创伤性脑损伤退伍军人就业结果的预测因素：一项退伍军人事务部创伤性脑损伤模型系统研究
Predictors of Employment Outcomes in Veterans With Traumatic Brain Injury: A VA Traumatic Brain Injury Model Systems Study.
作者信息
Dillahunt-Aspillaga Christina, Nakase-Richardson Risa, Hart Tessa, Powell-Cope Gail, Dreer Laura E, Eapen Blessen C, Barnett Scott D, Mellick Dave, Haskin Adam, Silva Marc A
机构信息
University of South Florida, Rehabilitation and Mental Health Counseling Program, Tampa (Dr Dillahunt-Aspillaga); HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital, Tampa, Florida (Drs Dillahunt-Aspillaga, Nakase-Richardson, Powell-Cope, Barnett, and Silva); Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Defense and Veterans Brain Injury Center, Tampa, Florida (Drs Nakase-Richardson, Barnett, and Silva and Mr Haskin); MHBS, James A. Haley Veterans Hospital, Tampa, Florida (Drs Nakase-Richardson, Barnett, and Silva); Department of Medicine, University of South Florida, Tampa (Dr Nakase-Richardson); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Hart); South Texas Veterans Health Care System, Polytrauma Rehabilitation Center, San Antonio (Dr Eapen); Departments of Physical Medicine and Rehabilitation and Ophthalmology, The University of Alabama, Birmingham (Dr Dreer); Traumatic Brain Injury Model Systems National Data and Statistical Center, Craig Hospital, Englewood, Colorado (Mr Mellick); General Dynamics Health Solutions, Tampa, Florida (Mr Haskin); and Department of Psychology, University of South Florida, Tampa, Florida (Dr Silva).
出版信息
J Head Trauma Rehabil. 2017 Jul/Aug;32(4):271-282. doi: 10.1097/HTR.0000000000000275.
OBJECTIVES
To examine the length of time to return to work (RTW) among service members and veterans (SM/V) with traumatic brain injury (TBI) and to identify variables predictive of RTW.
SETTING
Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRC).
PARTICIPANTS
SM/V enrolled in the VA PRC Traumatic Brain Injury Model Systems database who were of 18 to 60 years of age and admitted with the diagnosis of TBI.
DESIGN
Prospective observational cohort study.
MAIN OUTCOME MEASURES
Employment status at 1-year postinjury follow-up; Time to Employment (ie, number of days it took to RTW) as documented during 1-year postinjury follow-up.
RESULTS
The final sample (n = 293) included male (96%) SM/V with severe TBI (69%). Approximately 21% of the sample participants were employed at 1 year postinjury. Younger individuals who self-identified as nonminority returned to work sooner. Significant associations were observed for time to employment for cause of injury and injury severity.
CONCLUSIONS
Few SM/V with moderate to severe TBI returned to work at 1 year postinjury. Predictors such as younger age at the time of injury, minority status, and severity of TBI affected time to and probability of RTW. Findings from this study have important implications for rehabilitation planning and service delivery across the continuum of recovery.
目的
研究创伤性脑损伤（TBI）的现役军人和退伍军人（SM/V）恢复工作（RTW）的时间长度，并确定预测RTW的变量。
设置
退伍军人事务部多创伤康复中心（VA PRC）。
参与者
纳入VA PRC创伤性脑损伤模型系统数据库的18至60岁、诊断为TBI的SM/V。
设计
前瞻性观察队列研究。
主要结局指标
伤后1年随访时的就业状况；伤后1年随访记录的就业时间（即RTW所需天数）。
结果
最终样本（n = 293）包括重度TBI的男性（96%）SM/V（69%）。约21%的样本参与者在伤后1年就业。自我认定为非少数族裔的较年轻个体恢复工作更快。观察到就业时间与损伤原因和损伤严重程度之间存在显著关联。
结论
中度至重度TBI的SM/V在伤后1年很少恢复工作。诸如受伤时年龄较小、少数族裔身份和TBI严重程度等预测因素会影响RTW的时间和可能性。本研究结果对整个康复连续过程中的康复计划和服务提供具有重要意义。
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