
Objective: To assess the internal construct validity (ICV) of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQ) with Classical Test Theory methods.Methods: Multicenter cross-sectional study involving 11 Italian rehabilitation centers. BIRT-PQs were administered to patients with severe Acquired Brain Injury and their respective caregivers. ICV was assessed by the mean of an internal consistency analysis (ICA) and a Confirmatory Factor Analysis (CFA).Results: Data from 154 patients and their respective caregivers were pooled, giving a total sample of 308 subjects. Despite good overall values (alphas ranging from 0.811 to 0.937), the ICA revealed that several items within each scale did not contribute as expected to the total score. This result was confirmed by the CFA, which showed the misfit of the data to a unidimensional model (RMSEA ranging from 0.077 to 0.097). However, after accounting for local dependency found within the data, fitness to a unidimensional model improved significantly (RMSEA ranging from 0.050 to 0.062).Conclusion: Despite some limitations, our analyses demonstrated the lack of ICV for the BIRT-PQ total scores. It is envisaged that a more comprehensive ICV analysis will be performed with Rasch analysis, aiming to improve both the measurement properties and the administrative burden of each BIRT-PQ.
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Affiliation(s)
- Benedetta Basagni
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Antonio De Tanti
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | | | - Lorella Algeri
- UOC Psicologia, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Serena Caselli
- Unità Operativa di Medicina Riabilitativa, Dipartimento di Neuroscienze, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.,Scuola di Dottorato in Sanità Pubblica, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Rita Formisano
- Unità Post-Coma Ospedale di Riabilitazione Fondazione Santa Lucia, Rome, Italy
| | - Jessica Conforti
- Centro Cardinali Ferrari, Santo Stefano Riabilitazione, Fontanellato, Italy
| | - Anna Estraneo
- IRCCS; Fondazione Don Carlo Gnocchi, Severe Brain Injury Department, Florence, Italy
| | - Pasquale Moretta
- Maugeri Scientific and Clinical Institutes, IRCCS Department of Neurorehabilitation, Institute of Telese Terme, Telese Terme, Italy
| | - Maria Grazia Gambini
- Dipartimento di riabilitazione, Ospedale Sacro cuore- Don Calabria, Negrar, Verona
| | | | - Gianfranco Lamberti
- Unità Spinale e Medicina Riabilitativa Intensiva, AUSL Piacenza, Piacenza, Italy
| | - Mauro Mancuso
- Department of Rehabilitation, National Health Service South-Est Tuscany, Grosseto, Italy.,Research Centre, Tuscany Rehabilitation Clinic, Montevarchi, Italy
| | - Cristina Quinquinio
- Santo Stefano Riabilitazione, Istituto di Riabilitazione Santo Stefano, Porto Potenza Picena, Italy
| | - Matteo Sozzi
- Dipartimento di Scienze Neuroriabilitative, Casa di Cura del Policlinico, Milan, Italy
| | - Laura Abbruzzese
- Research Centre, Tuscany Rehabilitation Clinic, Montevarchi, Italy
| | - Marina Zettin
- Centro Puzzle, Turin, Italy.,Dipartimento di Psicologia, Università di Torino, Turin, Italy
| | - Fabio La Porta
- Neurorehabilitation Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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6
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Alves DE, Nilsen W, Fure SCR, Enehaug H, Howe EI, Løvstad M, Fink L, Andelic N, Spjelkavik Ø. What characterises work and workplaces that retain their employees following acquired brain injury? Systematic review. Occup Environ Med 2020; 77:122-130. [PMID: 31907293 PMCID: PMC7029230 DOI: 10.1136/oemed-2019-106102] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/11/2019] [Accepted: 12/14/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The objective of this study was to conduct a systematic review assessing workplace factors related to work retention (or return to work) in employees with acquired brain injury (ABI). Additionally, we aimed to synthesise the evidence and state of knowledge on this subject. METHODS A database search was performed in nine relevant electronic databases. Inclusion criteria were quantitative peer-reviewed publications empirically investigating the relationship between work/workplace factors and work retention in employees following ABI. The methodological quality was determined by Effective Public Health Practice Project scoring, and evidence was synthesised narratively. RESULTS Thirteen studies were included. We found moderate evidence for a negative relationship between manual work and work retention. We also found limited evidence for a U-shaped relationship between workload and complete work retention at 6 months and no relationship at 12 months; a positive relationship between managers, compared with non-managers, and faster work retention; a positive relationship between large enterprise size defined as ≥250 employees, and no relationship between large enterprise size, defined as ≥1000 employees, and work retention. CONCLUSION Relative to individual factors, there is little evidence on specific workplace factors' relationship to work retention among employees with ABI. For most workplace factors, there were too few high-quality studies to designate evidence as more than limited or insufficient. Future studies should replicate rigorous studies of well-defined modifiable workplace factors related to work retention. PROSPERO REGISTRATION NUMBER CRD42018082201.
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Affiliation(s)
| | - Wendy Nilsen
- Work Research Institute, OsloMet- Oslo Metropolitan University, Oslo, Norway
| | - Silje Christine Reistad Fure
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Heidi Enehaug
- Work Research Institute, OsloMet- 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
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Louisa Fink
- Institute of Social Psychology, Goethe University Frankfurt, Frankfurt, Hessen, Germany
| | - Nada Andelic
- Department of Physical medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øystein Spjelkavik
- Work Research Institute, OsloMet- Oslo Metropolitan University, Oslo, Norway
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Brakenridge CL, Gane EM, Smits EJ, Andrews NE, Johnston V. Impact of interventions on work-related outcomes for individuals with musculoskeletal injuries after road traffic crash: a systematic review protocol. Syst Rev 2019; 8:247. [PMID: 31665095 PMCID: PMC6819343 DOI: 10.1186/s13643-019-1178-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/09/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Musculoskeletal injuries are the most common non-fatal injury from road traffic crashes. Even when the injuries are mild, they can cause pain which can affect return to work rates and work ability post-crash. Workplace output losses are the biggest cost from traffic crash-related injuries. There is a need to identify effective interventions that can improve work-related outcomes (e.g. time to return to work, sick leave, and work ability) in this group and a need to understand the intervention components, external factors, and participant characteristics that may be associated with improvement. METHODS A systematic review will be conducted using seven databases and search terms related to road traffic crash, musculoskeletal injury, work-related outcomes, and study design. Intervention studies will be eligible if they report on at least one work-related outcome, include adults with a traffic crash-related musculoskeletal injury (e.g. fracture or whiplash), include a comparison group, and are written in English. Interventions can be medical, therapeutic, work-based, multicomponent, or other. Two researchers will independently screen titles and abstracts, review full texts for inclusion in the review, and perform the data extraction. The main outcomes of the review will be time until return to work and duration of sick leave. The results will be narratively described, with meta-analyses conducted where possible. DISCUSSION This review will explore the effectiveness of interventions in individuals with traffic crash-related musculoskeletal injury on work-related outcomes and will act as a useful source for researchers, policy makers, and stakeholders when developing and implementing interventions in this group. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018103746.
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Affiliation(s)
| | - Elise M. Gane
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD Australia
| | - Esther J. Smits
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD Australia
| | - Nicole E. Andrews
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD Australia
- Occupational Therapy Department and The Professor Tess Cramond Multidisciplinary Pain Centre, The Royal Brisbane and Women’s Hospital, Brisbane, QLD Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD Australia
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8
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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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9
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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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10
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Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study. Injury 2017; 48:1120-1128. [PMID: 28343652 DOI: 10.1016/j.injury.2017.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/09/2017] [Accepted: 03/12/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC. METHOD Participants were 194 claimants (63.4% female) within a common-law "fault-based" system from the UQ SuPPORT cohort who were working prior to their RTC. Participants were assessed at 6 months on a variety of physical and mental health measures and RTW status was determined at 2 years post-RTC. RTW rate was 78.4%. RESULTS Univariate predictors of NRTW included being the driver or passenger, having a prior psychiatric diagnosis, high disability level, low mental or physical quality of life, predicted non-recovery, high pain, low function, high expectations of pain persistency, low expectations about RTW, having a psychiatric diagnosis, elevated depression or anxiety. The final multivariable logistic regression model included only two variables: disability level and expectations about RTW. Seventy-five percent of individuals who will not RTW by 2 years can be identified accurately at an early stage, using only these two predictors. CONCLUSION The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW.
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11
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Navigating Employment Pathways and Supports Following Brain Injury in Australia: Client Perspectives. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2016. [DOI: 10.1017/jrc.2016.14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study investigated the vocational rehabilitation experiences of 29 clients, up to 14 years post brain injury. Data obtained from participant interviews were thematically analysed by employment pathway (‘return to pre-injury employment’, ‘job seeking’ and ‘not worked since injury’). A total of nine themes were identified. Across all pathways, participants identified the importance of working, impact of injury and their own determination. The content for the remaining themes (understanding, adjustment, access, support, disclosure of injury, intervention) varied by pathway, reflecting the differing perspectives arising from integrating back into a familiar workplace versus seeking new employment. In conclusion, programme approaches to vocational rehabilitation need to be tailored to the individual circumstances, opportunities and support needs of people with brain injury pursuing these different pathways.
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12
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Schultz IZ, Law AK, Cruikshank LC. Prediction of occupational disability from psychological and neuropsychological evidence in forensic context. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 49:183-196. [PMID: 27810113 DOI: 10.1016/j.ijlp.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Within the fields of psychiatry, psychology, and neuropsychology, medical examiners are often tasked with providing an opinion about an injured individual's health prognosis and likelihood of returning to work. Traditionally, examiners have conducted such assessments by employing clinical intuition, expert knowledge, and judgment. More recently, however, an accumulation of research on factors predictive of disability has allowed examiners to provide prognostications using specific empirically supported evidence. This paper integrates current evidence for four common clinical issues encountered in forensic assessments-musculoskeletal pain, depression, Posttraumatic Stress Disorder, and traumatic brain injury. It discusses an evidence-informed, cross-diagnostic and multifactorial model of predicting disability that is emerging from the literature synthesis, along with recommendations for best forensic assessment practice.
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Affiliation(s)
- Izabela Z Schultz
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Ada K Law
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Leanna C Cruikshank
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
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Cancelliere C, Donovan J, Stochkendahl MJ, Biscardi M, Ammendolia C, Myburgh C, Cassidy JD. Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews. Chiropr Man Therap 2016; 24:32. [PMID: 27610218 PMCID: PMC5015229 DOI: 10.1186/s12998-016-0113-z] [Citation(s) in RCA: 237] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/07/2016] [Indexed: 01/23/2023] Open
Abstract
Background Work disability is a major personal, financial and public health burden. Predicting future work success is a major focus of research. Objectives To identify common prognostic factors for return-to-work across different health and injury conditions and to describe their association with return-to-work outcomes. Methods Medline, Embase, PsychINFO, Cinahl, and Cochrane Database of Systematic Reviews and the grey literature were searched from January 1, 2004 to September 1, 2013. Systematic reviews addressing return-to-work in various conditions and injuries were selected. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria to identify low risk of bias reviews. Results Of the 36,193 titles screened and the 94 eligible studies reviewed, 56 systematic reviews were accepted as low risk of bias. Over half of these focused on musculoskeletal disorders, which were primarily spine related (e.g., neck and low back pain). The other half of studies assessed workers with mental health or cardiovascular conditions, stroke, cancer, multiple sclerosis or other non-specified health conditions. Many factors have been assessed, but few consistently across conditions. Common factors associated with positive return-to-work outcomes were higher education and socioeconomic status, higher self-efficacy and optimistic expectations for recovery and return-to-work, lower severity of the injury/illness, return-to-work coordination, and multidisciplinary interventions that include the workplace and stakeholders. Common factors associated with negative return-to-work outcomes were older age, being female, higher pain or disability, depression, higher physical work demands, previous sick leave and unemployment, and activity limitations. Conclusions Expectations of recovery and return-to-work, pain and disability levels, depression, workplace factors, and access to multidisciplinary resources are important modifiable factors in progressing return-to-work across health and injury conditions. Employers, healthcare providers and other stakeholders can use this information to facilitate return-to-work for injured/ill workers regardless of the specific injury or illness. Future studies should investigate novel interventions, and other factors that may be common across health conditions.
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Affiliation(s)
- Carol Cancelliere
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - James Donovan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | | | | | - Carlo Ammendolia
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ; Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
| | - Corrie Myburgh
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - J David Cassidy
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada ; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark ; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
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Peters S, Johnston V, Hines S, Ross M, Coppieters M. Prognostic factors for return-to-work following surgery for carpal tunnel syndrome. ACTA ACUST UNITED AC 2016; 14:135-216. [DOI: 10.11124/jbisrir-2016-003099] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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15
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Douglas JM, Bracy CA, Snow PC. Return to Work and Social Communication Ability Following Severe Traumatic Brain Injury. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:511-520. [PMID: 27124205 DOI: 10.1044/2015_jslhr-l-15-0025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 11/05/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE Return to competitive employment presents a major challenge to adults who survive traumatic brain injury (TBI). This study was undertaken to better understand factors that shape employment outcome by comparing the communication profiles and self-awareness of communication deficits of adults who return to and maintain employment with those who do not. METHOD Forty-six dyads (46 adults with TBI, 46 relatives) were recruited into 2 groups based on the current employment status (employed or unemployed) of participants with TBI. Groups did not differ in regard to sex, age, education, preinjury employment, injury severity, or time postinjury. The La Trobe Communication Questionnaire (Douglas, O'Flaherty, & Snow, 2000) was used to measure communication. Group comparisons on La Trobe Communication Questionnaire scores were analyzed by using mixed 2 × 2 analysis of variance (between factor: employment status; within factor: source of perception). RESULTS Analysis yielded a significant group main effect (p = .002) and a significant interaction (p = .004). The employed group reported less frequent difficulties (self and relatives). Consistent with the interaction, unemployed participants perceived themselves to have less frequent difficulties than their relatives perceived, whereas employed participants reported more frequent difficulties than their relatives. CONCLUSION Communication outcome and awareness of communication deficits play an important role in reintegration to the workplace following TBI.
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Newnam S, Collie A, Vogel AP, Keleher H. The impacts of injury at the individual, community and societal levels: a systematic meta-review. Public Health 2014; 128:587-618. [PMID: 25065515 DOI: 10.1016/j.puhe.2014.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 04/06/2014] [Accepted: 04/07/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Injury is a major public health problem. While the impacts of injury on the injured person are well documented, there is relatively little knowledge about the impacts of injury on those individuals and groups in the community connected to the injured person. This study seeks to describe this breadth of research using a meta-review methodology. STUDY DESIGN Systematic meta-review. METHODS To gain a better understanding of the known impacts of injury on family, community and society, a systematic meta-review of injury outcomes research literature was conducted. Seventy-eight peer-reviewed published literature reviews were included in the meta-review. RESULTS Of these, 70 reported outcomes at the level of the injured person including mortality, body functions, activity and participation limitations. Nine reviews reported impacts at the level of the community including impacts on family members, work colleagues and carers. Six studies reported impacts at the societal level including economic, health system and injury compensation system impacts. CONCLUSIONS In summary, the meta-review identified a substantial body of knowledge at the individual level outcomes of injury, and a relative lack of information regarding the community and societal impacts of injury. An injury outcome framework is proposed on the basis of the findings of the meta-review to guide future research activity, particularly with regard to injury outcome domains where there is currently limited evidence. A comprehensive framework that takes account of all levels of impact is necessary for effective policies, systems and strategies to support recovery following injury.
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Affiliation(s)
- S Newnam
- Monash Injury Research Institute (MIRI), Building 70, Monash University, VIC 3800, Australia.
| | - A Collie
- Institute for Safety, Compensation and Recovery Research (ISCRR), Level 11, 499 St Kilda Rd, Melbourne, VIC 3004, Australia; School of Public Health and Preventive Medicine, Monash University, Commercial Road, Prahran, VIC 3181, Australia.
| | - A P Vogel
- University of Melbourne, School of Health Sciences, 550 Swanston Street, Parkville, VIC 3010, Australia.
| | - H Keleher
- School of Public Health and Preventive Medicine, Monash University, Commercial Road, Prahran, VIC 3181, Australia.
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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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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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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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Rietdijk R, Simpson G, Togher L, Power E, Gillett L. An exploratory prospective study of the association between communication skills and employment outcomes after severe traumatic brain injury. Brain Inj 2013; 27:812-8. [DOI: 10.3109/02699052.2013.775491] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Barrash J, Asp E, Markon K, Manzel K, Anderson SW, Tranel D. Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change. J Clin Exp Neuropsychol 2011; 33:833-52. [PMID: 21500116 PMCID: PMC3140575 DOI: 10.1080/13803395.2011.561300] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study employed a multistep, rational-empirical approach to identify dimensions of personality disturbance in brain-damaged individuals: (a) Five dimensions were hypothesized based on empirical literature and conceptual grounds; (b) principal components analysis was performed on the Iowa Scales of Personality Change (ISPC) to determine the pattern of covariance among 30 personality characteristics; (c) when discrepancies existed between principal components analysis results and conceptually based dimensions, empirical findings and clinical considerations were weighed to determine assignment of ISPC scales to dimensions; (d) the fit of data to the refined dimensions was assessed by examination of intercorrelations; (e) differential predictions concerning the relationship of dimensions to ventromedial prefrontal cortex (vmPFC) damage were tested. This process resulted in the specification of five dimensions: Disturbed Social Behavior, Executive/Decision-Making Deficits, Diminished Motivation/Hypo-Emotionality, Irascibility, and Distress. In accord with predictions, the 28 participants with vmPFC lesions, compared to 96 participants with focal lesions elsewhere in the brain, had significantly more Disturbed Social Behavior and Executive/Decision-Making Deficits and tended to have more Diminished Motivation/Hypo-Emotionality. Irascibility was not significantly higher among the vmPFC group, and the groups had very similar levels of Distress. The findings indicate that conceptually distinctive dimensions with differential relationships to vmPFC can be derived from the Iowa Scales of Personality Change.
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Affiliation(s)
- Joseph Barrash
- Department of Neurology, University of Iowa, Iowa City, USA.
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Anne Jones J, Curtin M. Reformulating masculinity: Traumatic brain injury and the gendered nature of care and domestic roles. Disabil Rehabil 2011; 33:1568-78. [DOI: 10.3109/09638288.2010.537803] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Curtin M, Jones J, Tyson GA, Mitsch V, Alston M, McAllister L. Outcomes of participation objective, participation subjective (POPS) measure following traumatic brain injury. Brain Inj 2011; 25:266-73. [PMID: 21280979 DOI: 10.3109/02699052.2010.542793] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To investigate the participation of adults living with traumatic brain injury in regional and rural NSW as measured by the Participation Objective Participation Subjective (POPS) measure. RESEARCH DESIGN A quantitative survey of a single cohort as the first of a two phase mixed methods study. METHODS AND PROCEDURES One hundred and thirty-one adults with a TBI were recruited through eight rural brain injury rehabilitation programmes in NSW. These adults completed a range of survey instruments, including the POPS. MAIN OUTCOMES AND RESULTS The POPS measure supported findings from other research that identified varying impacts of TBI. However, in contrast to other studies, there was no correlation between participation scores and age, gender, time since injury and severity of injury. CONCLUSIONS The findings from this study suggest that the issue of participation of adults with TBI living in non-metropolitan areas needs to be further researched.
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Affiliation(s)
- Michael Curtin
- Occupational Therapy, School of Community Health, Charles Sturt University, Albury, NSW, Australia.
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Clay FJ, Newstead SV, McClure RJ. A systematic review of early prognostic factors for return to work following acute orthopaedic trauma. Injury 2010; 41:787-803. [PMID: 20435304 DOI: 10.1016/j.injury.2010.04.005] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 03/17/2010] [Accepted: 04/07/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Acute orthopaedic trauma is a major contributor to the global burden of disease. This study aims to synthesise and summarise current knowledge concerning prognostic factors for return to work and duration of work disability following acute orthopaedic trauma. METHODS A systematic review of prognostic studies was performed. The Medline, Embase, PsychINFO, CINAHL and AMED electronic databases were searched for studies between 1985 and May 2009. Included studies were longitudinal, reported results with multivariate statistical analyses appropriate to prognostic studies, comprised persons employed at the time of the injury, included prognostic factors measured proximal to the injury and focused on upper and lower extremity injuries. RESULTS Searches yielded 980 studies of which 15 met the inclusion criteria and were rated for methodological quality. Analysis focused on the 14 factors considered in more than one study. There was limited evidence for the role of any factor as a predictor of return to work. There is strong evidence for level of education and blue collar work and moderate evidence for self-efficacy, injury severity and compensation as prognostic factors for the duration of work disability. Significant methodological issues were encountered in the course of the review that limited interpretation of the evidence and the conclusions that could be drawn from the findings. CONCLUSION People who have sustained acute orthopaedic trauma regardless of severity experience difficulties in returning to work. Due to the lack of factors considered in more than one cohort, the results of this review are inconclusive. The review highlights the need for more prospective studies that are methodologically rigorous, have larger sample sizes and considers a comprehensive range of factors.
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Affiliation(s)
- Fiona J Clay
- Monash University, Accident Research Centre, Clayton, Victoria 3800, Australia.
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Velikonja D, Warriner E, Brum C. Profiles of emotional and behavioral sequelae following acquired brain injury: Cluster analysis of the Personality Assessment Inventory. J Clin Exp Neuropsychol 2009; 32:610-21. [DOI: 10.1080/13803390903401302] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Diana Velikonja
- a McMaster University, DeGroote School of Medicine, Hamilton Health Sciences , Hamilton, Ontario, Canada
| | - Erin Warriner
- a McMaster University, DeGroote School of Medicine, Hamilton Health Sciences , Hamilton, Ontario, Canada
| | - Christine Brum
- a McMaster University, DeGroote School of Medicine, Hamilton Health Sciences , Hamilton, Ontario, Canada
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Bernabeu M, Laxe S, Lopez R, Stucki G, Ward A, Barnes M, Kostanjsek N, Reed G, Tate R, Whyte J, Zasler N, Cieza A. Developing core sets for persons with traumatic brain injury based on the international classification of functioning, disability, and health. Neurorehabil Neural Repair 2009; 23:464-7. [PMID: 19221004 DOI: 10.1177/1545968308328725] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors outline the process for developing the International Classification of Functioning, Disability, and Health (ICF) Core Sets for traumatic brain injury (TBI). ICF Core Sets are selections of categories of the ICF that identify relevant categories of patients affected by specific diseases. Comprehensive and brief ICF Core Sets for TBI should become useful for clinical practice and for research. The final definition of the ICF Core Sets for TBI will be determined at an ICF Core Sets Consensus Conference, which will integrate evidence from preliminary studies. The development of ICF Core Sets is an inclusive and open process and rehabilitation professionals are invited to participate.
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Affiliation(s)
- Montserrat Bernabeu
- Brain Injury Unit, Institut Guttmann, Neurorehabilitation Hospital, Barcelona, Spain
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