Screening for job loss: development of a work instability scale for traumatic brain injury.
OBJECTIVE
The objective of this study was to explore the concept of work instability (a mis-match between an individual's functional and cognitive abilities and the demands of their job) following traumatic brain injury (TBI) and develop a work instability scale specific to this population.


METHODS
Work instability (WI) following TBI was explored through qualitative interviews which were then used to generate items for a work instability scale (WIS). Rasch analysis was used to examine the scaling properties of the TBI-WIS which was then validated against a gold standard of expert vocational assessment by occupational psychologists.


CONCLUSIONS
The resulting measure is a 36 item, self-administered scale which can be scored in three bands indicating low, medium and high risk of job retention problems. The scale meets modern psychometric requirements for measurement and presents an opportunity in routine clinical practice to take positive action to prevent job loss.
Gilworth
Gill
G
Academic Unit of Musculoskeletal Medicine and Rehabilitation Medicine, University of Leeds, Leeds, UK. gilworths@aol.com
Carey
Amy
A
Eyres
Sophie
S
Sloan
John
J
Rainford
Bruce
B
Bodenham
Debra
D
Neumann
Vera
V
Tennant
Alan
A
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012050:Rehabilitation, Vocational / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014478:Unemployment; D014938:Work Capacity Evaluation; D016526:Workload