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
List of abbreviations:
TBI (traumatic brain injury), WLQ-25 (Work Limitations Questionnaire)To read this article in full you will need to make a payment
Purchase one-time access:
Academic and PersonalCorporate R&D ProfessionalsOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury.J Rehabil Med. 2004; : 28-60
- Incidence of traumatic brain injury in New Zealand: a population-based study.Lancet Neurol. 2013; 12: 53-64
- Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand.Br J Gen Pract. 2016; 66: e16-e23
- Symptomatology and functional outcome in mild traumatic brain injury: results from the Prospective TRACK-TBI Study.J Neurotrauma. 2014; 31: 26-33
- Systematic review of the prognosis after mild traumatic brain injury in adults: cognitive, psychiatric, and mortality outcomes: results of the international collaboration on mild traumatic brain injury prognosis.Arch Phys Med Rehabil. 2014; 95: S152-S173
- The effect of employment on quality of life and community integration after traumatic brain injury.J Head Trauma Rehabil. 1998; 13: 68-79
- Factors associated with perceived quality of life many years after traumatic brain injury.J Head Trauma Rehabil. 2001; 16: 330-342
- Return to work following mild traumatic brain injury.J Head Trauma Rehabil. 2014; 29: 443-450
- Workers' compensation benefits, coverage, and costs, 2008.National Academy of Social Insurance, Washington (DC)2010
- Systematic review of return to work after mild traumatic brain injury: results of the international collaboration on mild traumatic brain injury prognosis.Arch Phys Med Rehabil. 2014; 95: S201-S209
- Predictors for return to work in subjects with mild traumatic brain injury.Behav Neurol. 2016; 2016: 8026414
- Neuropsychological assessment and employment outcome after traumatic brain injury: a review.Clin Neuropsychol. 2002; 16: 157-178
- The Work Limitations Questionnaire.Med Care. 2001; 39: 72-85
- Prevalence of traumatic brain injury among children, adolescents and young adults: prospective evidence from a birth cohort.Brain Inj. 2008; 22: 175-181
- Frequency and impact of recurrent traumatic brain injury in a population-based sample.J Neurotrauma. 2015; 32: 674-681
New Zealand Government, Ministry of Education. Participation rates in tertiary education. Available at: https://www.educationcounts.govt.nz/statistics/indicators/main/student-engagement-participation/participation_rates_in_tertiary_education. Accessed December 1, 2016.
- The spectrum captured: a methodological approach to studying incidence and outcomes of traumatic brain injury on a population level.Neuroepidemiol. 2012; 38: 18-29
- Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury.J Rehabil Med. 2004; : 113-125
- Australian and New Zealand Standard Classification of Occupations.Australian Bureau of Statistics, Canberra2006
- The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability.J Neurol. 1995; 242: 587-592
- The Hospital Anxiety and Depression Scale.Acta Psychiatr Scand. 1983; 67: 361-370
- Validity of the Hospital Anxiety & Depression Scale to assess depression & anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IV.J Affect Dis. 2008; 114: 94-102
- Work Limitations Questionnaire.The Health Institute, Tufts-New England Medical Center, Boston1998
- The work limitations questionnaire.Quality of Life. 2002; 28: 9-10
Statistics NZ. Unemployment rate. Available at: http://www.stats.govt.nz/browse_for_stats/snapshots-of-nz/nz-progress-indicators/home/economic/unemployment-rate.aspx. Accessed December 1, 2016.
- ldquo;Cancer put my life on hold”: work-related challenges among middle-aged adults 12 months after a diagnosis of colorectal cancer.Cancer Nurs. 2017; 40: 160-167
- Cost of traumatic brain injury in New Zealand: evidence from a population-based study.Neurology. 2014; 83: 1645-1652
- Work productivity loss and fatigue in psoriatic arthritis.J Rheumatol. 2014; 41: 1670-1674
- Productivity at work and quality of life in patients with rheumatoid arthritis.BMC Musculoskel Dis. 2015; 16: 107
- Assessment of work limitations and disability in systemic vasculitis.Clin Exp Rheumatol. 2016; 34: 111-114
Article Info
Publication History
Published online: February 07, 2017
Footnotes
Supported by the Health Research Council of New Zealand (grant nos. 09/063A, 11/192, and 13/408).
Disclosures: Theadom was cofunded by ABI Management Rehabilitation. McPherson was appointed as the Chief Executive of the Health Research Council in 2015 but was neither in post nor involved in the funding decisions for this study. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
