Abstract
Objective
To examine incidence and predictors of employment stability in veterans and military
service members with traumatic brain injury (TBI) who return to work.
Design
Prospective observational cohort study.
Setting
Four rehabilitation centers.
Participants
Veterans and military service members (N=110) with mild (26%), moderate (22%), or
severe (52%) TBI enrolled in the Department of Veterans Affairs Polytrauma Rehabilitation
Centers TBI Model Systems database within 2 years of injury who were discharged between
January 2009 and June 2015.
Interventions
Not applicable.
Main Outcome Measure
Employment stability as reflected by competitive employment at 1- and/or 2-year follow-up.
Results
Over half (n=61, 55%) of the participants had stable employment at the time the first
competitive employment date was recorded. Individuals with stable employment were
more likely to be white (79%) and to have slightly higher cognitive and motor discharge
scores on the FIM. Based on univariate analysis, more severe TBI and higher FIM motor
scores at discharge were significantly associated with employment stability. At follow-up,
compared with veterans and military service members who had unstable employment, those
with stable employment had higher scores on motor and cognitive FIM and lower scores
of self-report symptoms on the Neurobehavioral Symptom Inventory, the 9-item Patient
Health Questionnaire-Depression, the 7-item Generalized Anxiety Disorder Questionnaire,
and the PTSD Checklist-Civilian version.
Conclusions
A number of unique factors affect employment stability in veterans and military service
members with TBI. Study findings identify veterans and military service members who
have stable employment and predictors of employment stability.
Keywords
List of abbreviations:
GAD-7 (7-item Generalized Anxiety Disorder Scale), GCS (Glasgow Coma Scale), GOAT (Galveston Orientation and Amnesia Test), mTBI (mild traumatic brain injury), NSI (Neurobehavioral Symptom Inventory), PCL-C (PTSD Checklist-Civilian Version), PHQ-9 (9-item Patient Health Questionnaire), PRC (Polytrauma Rehabilitation Center), PTA (posttraumatic amnesia), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 16, 2017
Footnotes
The Polytrauma Rehabilitation Center Traumatic Brain Injury (TBI) Model System collaboration is funded through an Interagency Agreement between the Department of Veterans Affairs and the Department of Education, National Institute on Disability, Independent Living, and Rehabilitation Research. This research is sponsored by the VHA Central Office VA TBI Model System Program of Research and a subcontract from General Dynamics Health Solutions (contract no. W91YTZ-13-C-0015) from the Defense and Veterans Brain Injury Center, U.S. Army Medical Research and Material Command, U.S. Department of Veterans Affairs grants (grant nos. 1 I50 HX001233-01 and W81XWH-13-2-0095), and U.S. Department of Defense Congressionally Directed Medical Research Programs.
The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense position or any other federal agency, policy, or decision unless so designated by other official documentation.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
