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Moderating factors in return to work and job stability after traumatic brain injury
Jeffrey S Kreutzer1, Jennifer H Marwitz, William Walker
1The Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Box 980542, Richmond, VA 23298-0542, USA.
Objective:
To examine job stability moderating variables and develop a postinjury work stability prediction model.
Design:
Multicenter analysis of individuals with traumatic brain injury (TBI) who returned for follow-up at 1, 2, and 3, or 4 years postinjury, were of working age (between 18 and 62 years of age at injury), and were working preinjury.
Setting:
Six National Institute on Disability and Rehabilitation Research TBI Model System centers for coordinated acute and rehabilitation care.
Participants:
A total of 186 adults with TBI were included in the study.
Main Outcome Measures:
Job stability was categorized as stably employed (employed at all 3 follow-up intervals); unstably employed (employed at one or two of all three follow-up intervals); and unemployed (unemployed at all three follow-up intervals).
Results:
After injury, 34% were stably employed, 27% were unstably employed, and 39% were unemployed at all three follow-up intervals. Minority group members, people who did not complete high school, and unmarried people were more likely to be unemployed. Driving independence was highly influential and significantly related to employment stability. A discriminant function analysis, which included age, length of unconsciousness and Disability Rating Scale scores at 1 year postinjury, accurately predicted job stability groupings.
Conclusion:
Data analysis provided evidence that employment stability is predictable with a combination of functional, demographic, and injury severity variables. Identification of people at risk for poor employment outcomes early on can facilitate rehabilitation planning and intervention.