Moderating factors in return to work and job stability after traumatic brain injury.
OBJECTIVE
To examine job stability moderating variables and develop a postinjury work stability prediction model.


METHODS
Multicenter analysis of individuals with traumatic brain injury (TBI) who returned for follow-up at 1, 2, and 3, or 4 years postinjury, were of working age (between 18 and 62 years of age at injury), and were working preinjury.


METHODS
Six National Institute on Disability and Rehabilitation Research TBI Model System centers for coordinated acute and rehabilitation care.


METHODS
A total of 186 adults with TBI were included in the study.


METHODS
Job stability was categorized as stably employed (employed at all 3 follow-up intervals); unstably employed (employed at one or two of all three follow-up intervals); and unemployed (unemployed at all three follow-up intervals).


RESULTS
After injury, 34% were stably employed, 27% were unstably employed, and 39% were unemployed at all three follow-up intervals. Minority group members, people who did not complete high school, and unmarried people were more likely to be unemployed. Driving independence was highly influential and significantly related to employment stability. A discriminant function analysis, which included age, length of unconsciousness and Disability Rating Scale scores at 1 year postinjury, accurately predicted job stability groupings.


CONCLUSIONS
Data analysis provided evidence that employment stability is predictable with a combination of functional, demographic, and injury severity variables. Identification of people at risk for poor employment outcomes early on can facilitate rehabilitation planning and intervention.
Kreutzer
Jeffrey S
JS
The Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Box 980542, Richmond, VA 23298-0542, USA.
Marwitz
Jennifer H
JH
Walker
William
W
Sander
Angelle
A
Sherer
Mark
M
Bogner
Jennifer
J
Fraser
Robert
R
Bushnik
Tamara
T
D000328:Adult; D000367:Age Factors; D001334:Automobile Driving; D001930:Brain Injuries / Q000534:rehabilitation*; D004185:Disability Evaluation; D016002:Discriminant Analysis; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008913:Minority Groups; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D012847:Single Person; D013997:Time Factors; D014474:Unconsciousness / Q000150:complications; D014481:United States