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Arch Phys Med Rehabil. 2017 Aug;98(8):1560-1566. doi: 10.1016/j.apmr.2017.01.010. Epub 2017 Feb 8.

Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study.

Author information

1
National Institute for Stroke and Applied Neuroscience, School of Public Health & Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand. Electronic address: alice.theadom@aut.ac.nz.
2
School of Psychology, University of Auckland, Auckland, New Zealand.
3
National Institute for Stroke and Applied Neuroscience, School of Public Health & Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand.
4
Waikato Occupational Services, Hamilton, New Zealand.
5
Department of Biostatistics and Epidemiology, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland.
6
Health Research Council of New Zealand, Auckland, New Zealand.
7
School of Psychology, University of Waikato, Hamilton, New Zealand.

Abstract

OBJECTIVE:

To explore employment status, work limitations, and productivity loss after mild traumatic brain injury (TBI).

DESIGN:

Inception cohort study over 4 years.

SETTING:

General community.

PARTICIPANTS:

Adults (N=245; >16y at the time of injury) who experienced a mild TBI and who were employed prior to their injury.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Details of the injury, demographic information, and preinjury employment status were collected from medical records and self-report. Symptoms and mood were assessed 1 month postinjury using the Rivermead Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression Scale. Postinjury employment status and work productivity were assessed 4 years postinjury using the Work Limitations Questionnaire.

RESULTS:

Four years after mild TBI, 17.3% of participants had exited the workforce (other than for reasons of retirement or to study) or had reduced their working hours compared with preinjury. A further 15.5% reported experiencing limitations at work because of their injury. Average work productivity loss was 3.6%. The symptom of taking longer to think 1 month postinjury significantly predicted work productivity loss 4 years later (β=.47, t=3.79, P≤.001).

CONCLUSIONS:

Although changes in employment status and difficulties at work are likely over time, the results indicate increased unemployment rates, work limitations, and productivity loss in the longer term after a mild TBI. Identification of cognitive difficulties 1 month after TBI in working aged adults and subsequent interventions to address these difficulties are required to facilitate work productivity.

KEYWORDS:

Brain concussion; Brain injuries, traumatic; Employment; Longitudinal studies; Rehabilitation; Work

PMID:
28188778
DOI:
10.1016/j.apmr.2017.01.010
[Indexed for MEDLINE]

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