Arango-Lasprilla Juan Carlos, Ketchum Jessica M, Gary Kelli W, Kreutzer Jeffrey S, O'Neil-Pirozzi Therese M, Wehman Paul, Marquez de la Plata Carlos, Jha Amitabh
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Rehabilitation Psychology and Neuropsychology, VCU West Hospital, Richmond, VA 23298, USA.
PM R. 2009 Jan;1(1):41-9. doi: 10.1016/j.pmrj.2008.07.001. Epub 2008 Dec 11.
To determine the influence of minority status on job stability after traumatic brain injury (TBI).
TBI Model Systems Centers.
633 individuals (414 Caucasians vs. 219 Minorities) with primarily moderate to severe TBI hospitalized at one of the TBI Model Systems Centers between 1988 and 2001 with 3 years of continuous follow up employment data after discharge.
Job stability was defined as "stable" (competitively employed at all three follow-up visits), "unemployed" (not competitively employed at all three visits), and "unstable" (any other mixture of competitively employed and not competitively employed over the three follow-up visits).
A multinomial logistic regression model was used to model the effect of ethnicity on job stability post TBI after adjusting for injury and demographic characteristics.
Compared to Caucasians, the adjusted odds for minorities were 3.587 times greater for being unemployed versus being stably employed (95% CI = 1.930, 6.668), 1.911 times greater for being unstably employed versus being stably employed (95% CI = 1.006, 3.628), and 1.878 times more greater for being unemployed versus being unstably employed (95% CI = 1.157, 3.046) after adjusting for preinjury employment status, age, marital status, education, cause of injury, total length of stay in acute and rehabilitation hospitals, and DRS at discharge.
Minority status is an independent predictor of short-term job stability after TBI. Minority TBI survivors were more likely than Caucasians to be unemployed or unstably employed. Rehabilitation professionals should develop employment interventions that will address the specific needs of these racial/ethnic groups and facilitate optimal employment outcomes for minority TBI survivors.
确定少数族裔身份对创伤性脑损伤（TBI）后工作稳定性的影响。
TBI模型系统中心。
633名个体（414名白种人对219名少数族裔），主要为中度至重度TBI，于1988年至2001年期间在其中一个TBI模型系统中心住院，并在出院后有3年连续的后续就业数据。
工作稳定性被定义为“稳定”（在所有三次随访中均有竞争性就业）、“失业”（在所有三次随访中均无竞争性就业）和“不稳定”（在三次随访中竞争性就业和非竞争性就业的任何其他组合）。
使用多项逻辑回归模型，在调整损伤和人口统计学特征后，模拟种族对TBI后工作稳定性的影响。
与白种人相比，在调整伤前就业状况、年龄、婚姻状况、教育程度、损伤原因、急性和康复医院的总住院时间以及出院时的DRS后，少数族裔失业与稳定就业相比的调整后优势比高3.587倍（95%CI = 1.930, 6.668），不稳定就业与稳定就业相比高1.911倍（95%CI = 1.006, 3.628），失业与不稳定就业相比高1.878倍（95%CI = 1.157, 3.046）。
少数族裔身份是TBI后短期工作稳定性的独立预测因素。少数族裔TBI幸存者比白种人更有可能失业或就业不稳定。康复专业人员应制定就业干预措施，以满足这些种族/族裔群体的特定需求，并促进少数族裔TBI幸存者获得最佳就业结果。
