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Bonn MM, Dickey JP, Moran B, McGuire S, Graham L. The relationship between prognostic factors and patient satisfaction with performance of self-identified goals following interdisciplinary mild traumatic brain injury rehabilitation. Physiother Theory Pract 2024:1-9. [PMID: 39262105 DOI: 10.1080/09593985.2024.2397089] [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: 02/13/2024] [Revised: 08/13/2024] [Accepted: 08/21/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Individuals with persistent symptoms following a mild traumatic brain injury (mTBI) demonstrate improved satisfaction with their performance of self-identified rehabilitation goals after completing a combined occupational therapy and physiotherapy group intervention. However, the relationship between factors associated with developing persistent symptoms following an mTBI and satisfaction with their performance of self-identified goals after completing an intervention are unknown. OBJECTIVE(S) To evaluate whether factors associated with developing persistent symptoms influence satisfaction with the performance of self-identified goals after completing a combined occupational therapy and physiotherapy group intervention. METHODS During intake assessments, individuals with persistent mTBI symptoms completed the satisfaction section of the Canadian Occupational Performance Measure (COPM-S), the Rivermead Post-Concussion Symptom Questionnaire (RPQ), and the Generalized Anxiety Disorder Seven-Item Scale (GAD-7). Participants re-rated their satisfaction with performance of self-identified goals using the COPM-S during their discharge assessment. The influence of age, sex, days since injury, education, mechanism of injury, baseline COPM-S, GAD-7, and RPQ scores on goal satisfaction ratings were analyzed using a binomial logistic regression. RESULTS One hundred and ninety-eight individuals (44.7 ± 13.6 years old) were included in this study, and 92% experienced a clinically important improvement in their goal satisfaction ratings after completing the intervention. Neither age, sex, days since injury, education, mechanism of injury, baseline COPM-S, GAD-7, or RPQ scores significantly influenced satisfaction with performance of self-identified goals. CONCLUSIONS Factors associated with developing persistent symptoms following an mTBI did not influence goal satisfaction after completing a combined physiotherapy and occupational therapy group intervention.
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Affiliation(s)
- Marquise M Bonn
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada
| | - James P Dickey
- School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Becky Moran
- Regional Rehabilitation, Parkwood Institute, London, ON, Canada
| | - Shannon McGuire
- Regional Rehabilitation, Parkwood Institute, London, ON, Canada
| | - Laura Graham
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, ON, Canada
- Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada
- Regional Rehabilitation, Parkwood Institute, London, ON, Canada
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Toccalino D, Haag H(L, Nalder E, Chan V, Moore A, Colantonio A, Wickens CM. "A whole ball of all-togetherness": The interwoven experiences of intimate partner violence, brain injury, and mental health. PLoS One 2024; 19:e0306599. [PMID: 39178247 PMCID: PMC11343459 DOI: 10.1371/journal.pone.0306599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 06/20/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a global public health crisis, with physical violence leaving IPV survivors at high risk of brain injury (BI). Both BI and IPV have significant physical, psychological, cognitive, and social impacts, including a high risk of mental health concerns, yet there is limited exploration of IPV survivors' experiences with BI and mental health. This study aimed to explore the BI- and mental health-related needs and experiences of IPV survivors from the perspectives of survivors and service providers with the objective of developing knowledge translation materials to raise awareness and support survivors and service providers in addressing these concerns. METHODS This qualitative interpretive description study involved 19 semi-structured interviews and two focus group discussions (2-3 participants each) with 24 participants including IPV survivors experiencing BI and mental health concerns as well as IPV, mental health, and BI service providers between October 2020 and February 2021. Three screening questions were used to identify probable BI among survivors. Participants across groups were an average of 48.5±12.7 years old and were predominantly cisgender women (96%), of European origin (75%), with a university degree (71%). Interviews were recorded, transcribed, and thematically analyzed. FINDINGS Across interviews, participants spoke about IPV, BI, and mental health as being complex and interrelated experiences that have impacts across the survivor's life and extend well beyond the abusive relationship. Because of the underrecognized nature of BI in IPV, finding and accessing care requires persistence that survivors spoke of as being like "a full-time job." The benefit of making meaningful connections, particularly with other survivors, was highlighted. CONCLUSIONS Recognition of BI as a contributing factor shaping the lived experience of IPV survivors; acknowledgement that the impacts of IPV, BI, and mental health are far reaching and long lasting; and reducing barriers to finding and accessing appropriate care are critical to better supporting IPV survivors with BI and mental health concerns. Clinicians should consider BI and its lingering impacts among the IPV survivors with whom they work. Health and social policy that supports integration of care and the reduction of unnecessary barriers should be a priority.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
| | - Halina (Lin) Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Emily Nalder
- Temerty Faculty of Medicine University of Toronto, Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Amy Moore
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Angela Colantonio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, Ontario, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Temerty Faculty of Medicine University of Toronto, Department of Occupational Science and Occupational Therapy, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christine M. Wickens
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
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Wen L, Gao Z, Zhong X, Wen L, Zang S, Bai X. Readiness for return to work and its influencing factors among head and neck cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:420. [PMID: 38850487 DOI: 10.1007/s00520-024-08622-z] [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: 10/29/2023] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE This study aims to investigate the Readiness for Return-to-Work (RRTW) of patients with head and neck tumours and to analyse the relationships among self-efficacy, disease uncertainty, psychosocial adaptation, and RRTW in head and neck cancer (HNC) patients. METHODS A cross-sectional study was conducted with 259 HNC patients with a discharge length of ≥1 month at a tertiary hospital in Liaoning Province. The research tools included a self-designed general information questionnaire, the Readiness for Return-to-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), the Mishel Uncertainty in Illness Scale (MUIS), and the Self-Reporting Psychosocial Adjustment to Illness Scale (PAIS-SR). Descriptive statistical analysis, the rank sum test, Spearman correlation analysis, and ordered multiple and dichotomous logistic regression analyses were used. RESULTS The overall RRTW among HNC patients was low (41.9%). HNC patients who did not return to work were mainly in the precontemplation stage (38.1%) and contemplation stage (29.9%). HNC patients who returned to work were mainly in the active maintenance stage (64.2%). Children's status (OR = 0.218, 95% CI 0.068-0.703), self-efficacy (OR = 1.213, 95% CI 1.012-1.454), unpredictability (OR = 0.845, 95% CI 0.720-0.990), occupational environment (OR = 0.787, 95% CI 0.625-0.990), and family environment (OR = 0.798, 95% CI 0.643-0.990) influence the RRTW of HNC patients who have not returned to work. Educational level (OR = 62.196, 95% CI 63.307-68.567), children's status (OR = 0.058, 95% CI 1.004-2.547), self-efficacy (OR = 1.544, 95% CI 3.010-8.715), unpredictability (OR = 0.445, 95% CI 1.271-2.280), and psychological status (OR = 0.340, 95% CI 1.141-2.401) influence the RRTW of HNC patients who have returned to work. CONCLUSION Children's status, education level, self-efficacy, illness uncertainty, and psychosocial adjustment are crucial to RRTW. This study provides a theoretical basis for formulating intervention measures aimed at improving the RRTW of patients.
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Affiliation(s)
- Liying Wen
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhuoran Gao
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China
| | - Xia Zhong
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China
| | - Lijie Wen
- Oncology Day Clinic, The First Hospital of Dandong, Dandong, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Xinghua Bai
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China.
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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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Liu Z, Li J, Liu F, Guan N, Li Y, Zhang Y, Hou L, Jiang Q. Exploring the status and associated factors of the readiness for return-to-work in young and middle-aged stroke patients. Sci Rep 2024; 14:2841. [PMID: 38310121 PMCID: PMC10838315 DOI: 10.1038/s41598-024-53262-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
Stroke increasingly affects individuals of working age. An accurate assessment of Readiness for Return-to-Work (RRTW) can help determine the optimal timing for RRTW and facilitate an early reintegration into society. This study investigates the current state of RRTW and the influencing factors among young and middle-aged stroke patients in China. A sample of young and middle-aged stroke patients hospitalized in a tertiary hospital in Henan Province between December 2021 and May 2022 were included in this study. A general information questionnaire and the Readiness for RRTW scale, the Social Support Rate Scale, the Stroke Self-Efficacy Scale, and the Fatigue Severity Scale were administered to the patients. Of the 203 patients successfully surveyed, 60 (29.6%) were in the pre-contemplation stage, 35 (17.2%) in the contemplation stage, 81 (39.9%) in the prepared for action-self-evaluative stage, and 27 (13.3%) in the prepared for action- behavior stage. Logistic regression analysis identified education level, monthly income, time to start rehabilitation therapy, social support, stroke self-efficacy, and fatigue severity as key factors affecting RRTW scale readiness in young and middle-aged stroke patients. The readiness of young and middle-aged stroke patients to Return-to-Work needs to be increased further. Healthcare professionals should consider the influencing factors of RRTW and design targeted intervention programs to facilitate a successful Return-to-Work and normal life.
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Affiliation(s)
- Ziwei Liu
- Nursing Department, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, No. 19 Renmin Road, Jinshui District, Zhengzhou, 450099, He Nan, China
| | - Jiaxin Li
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Fangli Liu
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Ningxiao Guan
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Ye Li
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Yu Zhang
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Linlin Hou
- Institute of Nursing and Health, Henan University, Kaifeng, 475000, He Nan, China
| | - Qiuhuan Jiang
- Nursing Department, Henan Provincial People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 45003, He Nan, China.
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Toccalino D, Moore A, Cripps E, Gutierrez SC, Colantonio A, Wickens CM, Chan V, Nalder E, Haag H(L. Exploring the intersection of brain injury and mental health in survivors of intimate partner violence: A scoping review. Front Public Health 2023; 11:1100549. [PMID: 36935693 PMCID: PMC10018197 DOI: 10.3389/fpubh.2023.1100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Rationale Intimate partner violence (IPV) is the most commonly occurring form of violence against women. The most common site of injury in IPV is the head, face, and neck, resulting in possible brain injury (BI). Independently, mental health (MH) concerns are highly prevalent among both IPV survivors and individuals with BI; however, no systematic review exists on the combined experience of BI and MH in IPV. Objective The aim of this review was to describe the identification of and relationships between BI, MH, and IPV in the literature and the implications for health policy and practice. Methods A search strategy including text words and subject headings related to BI, IPV, and MH was developed for MEDLINE and translated to EMBASE, PsycINFO, CINAHL, Cochrane, Scopus, and Web of Science. Two reviewers independently assessed articles for inclusion. Articles discussing MH, BI, and IPV in relation to one another were included in the review. Results Twenty-eight articles were identified for inclusion. Methods for identifying IPV, BI, and MH were highly variable across studies. Fourteen studies reported significantly higher MH scores in IPV survivors with BI than in those without BI. Articles predominantly focused on cis gender women in heterosexual relationships and the impact of race and ethnicity were largely overlooked. Healthcare access was explored by eight articles, though none discussed the implications of co-occurring BI and MH. Conclusion Brain injury and MH are highly prevalent among IPV survivors; however, little research discusses the implication for healthcare. Future research should explore healthcare-related needs and experiences to inform policy and practice and better represent the diversity of IPV survivors.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Amy Moore
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Elizabeth Cripps
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sophia Chuon Gutierrez
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Christine M. Wickens
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Emily Nalder
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Halina (Lin) Haag
- Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
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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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8
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Norman A, Curro V, Holloway M, Percuklievska N, Ferrario H. Experiences of individuals with acquired brain injury and their families interacting with community services: a systematic scoping review. Disabil Rehabil 2023; 45:739-751. [PMID: 35244507 DOI: 10.1080/09638288.2022.2043465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This scoping review aims to (1) synthesise the research findings on the experiences of individuals with acquired brain injuries, and their families, when interacting with, or accessing, community-based services and (2) identify where gaps in service provision may exist and their cause. METHODS A systematic search strategy was employed across multiple databases to identify all studies relating to the experiences of individuals with acquired brain injuries and their families when interacting with, or accessing, community-based services. Inclusion was assessed by at least two reviewers at each stage and data extraction was completed by one researcher and validity checked by another. A narrative synthesis was employed. RESULTS A total of 101 papers met the inclusion criteria with the narrative synthesis identifying three main themes of (1) unmet needs, (2) types of access, and (3) barriers to access. CONCLUSIONS The results identify that those with acquired brain injuries, and their families, experience significant difficulties interacting with community-based services and often do not receive appropriate access. Many barriers to access were identified including a lack of knowledge of the long-term effects of acquired brain injury amongst professionals working in health and social care services.Implications for rehabilitationBrain injury is a leading cause of disability worldwide with a range of physical, cognitive, emotional, and behavioural difficulties.It is important that service users and families are given appropriate information about the long-term difficulties associated with ABI so they are better informed about the types of support they may need upon discharge from hospital.Rehabilitation professionals need to ensure they have good level of knowledge of the difficulties associated with ABI to ensure appropriate access to services for individuals and their families.Understanding more about unmet needs allows community rehabilitation services to be tailored and person-centred.
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Affiliation(s)
- Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, UK
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9
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Pinnow D, Causey-Upton R, Meulenbroek P. Navigating the impact of workplace distractions for persons with TBI: a qualitative descriptive study. Sci Rep 2022; 12:15881. [PMID: 36151133 PMCID: PMC9508104 DOI: 10.1038/s41598-022-20083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Persons with traumatic brain injuries (TBIs) who return to work often struggle with managing environmental distractions due to residual cognitive impairments. Previous literature has established that environmental distractions impact persons with TBI, yet, the extent to which distractions impact workplace performance is unknown. This qualitative descriptive study using phenomenology methods, explored the experiences of seven individuals with TBIs and how they perceived workplace distractions to impact their productivity. Data was collected using semi-structured interviews with seven participants who were diagnosed with mild, moderate, and severe TBIs. Interviews were transcribed and analyzed using thematic analysis. Main findings centered around what environmental distractions impacted work performance, the farther-reaching consequences of distractibility, strong emotional feelings and worry about perceived work performance associated with distractibility, mitigating distractibility through “gaming the attentional system”, and utilizing music as a distraction masker to enhance task performance. In light of this study’s findings, researchers, and clinicians are encouraged to consider the wider impact of distractions on persons with TBI. The real-life accounts documented in this study will assist researchers and clinicians to account for the impact of environmental distractions in rehabilitation and support employment for persons with TBI.
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Affiliation(s)
- DeAnna Pinnow
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington, KY, USA.
| | - Renee Causey-Upton
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University, Richmond, KY, USA
| | - Peter Meulenbroek
- Department of Communication Sciences and Disorders, University of Kentucky, Lexington, KY, USA
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10
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van Beukering IE, Smits SJC, Janssens KME, Bogaers RI, Joosen MCW, Bakker M, van Weeghel J, Brouwers EPM. In What Ways Does Health Related Stigma Affect Sustainable Employment and Well-Being at Work? A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:365-379. [PMID: 34487290 PMCID: PMC9576674 DOI: 10.1007/s10926-021-09998-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 05/26/2023]
Abstract
PURPOSE Studies are increasingly showing that health related stigma is a barrier to employment, but it is not known how. The aim of this systematic review is to identify, appraise and analyse studies that have directly or indirectly addressed ways in which stigma affects sustainable employment and well-being at work of people with disabilities. METHODS Using a multiphase screening process, this review is based on a comprehensive literature search (2000-2019) carried out in six electronic databases: Embase, Web of Science, Medline Ovid, Cochrane CENTRAL, PsycINFO and Google Scholar. RESULTS 7.263 publications were identified; 96 studies were found eligible to be included in the review. 72% of the studies were conducted in North America or Europe. Few studies directly assessed how stigma affects the employment of people with disabilities. Most studies highlighted that attitudes and behaviour of employers formed a barrier to employment, as well as anticipated stigma and self-stigma in people with health problems. However, the findings also showed that the attitudes and behaviour of co-workers, health care professionals, reintegration professionals, customers, and family and friends could act as a barrier to employment although these influences are under-researched. Although many similarities were seen in the relevant findings of studies about both physical and mental disabilities, several nuances were found. CONCLUSION Stigma hampers sustainable employment and well-being in multiple ways. Whereas the number of publications on this topic is rapidly increasing, the roles of health care professionals, reintegration professionals, co-workers, customers, and family and friends particularly warrant more attention.
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Affiliation(s)
- I E van Beukering
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
- Inspectorate SZW, Den Haag, The Netherlands.
- , P.O. Box 90513, 5000 LE, Tilburg, The Netherlands.
| | - S J C Smits
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Summa College, Eindhoven, The Netherlands
| | - K M E Janssens
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - R I Bogaers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Brain Research and Innovation Centre, Ministry of Defense, Den Haag, The Netherlands
| | - M C W Joosen
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - M Bakker
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - J van Weeghel
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Phrenos Center of Expertise, Utrecht, The Netherlands
| | - E P M Brouwers
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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11
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Bonn MM, Alvarez L, Graham L, Thompson JW, Dickey JP. Biofeedback as an intervention for persistent post-concussive symptoms: A randomized feasibility trial. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211046459] [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] Open
Abstract
Background Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible. Purpose To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms. Methods Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention. Results Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups. Conclusions Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&draw=2&rank=1 ).
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Affiliation(s)
- Marquise M Bonn
- Health and Rehabilitation Sciences, Western University, Canada
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12
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Brakenridge CL, Leow CKL, Kendall M, Turner B, Valiant D, Quinn R, Johnston V. Exploring the lived return-to-work experience of individuals with acquired brain injury: use of vocational services and environmental, personal and injury-related influences. Disabil Rehabil 2021; 44:4332-4342. [PMID: 33794118 DOI: 10.1080/09638288.2021.1903101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore work outcomes, vocational services, barriers and facilitators for returning to work in individuals with acquired brain injury (ABI) in Queensland, Australia and to identify areas for improvement. DESIGN AND METHODS Ten semi-structured interviews were conducted with individuals with ABI (stroke, traumatic brain injury, tumour). Interviews were analysed using a realist thematic analysis approach. RESULTS Participants either returned to the same work, different work, did not maintain work or did not have any work since their injury. Use of vocational services depended on participants' needs and insurance. Facilitators for return to work (RTW) were a supportive workplace and family, vocational rehabilitation that met the individual's needs, insurance coverage and self-motivation. Workplaces that were not understanding of brain injury, employment service providers who were unable to find work for participants, and physical and cognitive deficits were barriers to RTW. Workplaces, employment service providers and individuals require more information about the deficits associated with brain injury. CONCLUSIONS The use and effectiveness of vocational services were variable across participants and depended on insurance coverage and needs. Barriers and facilitators for RTW were affected by both the environment and the individual. Implications for vocational rehabilitation were identified.Implications for RehabilitationA supportive workplace and family, and access to appropriate vocational rehabilitation are important environmental facilitators for RTW in individuals with ABI.Workplaces with a poor understanding of ABI and employment service providers unable to find work for individuals with ABI are environmental barriers to RTW.Workplaces, employment service providers and individuals with ABI require more information about the physical and cognitive deficits associated with ABI.Employment service providers need more training to develop comprehensive strategies to help individuals with ABI find new employment.
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Affiliation(s)
| | - Charmaine Kai Ling Leow
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Melissa Kendall
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Ben Turner
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Donna Valiant
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Ray Quinn
- Acquired Brain injury Outreach Service, The Hopkins Centre, Princess Alexandra Hospital, Brisbane, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
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13
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Beaton MD, Hadly G, Babul S. Stakeholder Recommendations to Increase the Accessibility of Online Health Information for Adults Experiencing Concussion Symptoms. Front Public Health 2021; 8:557814. [PMID: 33505948 PMCID: PMC7829503 DOI: 10.3389/fpubh.2020.557814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/13/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Concussion is a global public health problem. In Canada, concussion is among the top five reasons for workplace time-loss. Concussion results in physical, cognitive, and/or emotional symptoms that temporarily worsen with physical and mental exertion, such as viewing electronic screens. The Internet is the primary source of consumer health information. Studies on the end-user needs of adults with brain injuries in regards to digital health technologies largely focus on informational content. There is little to no research on the accessibility of screen-based informational websites and smartphone applications among this population. Objective: The aim of this research was to involve stakeholders in the design of a comprehensive educational resource to guide concussion recognition, recovery, and return-to-work, called the Concussion Awareness Training Tool for Workers and Workplaces (CATT WW). In order to ensure both relevant content and appropriate delivery of the information to the target groups, participants were asked whether adaptations could increase the accessibility of online health information for the general adult population experiencing concussion symptoms. Methods: Data have been generated through semi-structured in-depth interviews and focus groups with participants from across British Columbia (BC): workers from various industries who were in the concussion recovery process or had returned to work (n = 31); and healthcare or workplace professionals who support concussion diagnosis, recovery, and return-to-work (n = 16). Data were analyzed using NVivo 12. Before commencing data collection, ethical permission was granted by the University of British Columbia Research Ethics Board (H18-00604), and approval was received from WorkSafeBC Research Services. Results: Participants (n = 47) recommended twenty adaptations or supplements to electronic screen-based digital health technologies. Conclusion: Given the high prevalence of concussion among the working adult population, the symptom exacerbation commonly caused by prolonged use of electronic screens, and the demand for online educational resources, these findings can guide clinicians, researchers, technology developers, employers, and occupational health and safety committees to further support adults in concussion recovery and return-to-work.
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Affiliation(s)
- M Denise Beaton
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Population and Public Health, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Gabrielle Hadly
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Shelina Babul
- British Columbia Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada
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14
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Toccalino D, Colantonio A, Chan V. Update on the epidemiology of work-related traumatic brain injury: a systematic review and meta-analysis. Occup Environ Med 2021; 78:769-776. [PMID: 33380517 DOI: 10.1136/oemed-2020-107005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/21/2020] [Accepted: 12/01/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a public health concern that can occur in a range of contexts. Work-related TBI (wrTBI) is particularly concerning. Despite overall work-related injury claims decreasing, the proportion of claims that are wrTBI have increased, suggesting prevention and support of wrTBI requires ongoing attention. OBJECTIVES This review aimed to provide updated information on the burden and risk factors of wrTBI among the working adult population. METHODS Medline, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using a combination of TBI, work, and epidemiology text words and medical subject headings. Two reviewers independently assessed articles for inclusion. Meta-analyses were conducted to estimate prevalence and mortality of wrTBI and a narrative synthesis was conducted to provide additional context. RESULTS Pooled proportions meta-analyses estimate that 17.9% of TBIs were work-related and 6.3% of work-related injuries resulted in TBI, with 3.6% of wrTBI resulting in death. Populations of wrTBI were predominantly male (76.2%) and were 40.4 years of age, on average. The most commonly reported industries for wrTBI were education and training, healthcare and social assistance, construction, manufacturing, and transportation. Falls, being struck by an object or person, motor vehicle collisions, and assaults were the most commonly reported mechanisms of wrTBI. CONCLUSIONS A better understanding of the epidemiology of wrTBI can inform prevention and management strategies. This review highlights existing gaps, including a notable lack of sex or gender stratified data, to direct future investigation. PROSPERO REGISTRATION NUMBER CRD42020169642.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Department of Occupational Science and Occupational Therapy; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,KITE -Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Vincy Chan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,KITE -Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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15
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Berger I, Beck L, Jones J, MacEachen E, Kirsh B. Exploring the Needs of Cancer Survivors When Returning to or Staying in the Workforce. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:480-495. [PMID: 32016649 DOI: 10.1007/s10926-020-09877-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Cancer survivors have strong personal desires to resume work to feel productive and meet financial needs. However, they may be faced with physical and psychological challenges. This research addresses the question: "What are the needs of cancer survivors when returning to or staying in the workforce?" by (i) examining cancer survivors' perspectives on supports needed when returning to or staying in the workforce and (ii) exploring personal and employment factors that influence the return to work process. Methods An exploratory qualitative design was used. We conducted focus groups and one-on-one semi-structured interviews with cancer survivors (n = 15). Inductive thematic analysis was used to analyze the data. Results Four key themes were identified as significant aspects of the return-to-work process for cancer survivors: (1) changing perspectives on self and work; (2) managing work and social systems; (3) determining disclosure and accommodation; and (4) the importance of supports for return to work and daily life. Conclusions There is a growing interest in developing targeted interventions to improve work outcomes for cancer survivors. This study informs cancer rehabilitation research by developing an understanding of the supports and strategies that should be implemented to help cancer survivors return to work successfully and improve quality of life.
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Affiliation(s)
- Ivona Berger
- Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada.
| | - Lydia Beck
- Princess Margaret Cancer, Cancer Rehabilitation and Survivorship Program, Centre University Health Network, Toronto, ON, Canada
| | - Jennifer Jones
- Princess Margaret Cancer, Cancer Rehabilitation and Survivorship Program, Centre University Health Network, Toronto, ON, Canada
| | - Ellen MacEachen
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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16
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Robinson-Freeman KE, Collins KL, Garber B, Terblanche R, Risling M, Vermetten E, Besemann M, Mistlin A, Tsao JW. A Decade of mTBI Experience: What Have We Learned? A Summary of Proceedings From a NATO Lecture Series on Military mTBI. Front Neurol 2020; 11:836. [PMID: 32982907 PMCID: PMC7477387 DOI: 10.3389/fneur.2020.00836] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Mild traumatic brain injury (mTBI, also known as a concussion) as a consequence of battlefield blast exposure or blunt force trauma has been of increasing concern to militaries during recent conflicts. This concern is due to the frequency of exposure to improvised explosive devices for forces engaged in operations both in Iraq and Afghanistan coupled with the recognition that mTBI may go unreported or undetected. Blasts can lead to mTBI through a variety of mechanisms. Debate continues as to whether exposure to a primary blast wave alone is sufficient to create brain injury in humans, and if so, exactly how this occurs with an intact skull. Resources dedicated to research in this area have also varied substantially among contributing NATO countries. Most of the research has been conducted in the US, focused on addressing uncertainties in management practices. Development of objective diagnostic tests should be a top priority to facilitate both diagnosis and prognosis, thereby improving management. It is expected that blast exposure and blunt force trauma to the head will continue to be a potential source of injury during future conflicts. An improved understanding of the effects of blast exposure will better enable military medical providers to manage mTBI cases and develop optimal protective measures. Without the immediate pressures that come with a high operational tempo, the time is right to look back at lessons learned, make full use of available data, and modify mitigation strategies with both available evidence and new evidence as it comes to light. Toward that end, leveraging our cooperation with the civilian medical community is critical because the military experience over the past 10 years has led to a renewed interest in many similar issues pertaining to mTBI in the civilian world. Such cross-fertilization of knowledge will undoubtedly benefit all. This paper highlights similarities and differences in approach to mTBI patient care in NATO and partner countries and provides a summary of and lessons learned from a NATO lecture series on the topic of mTBI, demonstrating utility of having patients present their experiences to a medical audience, linking practical clinical care to policy approaches.
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Affiliation(s)
| | - Kassondra L Collins
- Department of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada
| | - Bryan Garber
- Research and Analysis Section, Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, ON, Canada
| | - Ronel Terblanche
- Centre for Mental and Cognitive Health, DMRC Headey Court, Epsom, United Kingdom
| | - Marten Risling
- Department of Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Eric Vermetten
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Markus Besemann
- Physical Medicine and Rehabilitation, Canadian Forces Health Services Group, Ottawa, ON, Canada
| | - Alan Mistlin
- Centre for Mental and Cognitive Health, DMRC Headey Court, Epsom, United Kingdom
| | - Jack W Tsao
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, Children's Foundation Research Institute, Memphis, TN, United States
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17
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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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18
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Gaudet LA, Eliyahu L, Beach J, Mrazik M, Cummings G, Voaklander DC, Rowe BH. Workers' recovery from concussions presenting to the emergency department. Occup Med (Lond) 2020; 69:419-427. [PMID: 31340019 DOI: 10.1093/occmed/kqz089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The emergency department (ED) is the first point of care for many patients with concussion, and post-concussion syndrome can impact vocational outcomes like successful return to work. Evaluation of concussion in general adult populations is needed. AIMS To document the occurrence and outcomes of work-related concussion presenting to the ED for treatment. METHODS This study enrolled adults presenting with concussion to three urban Canadian EDs. Baseline ED interviews, physician questionnaires and patient phone interviews at 30 and 90 days documented work-related events, ED management, discharge advice, patient adherence and symptom severity. Work-related injury and return to work were modelled using logistic or linear regression, as appropriate. RESULTS Overall, 172 enrolled workers completed at least one follow-up. Work-related concussions were uncommon (n = 28). Most employees (80%) missed at least 1 day of work (median = 7; interquartile range: 3-14). Most (91%) employees returned to work within 90 days, while 41% reported persistent symptoms. Manual labour and self-reported history of attention deficit hyperactivity disorder were associated with work-related concussion, while days of missed work increased with marital status (divorced), history of sleep disorder and physician's advice to avoid work. CONCLUSION Work-related concussions are infrequent; however, most workers who sustain a concussion will miss work, and many return while still experiencing symptoms. Work-related concussion and days of missed work are mainly affected by non-modifiable factors. Workers, employers and the workers' compensation system should take necessary precautions to ensure that workers return to work safely and successfully following a concussion.
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Affiliation(s)
- L A Gaudet
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - L Eliyahu
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - J Beach
- College of Physicians & Surgeons of Alberta, Edmonton, Alberta, Canada.,Division of Preventive Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - M Mrazik
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - G Cummings
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - D C Voaklander
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - B H Rowe
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Alberta Health Services, Edmonton, Alberta, Canada
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19
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Senthanar S, MacEachen E, Lippel K. Return to Work and Ripple Effects on Family of Precariously Employed Injured Workers. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:72-83. [PMID: 31309411 DOI: 10.1007/s10926-019-09847-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Work injury and return to work processes can have adverse effects on injured workers and their families. Family members may experience increased workloads, role reversals, dissolution of marriages or changes in relationships with children, as well as financial strain from loss of income. How these associations interact when the injured worker is precariously employed, however, is unknown. The aim of this study was to explore the impacts of work-related injury or illness as well as subsequent compensation and return to work processes on families and relationships of precariously employed workers. Methods Interviews were conducted with fifteen precariously employed injured workers recruited through on-line advertising, injured worker groups, and social media platforms in Ontario. Situational analysis was used to identify how family members were affected and their role throughout the injury process. Results Precariously employed injured workers felt caught between self-interested employers and disinterested workers' compensation. In some cases, this led to deteriorated mental health and well-being. The worker's difficulties with RTW challenged financial security of families and affected their day-to-day normal routines. While some workers received emotional and instrumental support from their family members, others had their families fall apart when chronic disability and unemployment proved to be too much. Conclusions This study addressed the complex ways that work injury and illness among precariously employed workers interact with family life and relationships. Findings illustrate how the income and employment insecurity associated with precarious employment has ripple effects on workers and their families when they become injured.
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Affiliation(s)
- Sonja Senthanar
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Ellen MacEachen
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Katherine Lippel
- Faculty of Law (Civil Law Section), University of Ottawa, 603 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
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20
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Watkin C, Phillips J, Radford K. What is a ‘return to work’ following traumatic brain injury? Analysis of work outcomes 12 months post TBI. Brain Inj 2019; 34:68-77. [DOI: 10.1080/02699052.2019.1681512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Connor Watkin
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Julie Phillips
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Kathryn Radford
- School of Medicine, University of Nottingham, Nottingham, UK
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21
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Sharma B, Nowrouzi-Kia B, Mollayeva T, Kontos P, Grigorovich A, Liss G, Gibson B, Mantis S, Lewko J, Colantonio A. Work-related traumatic brain injury: A brief report on workers perspective on job and health and safety training, supervision, and injury preventability. Work 2019; 62:319-325. [PMID: 30829642 DOI: 10.3233/wor-192866] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Although work-related injuries are on the decline, rates of work-related traumatic brain injury (wrTBI) continue to rise. As even mild wrTBI can result in cognitive, behavioural, and functional impairments that can last for months and even years, injury prevention is a primary research focus. Administrative claims data have provided valuable insights into the mechanisms that cause wrTBI; however, data from the perspective of injured workers on wrTBI prevention is limited. OBJECTIVE Our study aimed to better understand the factors that precipitate wrTBI, as perceived by injured workers. METHODS We recruited 101 injured workers from a neurology services clinic with a province-wide catchment area in a large, urban teaching hospital and studied perceived preventability of these injuries from the injured workers' perspective. RESULTS Key findings were that nearly 80% of injuries were perceived as preventable, and nearly 25% and 50% of workers reported that they did not receive job and health and safety training, respectively. Less than half of all workers reported being regularly supervised, and of those who were supervised, approximately two-thirds reported that supervision was adequate. Moreover, 84% and 77% reported they were advised to rest and take time-off after the injury, respectively. CONCLUSIONS Our study is the first to show that the vast majority of injured workers consider their wrTBI to be preventable. In addition, we found that training and supervision are two areas that can be targeted by wrTBI prevention strategies. Our study provides valuable and unique perspectives to consider when designing wrTBI prevention initiatives.
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Affiliation(s)
| | | | - Tatyana Mollayeva
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Pia Kontos
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Alisa Grigorovich
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Gary Liss
- University of Toronto, Gage Occupational and Environmental Health Unit, Toronto, ON, Canada
| | - Brian Gibson
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Steve Mantis
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - John Lewko
- Laurentian University, Sudbury, ON, Canada
| | - Angela Colantonio
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.,University of Toronto, Rehabilitation Sciences Institute, Toronto, ON, Canada
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22
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Radford K, Sutton C, Sach T, Holmes J, Watkins C, Forshaw D, Jones T, Hoffman K, O'Connor R, Tyerman R, Merchán-Baeza JA, Morris R, McManus E, Drummond A, Walker M, Duley L, Shakespeare D, Hammond A, Phillips J. Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT. Health Technol Assess 2019; 22:1-124. [PMID: 29863459 DOI: 10.3310/hta22330] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Up to 160,000 people incur traumatic brain injury (TBI) each year in the UK. TBI can have profound effects on many areas of human functioning, including participation in work. There is limited evidence of the clinical effectiveness and cost-effectiveness of vocational rehabilitation (VR) after injury to promote early return to work (RTW) following TBI. OBJECTIVE To assess the feasibility of a definitive, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early, specialist VR plus usual care (UC) compared with UC alone on work retention 12 months post TBI. DESIGN A multicentre, feasibility, parallel-group RCT with a feasibility economic evaluation and an embedded mixed-methods process evaluation. Randomisation was by remote computer-generated allocation. SETTING Three NHS major trauma centres (MTCs) in England. PARTICIPANTS Adults with TBI admitted for > 48 hours and working or studying prior to injury. INTERVENTIONS Early specialist TBI VR delivered by occupational therapists (OTs) in the community using a case co-ordination model. MAIN OUTCOME MEASURES Self-reported RTW 12 months post randomisation, mood, functional ability, participation, work self-efficacy, quality of life and work ability. Feasibility outcomes included recruitment and retention rates. Follow-up was by postal questionnaires in two centres and face to face in one centre. Those collecting data were blind to treatment allocation. RESULTS Out of 102 target participants, 78 were recruited (39 randomised to each arm), representing 39% of those eligible and 5% of those screened. Approximately 2.2 patients were recruited per site per month. Of those, 56% had mild injuries, 18% had moderate injuries and 26% had severe injuries. A total of 32 out of 45 nominated carers were recruited. A total of 52 out of 78 (67%) TBI participants responded at 12 months (UC, n = 23; intervention, n = 29), completing 90% of the work questions; 21 out of 23 (91%) UC respondents and 20 out of 29 (69%) intervention participants returned to work at 12 months. Two participants disengaged from the intervention. Face-to-face follow-up was no more effective than postal follow-up. RTW was most strongly related to social participation and work self-efficacy. It is feasible to assess the cost-effectiveness of VR. Intervention was delivered as intended and valued by participants. Factors likely to affect a definitive trial include deploying experienced OTs, no clear TBI definition or TBI registers, and repatriation of more severe TBI from MTCs, affecting recruitment of those most likely to benefit/least likely to drop out. LIMITATIONS Target recruitment was not reached, but mechanisms to achieve this in future studies were identified. Retention was lower than expected, particularly in UC, potentially biasing estimates of the 12-month RTW rate. CONCLUSIONS This study met most feasibility objectives. The intervention was delivered with high fidelity. When objectives were not met, strategies to ensure feasibility of a full trial were identified. Future work should test two-stage recruitment and include resources to recruit from 'spokes'. A broader measure covering work ability, self-efficacy and participation may be a more sensitive outcome. TRIAL REGISTRATION Current Controlled Trials ISRCTN38581822. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 33. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Kate Radford
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Chris Sutton
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Tracey Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jain Holmes
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Denise Forshaw
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Trevor Jones
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Karen Hoffman
- Centre for Trauma Sciences, Queen Mary University of London, London, UK
| | - Rory O'Connor
- Academic Department of Rehabilitation Medicine, School of Medicine, University of Leeds, Leeds, UK
| | - Ruth Tyerman
- Community Head Injury Service, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
| | | | - Richard Morris
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emma McManus
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Avril Drummond
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Marion Walker
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Lelia Duley
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Alison Hammond
- Health Sciences Research Centre, University of Salford, Salford, UK
| | - Julie Phillips
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
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23
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Côté D, Dubé J, Gravel S, Gratton D, White BW. Cumulative stigma among injured immigrant workers: a qualitative exploratory study in Montreal (Quebec, Canada). Disabil Rehabil 2019; 42:1153-1166. [PMID: 30686038 DOI: 10.1080/09638288.2018.1517281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This paper presents the phenomenon of stigmatisation among injured immigrant and ethnocultural minority workers experiencing a long-standing disability. Stigmatisation was one of the main findings of our study, the aim of which was to gain insight into the work rehabilitation process in the context of intercultural relations in Quebec. Various categories of stakeholders took part in the study, which sought to describe their experiences and perspectives and to identify the constraints, barriers, facilitators, and specific needs they encounter in terms of intercultural competencies.Methods: A purposive sample of 40 individuals was selected and divided into four groups: workers (N = 9), clinicians (N = 15), workers' compensation board rehabilitation experts (N = 14), and workplace representatives (N = 2). Semi-structured interviews were conducted using the critical incident technique, combined with an "explicitation" interviewing technique. Data collection and analysis procedures were based on grounded theory.Results: This study shows that immigrant and ethnocultural minority workers may experience stigmatisation as a cumulative process involving different concomitant parts of their "identity": age, gender, social class, ethnicity, mental health, and occupational injuries. Cumulative stigma may aggravate personal distress and feelings of shame, rejection, and disqualification from full social acceptance. Negative anticipatory judgements made by practitioners may undermine the therapeutic relationship and breach mutual trust and confidence.Conclusions: The phenomenon of stigmatisation is well documented in the sociological and health literature, but studies tend to focus on only one type of stigma at a time. Future research should focus on the cumulative process of stigmatisation specifically affecting immigrant and ethnocultural minority workers and its potentially damaging impact on self-concept, healthcare delivery, rehabilitation interventions, and the return to work.Implications for rehabilitationThe repetition of certain clinical situations with people from certain groups should not lead practitioners to undue generalizations, even if they may sometimes be accurate; these generalizations must always be verified on a case by case basis.Ethnicity and culture, along with other social attributions, should serve as working hypotheses or support tools in health communication, not as hindrances to clinical reasoning.Practitioners should deepen their understanding of the patient's treatment expectations and the support available for rehabilitation in his family and community.Stigma in the context of care is linked to the idea of conforming to the proposed institutional models of care (including expected beliefs, attitudes, and behaviours). Therefore, practitioners should be aware that alleged differences, misunderstanding or disagreements can highlight an asymmetry in practitioner-patient power relationships.Organisations should also promote exchange and reflection on how to adapt their institutional models to avoid asymmetrical power relations.Intercultural training should be promoted at the various organisational levels so that managers, decision-makers, and practitioners share a common knowledge of the challenges of intervention in multi-ethnic settings.
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Affiliation(s)
- Daniel Côté
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada.,Département d'anthropologie, Universite de Montreal, Montreal, Canada
| | - Jessica Dubé
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada.,École des sciences de la gestion, Université du Québec à Montréal (UQAM), Montreal, Canada
| | - Sylvie Gravel
- Département d'anthropologie, Universite de Montreal, Montreal, Canada
| | - Danielle Gratton
- Centre intégré de santé et de services sociaux de Laval, Laval, Canada
| | - Bob W White
- Département d'anthropologie, Universite de Montreal, Montreal, Canada
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24
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Gourdeau J, Fingold A, Colantonio A, Mansfield E, Stergiou-Kita M. Workplace accommodations following work-related mild traumatic brain injury: what works? Disabil Rehabil 2018; 42:552-561. [DOI: 10.1080/09638288.2018.1503733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jenna Gourdeau
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Alissa Fingold
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Angela Colantonio
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Elizabeth Mansfield
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Canada
| | - Mary Stergiou-Kita
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Institute for Work & Health, Toronto, Canada
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25
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Sullivan KA, Hills AP, Iverson GL. Graded Combined Aerobic Resistance Exercise (CARE) to Prevent or Treat the Persistent Post-concussion Syndrome. Curr Neurol Neurosci Rep 2018; 18:75. [DOI: 10.1007/s11910-018-0884-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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26
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Terry DP, Iverson GL, Panenka W, Colantonio A, Silverberg ND. Workplace and non-workplace mild traumatic brain injuries in an outpatient clinic sample: A case-control study. PLoS One 2018; 13:e0198128. [PMID: 29856799 PMCID: PMC5983513 DOI: 10.1371/journal.pone.0198128] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/14/2018] [Indexed: 11/29/2022] Open
Abstract
Individuals who are injured in the workplace typically have a greater risk of delayed return to work (RTW) and other poor health outcomes compared to those not injured at work. It is not known whether these differences hold true for mild traumatic brain injuries (MTBI). The present study examined differences associated with workplace and non-workplace MTBI upon intake to a specialty MTBI clinic, their outcomes, and risk factors that influence RTW. Slow-to-recover participants were recruited from consecutive referrals to four outpatient MTBI clinics from March 2015 to February 2017. Two clinics treat Worker’s Compensation claimants and two clinics serve patients with non-work related injuries in the publically funded health care system. Of 273 eligible patients, 102 completed an initial study assessment (M age = 41.2 years, SD age = 11.7; 54% women) at an average of 2–3 months post injury. Participants were interviewed about their MTBI and completed a battery of standardized questionnaires and performance validity testing. Outcomes, including RTW, were assessed via telephone follow-up 4–5 months later. Workplace injuries comprised 45.1% of the sample. The workplace MTBI group had a greater proportion of men and lower education levels compared to the non-workplace MTBI group. The two groups had a comparable post-concussion symptom burden and performance validity test failure rate. Workplace MTBI was associated with greater post-traumatic stress symptoms. Fifteen patients (14.7%) were lost to follow-up. There were no workplace/non-workplace MTBI differences in RTW outcome at 6–7 months post injury. Of the entire sample, 42.5% of patients had full RTW, 18.4% had partial RTW, and 39.1% had no RTW. Greater post-concussion symptom burden was most predictive of no RTW at follow-up. There was no evidence that the workplace and non-workplace MTBI groups had different risk factors associated with prolonged work absence. Despite systemic differences in compensation and health care access, the workplace and non-workplace MTBI groups were similar at clinic intake and indistinguishable at follow-up, 6–7 months post injury.
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Affiliation(s)
- Douglas P Terry
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America.,Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America.,MassGeneral Hospital for Children™ Sports Concussion Program, Boston, Massachusetts, United States of America.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, United States of America
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, United States of America.,Spaulding Rehabilitation Hospital, Boston, Massachusetts, United States of America.,MassGeneral Hospital for Children™ Sports Concussion Program, Boston, Massachusetts, United States of America.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, Massachusetts, United States of America
| | - William Panenka
- British Columbia Neuropsychiatry Program, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Angela Colantonio
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Noah D Silverberg
- Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada.,Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
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27
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Colantonio A, Salehi S, Kristman V, Cassidy JD, Carter A, Vartanian O, Bayley M, Kirsh B, Hébert D, Lewko J, Kubrak O, Mantis S, Vernich L. Return to work after work-related traumatic brain injury. NeuroRehabilitation 2016; 39:389-99. [DOI: 10.3233/nre-161370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Colantonio
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Sara Salehi
- Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, ON, Canada
| | - Vicki Kristman
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
- Institute for Work & Health, Toronto, ON, Canada
| | - J. David Cassidy
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - Angela Carter
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Oshin Vartanian
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada
| | - Mark Bayley
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
| | - Debbie Hébert
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto ON, Canada
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - John Lewko
- Centre for Research in Human Development, Laurentian University, Sudbury, ON, Canada
| | - Olena Kubrak
- Public Services Health & Safety Association, Toronto, ON, Canada
| | - Steve Mantis
- Research Action Alliance on the Consequences of Work Injury, Thunder Bay, ON, Canada
| | - Lee Vernich
- Research Service Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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28
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Stergiou-Kita M, Pritlove C, Holness DL, Kirsh B, van Eerd D, Duncan A, Jones J. Am I ready to return to work? Assisting cancer survivors to determine work readiness. J Cancer Surviv 2016; 10:699-710. [PMID: 26816271 DOI: 10.1007/s11764-016-0516-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/16/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE A critical initial step in work re-entry involves the determination of work readiness. Cancer survivors have requested increased health care provider involvement in their work readiness decisions. However, there has been no exploration of current practices in determining work readiness, and thus no specific recommendations regarding how to assist survivors in answering the question: Am I ready to return to work? METHODS To explore return to work following cancer and the workplace supports survivors require, we completed an exploratory qualitative study. We conducted semi-structured interviews with (i) cancer survivors (n = 16) and (ii) health care/vocational service providers (n = 16). Data were analyzed using thematic analysis. Themes specific to work readiness are discussed. RESULTS Three key processes were deemed relevant to determining work readiness by health care providers and survivors: (1) assessing functional abilities in relation to job demands; (2) identifying survivor strengths and barriers to return to work; and (3) identifying supports available in the workplace. Challenges to work readiness determinations, were described by survivors and providers, related to: (i) the complexity of cancer, (ii) the accuracy of work readiness determinations, and (iii) the lack of established processes for addressing work goals. CONCLUSIONS Health care providers need to work collaboratively with survivors to determine if they are physically, cognitively, and emotionally ready to return to work, and with workplaces to determine if they are prepared to provide the necessary supports. Further stakeholder collaboration is also warranted. IMPLICATIONS FOR CANCER SURVIVORS Supports from health care providers in determining work readiness can ensure survivors do not return to work either "too early" or "too late."
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Affiliation(s)
- Mary Stergiou-Kita
- Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Ave., Toronto, ON, M5G 1V7, Canada. .,Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. .,Institute of Work and Health, Toronto, ON, Canada. .,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
| | - Cheryl Pritlove
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.,Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre University Health Network, Toronto, ON, Canada
| | - D Linn Holness
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, Toronto, ON, Canada.,Department of Occupational and Environmental Health and Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Ave., Toronto, ON, M5G 1V7, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dwayne van Eerd
- Institute of Work and Health, Toronto, ON, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Andrea Duncan
- Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Ave., Toronto, ON, M5G 1V7, Canada
| | - Jennifer Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre University Health Network, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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