Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T03:00:16.416Z Has data issue: false hasContentIssue false

Stability of employment after traumatic brain injury

Published online by Cambridge University Press:  16 December 2005

JOAN MACHAMER
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
NANCY TEMKIN
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington Department of Neurological Surgery, University of Washington, Seattle, Washington Department of Biostatistics, University of Washington, Seattle, Washington
ROBERT FRASER
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington Department of Neurological Surgery, University of Washington, Seattle, Washington Department of Neurology, University of Washington, Seattle, Washington
JASON N. DOCTOR
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington Department of Medical Education & Biomedical Informatics, University of Washington, Seattle, Washington Department of Health Services, University of Washington, Seattle, Washington
SUREYYA DIKMEN
Affiliation:
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington Department of Neurological Surgery, University of Washington, Seattle, Washington Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Abstract

Although substantial information exists about factors related to who returns to work and time taken to return to work after traumatic brain injury (TBI), less is known about the stability of the work experience after the injury. One hundred sixty-five workers with complicated mild to severe traumatic brain injury were followed for 3 to 5 years postinjury. Work stability definitions included amount of time worked (amount of time worked divided by time observed postinjury) and maintenance of uninterrupted employment once a person returned to work. Amount of time worked was significantly and systematically related to brain injury severity, neuropsychological functioning at 1-month postinjury, and preinjury characteristics such as prior work stability and earnings. However, once persons returned to work, the ability to maintain uninterrupted employment was largely related to premorbid characteristics such as being older, higher income before the injury, or a preinjury job with benefits. It was also related to higher neuropsychological functioning at 1-month postinjury (reflecting the combined effects of premorbid functioning and traumatic brain injury severity), but not related to neurologic indices of severity. (JINS, 2005, 11, 807–816.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

The Abbreviated Injury Scale. (1990). Barrington, IL: Association for the Advancement of Automotive Medicine.
Buschke, H. (1973). Selective reminding for analysis of memory and learning. Journal of Verbal Learning and Verbal Behavior, 12, 543550.CrossRefGoogle Scholar
Dikmen, S.S., Machamer, J.E., Powell, J M., & Temkin, N.R. (2003). Outcome 3 to 5 years after moderate to severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 84, 14491457.CrossRefGoogle Scholar
Dikmen, S.S., Machamer, J.E., Winn, H.R., Anderson, G.D., & Temkin, N.R. (2000). Neuropsychological effects of valproate in traumatic brain injury: A randomized trial. Neurology, 54, 895902.CrossRefGoogle Scholar
Dikmen, S.S., Ross, B.L., Machamer, J.E., & Temkin, N.R. (1995). One year psychosocial outcome in head injury. Journal of the International Neuropsychological Society, 1, 6777.Google Scholar
Dikmen, S.S., Temkin, N.R., Machamer, J.E., Holubkov, A.L., Fraser, R.T., & Winn, H.R. (1994). Employment following traumatic head injuries. Archives of Neurology, 51, 177186.Google Scholar
Doctor, J.N., Castro, J., Temkin, N.R., Fraser, R.T., Machamer, J.E., & Dikmen, S.S. (2005). Workers' risk of unemployment after traumatic brain injury: A normed comparison. Journal of the International Neuropsychological Society, 11, 747752.Google Scholar
Fleming, J., Tooth, L., Hassell, M., & Chan, W. (1999). Prediction of community integration and vocational outcome 2–5 years after traumatic brain injury rehabilitation in Australia. Brain Injury, 13, 417431.Google Scholar
Fraser, R., Dikmen, S., McLean, A., Jr., Miller, B., & Temkin, N. (1988). Employability of head injury survivors: First year post-injury. Rehabilitation Counseling Bulletin, 31, 276288.Google Scholar
Gollaher, K., High, W., Sherer, M., Bergloff, P., Boake, C., Young, M.E., & Ivanhoe, C. (1998). Prediction of employment outcome one to three years following traumatic brain injury (TBI). Brain Injury, 12, 255263.Google Scholar
Hanlon, R.E., Demery, J.A., Martinovich, Z., & Kelly, J.P. (1999). Effects of acute injury characteristics on neuropsychological status and vocational outcome following mild traumatic brain injury. Brain Injury, 13, 873887.Google Scholar
Johnson, R. (1998). How do people get back to work after severe head injury? A 10 year follow-up study. Neuropsychological Rehabilitation, 8, 6179.CrossRefGoogle Scholar
Kreutzer, J.S., Marwitz, J.H., Walker, W., Sander, A., Sherer, M., Bogner, J., Fraser, R., & Bushnik, T. (2003). Moderating factors in return to work and job stability after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 18, 128138.CrossRefGoogle Scholar
McLeod, A., Wills, A., & Etherington, J. (2004). Employment retention after moderate-severe traumatic brain injury (TBI) in the British Army 1989–98. Occupational and Environmental Medicine, 61, 414418.CrossRefGoogle Scholar
O'Neill, J., Hibbard, M.R., Brown, M., Jaffe, M., Sliwinski, M., Vandergoot, D., & Weiss, M.J. (1998). The effect of employment on quality of life and community integration after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 13, 6879.Google Scholar
Ownsworth, T. & McKenna, K. (2004). Investigation of factors related to employment outcome following traumatic brain injury: A critical review and conceptual model. Disability and Rehabilitation, 26, 765784.Google Scholar
Paniak, C., Toller-Lobe, G., Melnyk, A., & Nagy, J. (2000). Prediction of vocational status three to four months after treated mild traumatic brain injury. Journal of Musculoskeletal Pain, 8, 193200.Google Scholar
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation (2nd ed.). Tucson, AZ: Neuropsychology Press.
Reynolds, S., Paniak, C., Toller-Lobe, G., & Nagy, J. (2003). A longitudinal study of compensation-seeking and return to work in a treated mild traumatic brain injury sample. The Journal of Head Trauma Rehabilitation, 18, 139147.CrossRefGoogle Scholar
Sander, A.M., Kreutzer, J.S., Rosenthal, M., Delmonico, R., & Young, M.E. (1996). A multicenter longitudinal investigation of return to work and community integration following traumatic brain injury. The Journal of Head Trauma Rehabilitation, 11, 7084.Google Scholar
Selzer, M.L., Vinokur, A., & van Rooijen, L. (1975). A self-administered Short Michigan Alcoholism Screening Test (SMAST). Journal of Studies on Alcohol, 36, 127132.Google Scholar
Sherer, M., Novack, T.A., Sander, A.M., Struchen, M.A., Alderson, A., & Thompson, R.N. (2002a). Neuropsychological assessment and employment outcome after traumatic brain injury: A review. The Clinical Neuropsychologist, 16, 157178.Google Scholar
Sherer, M., Sander, A.M., Nick, T.G., High, W.M., Jr., Malec, J.F., & Rosenthal, M. (2002b). Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI model systems. Archives of Physical and Medical Rehabilitation, 83, 183192.Google Scholar
Teasdale, G. & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2, 8184.Google Scholar
Temkin, N.R., Dikmen, S.S., Anderson, G.D., Wilensky, A.J., Holmes, M.D., Cohen, W., Newell, D.W., Nelson, P., Awan, A., & Winn, H.R. (1999). Valproate therapy for prevention of posttraumatic seizures: A randomized trial. Journal of Neurosurgery, 91, 593600.CrossRefGoogle Scholar
U.S.Department of Labor, Bureau of Labor Statistics. (2005). Local area unemployment statistics. Retrieved August 5, 2005, from http://www.bls.gov/lau/home.htm.
Wechsler, D. (1955). Manual for Wechsler Adult Intelligence Scale. New York: Psychological Corporation.
Wehman, P., Kregel, J., Sherron, P., Nguyen, S., Kreutzer, J., Fry, R., & Zasler, N. (1993). Critical factors associated with the successful supported employment placement of patients with severe traumatic brain injury. Brain Injury, 7, 3144.Google Scholar
Wehman, P., West, M., Kregel, J., Sherron, P., & Kreutzer, J. (1995). Return to work for persons with severe traumatic brain injury: A data-based approach to program development. Journal of Head Trauma Rehabilitation, 10, 2739.Google Scholar