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Employment stability in the first 5 years after moderate to severe traumatic brain injury.
Archives of Physical Medicine and Rehabilitation 2018 July 26
OBJECTIVE: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate to severe traumatic brain injury (TBI) that may be clinically addressed.
DESIGN: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.
SETTING: Inpatient rehabilitation centers with telephone follow-up.
PARTICIPANTS: Individuals enrolled in the TBIMS-NDB since 2001, aged 18 to 59, with employment data at two or more follow-up interviews at years 1, 2, and 5 (N=5,683).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE: Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.
RESULTS: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, pre-injury employment, higher annual earnings, male sex, higher education, transportation independence post-injury, and no anxiety or depression at 1-year post-TBI.
CONCLUSIONS: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.
DESIGN: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.
SETTING: Inpatient rehabilitation centers with telephone follow-up.
PARTICIPANTS: Individuals enrolled in the TBIMS-NDB since 2001, aged 18 to 59, with employment data at two or more follow-up interviews at years 1, 2, and 5 (N=5,683).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE: Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed.
RESULTS: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, pre-injury employment, higher annual earnings, male sex, higher education, transportation independence post-injury, and no anxiety or depression at 1-year post-TBI.
CONCLUSIONS: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.
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