Indicators and predictors of return to work or education following traumatic brain injury : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology
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Date
1998
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Massey University
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Abstract
The leading cause of brain damage in previously healthy young adults, many of whom are of working age, is traumatic brain injury (TBI). Research to date generally agrees that TBI can lead to unemployment. However, knowledge about the determinants of return to work following TBI in the New Zealand context is minimal. This is remarkable given that failure to return to work following TBI is associated with tremendous costs. These include economic implications such as contribution to the economy through work Vs the necessity of financial support through government and community funding (i.e. invalids benefits or long-term care facilities). Furthermore, work affects an individual's self-concept; it represents a major social role, offering self-esteem, social contact and social support. Therefore, a need exists to understand various predictors and indicators and their influence on a client's ability to return to work or education following TBI. The present study was divided into two parts. Part one, was a retrospective analysis of a pre-existing database. In this part, the predictors: pre-injury employment status, job classification at TBI, age at TBI, years of post primary education at TBI, ethnicity, substance abuse after TBI and motor impairments, significantly influenced return to work/education and non return to work/education following TBI. The predictors: age at time of assessment, gender, substance abuse prior to TBI, injury severity, epilepsy, visual difficulties, hearing difficulties and speech difficulties, however, did not. In addition, the indicators: verbal IQ, verbal memory, attention, information processing speed and executive functioning, significantly influenced return to work/education and non return to work/education following TBI, however, the indicators: performance IQ, full scale IQ and visual memory did not. Part two of the present study was a planned analysis. In this part, the predictors: pre-injury job classification, pre-injury job stability, tertiary qualifications and alcohol use after TBI, significantly influenced a persons job classification following TBI and/or the number of hours they were able to work per week following TBI. However, the predictors: pre-injury employment status, age, years of post primary education, ethnicity, gender, substance use before TBI, criminal offending, injury severity, early post trauma sequelae, did not. In addition, the indicators; attention, services of a General Practitioner, the length of time a General Practitioners service was received, cognitive ability and activities of daily living as reported by a relative or close other, significantly influenced a persons job classification following TBI and/or the number of hours they were able to work per week following TBI. However, the remaining cognitive sequelae, rehabilitation information, emotional, behavioural sequelae, participant and relative/close other reports, did not. Qualitative information was also provided by the participant and a relative or close other and the results presented. In conclusion, the findings of both parts of the present study are discussed in relation to the findings of previous research, together with recommendations for future research.
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Keywords
Brain damage, Patients, Rehabilitation