Research Reports - Who among patients with acquired brain injury returned to work after occupational rehabilitation?

Disabil Rehabil. 2017 Jul 20:1-10. doi: 10.1080/09638288.2017.1354234. [Epub
ahead of print]

Aas RW(1)(2)(3), Haveraaen LA(1), Brouwers EPM(4), Skarpaas LS(1)(2).

BACKGROUND: Acquired brain injury (ABI) is known to be severely disabling. On
average, 40% of employees return to work (RTW) within two years after injury.
There is, however, limited research on what might contribute to successful RTW.
AIM: To examine factors that might impact the time-to first RTW for patients with
ABI, participating in a RTW-program.
METHODS: The study was designed as a cohort study of patients on sick leave due
to mild or moderate ABI (n = 137). The mean age of the patients was 51 years, and
58% were men. The most common diagnoses were stroke (75%) and traumatic brain
injury (12%). Data were collected through questionnaires, and combined with
register data on sickness absence. Survival analyses were used to analyse the
effect of different variables on time to first RTW (full or partial), at one- and
two-year follow-up.
RESULTS: Generally, women (HR = 0.447; CI: 0.239-0.283) had higher RTW-rates than
men, and patients with non-comorbid impairments returned to work earlier than
patients with multiple impairments. Although not statistically significant,
receiving individual consultations and participating in group-sessions were
generally associated with a delayed RTW at both follow-up-times. The only
service-related factor significantly associated with delayed RTW was meetings
with the social insurance office (HR = 0.522; CI: 0.282-0.965), and only at
one-year follow-up.
CONCLUSIONS: Women and patients with non-comorbid impairments returned to work
earlier than men and patients with multiple impairments. There seems to be an
association between intense and long-lasting participation in the RTW program and
prolonged time-to first-RTW, even after controlling for level of cognitive
impairments and comorbidity. Implications for Rehabilitation Acquired brain
injury (ABI) is known to be severely disabling, and persons with ABI often
experience difficulties in regard to returning to work. This study provides
information on prognostic factors that might contribute to return to work (RTW)
for patients with acquired brain injury, both at the individual level, but also
in regard to service and timing characteristics. Knowledge about such factors
provide rehabilitation professionals with information about effective service
components that might help patients with ABI to RTW, and thus makes it possible
to adapt and adjust the services to the patient's situation. Furthermore, having
more knowledge on factors that contribute to RTW gives clinics the opportunity to
select patients that might benefit the most from these services, thereby making
them more effective.

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