Aas Randi Wågø, Haveraaen Lise Aasen, Brouwers Evelien P M, Skarpaas Lisebet Skeie
a Presenter - Making Sense of Science , Stavanger , Norway.
b Faculty of Health Sciences , Oslo and Akershus University College for Applied Sciences , Oslo , Norway.
Disabil Rehabil. 2018 Oct;40(21):2561-2570. doi: 10.1080/09638288.2017.1354234. Epub 2017 Jul 20.
Acquired brain injury (ABI) is known to be severely disabling. On average, 40% of employees return to work (RTW) within two years after injury. There is, however, limited research on what might contribute to successful RTW.
To examine factors that might impact the time-to first RTW for patients with ABI, participating in a RTW-program.
The study was designed as a cohort study of patients on sick leave due to mild or moderate ABI (n = 137). The mean age of the patients was 51 years, and 58% were men. The most common diagnoses were stroke (75%) and traumatic brain injury (12%). Data were collected through questionnaires, and combined with register data on sickness absence. Survival analyses were used to analyse the effect of different variables on time to first RTW (full or partial), at one- and two-year follow-up.
Generally, women (HR = 0.447; CI: 0.239-0.283) had higher RTW-rates than men, and patients with non-comorbid impairments returned to work earlier than patients with multiple impairments. Although not statistically significant, receiving individual consultations and participating in group-sessions were generally associated with a delayed RTW at both follow-up-times. The only service-related factor significantly associated with delayed RTW was meetings with the social insurance office (HR = 0.522; CI: 0.282-0.965), and only at one-year follow-up.
Women and patients with non-comorbid impairments returned to work earlier than men and patients with multiple impairments. There seems to be an association between intense and long-lasting participation in the RTW program and prolonged time-to first-RTW, even after controlling for level of cognitive impairments and comorbidity. Implications for Rehabilitation Acquired brain injury (ABI) is known to be severely disabling, and persons with ABI often experience difficulties in regard to returning to work. This study provides information on prognostic factors that might contribute to return to work (RTW) for patients with acquired brain injury, both at the individual level, but also in regard to service and timing characteristics. Knowledge about such factors provide rehabilitation professionals with information about effective service components that might help patients with ABI to RTW, and thus makes it possible to adapt and adjust the services to the patient's situation. Furthermore, having more knowledge on factors that contribute to RTW gives clinics the opportunity to select patients that might benefit the most from these services, thereby making them more effective.
已知获得性脑损伤（ABI）具有严重致残性。平均而言，40%的员工在受伤后两年内重返工作岗位（RTW）。然而，关于哪些因素可能有助于成功重返工作岗位的研究有限。
研究可能影响参与重返工作岗位计划的ABI患者首次重返工作岗位时间的因素。
本研究设计为对因轻度或中度ABI而休病假的患者（n = 137）进行队列研究。患者的平均年龄为51岁，58%为男性。最常见的诊断是中风（75%）和创伤性脑损伤（12%）。通过问卷调查收集数据，并与病假登记数据相结合。采用生存分析来分析不同变量对首次重返工作岗位（全部或部分）时间的影响，随访时间为1年和2年。
总体而言，女性（HR = 0.447；CI：0.239 - 0.283）的重返工作岗位率高于男性，无合并症损伤的患者比有多种损伤的患者更早重返工作岗位。虽然无统计学意义，但在两次随访时，接受个人咨询和参加小组会议通常与重返工作岗位延迟有关。与重返工作岗位延迟显著相关的唯一服务相关因素是与社会保险办公室的会面（HR = 0.522；CI：0.282 - 0.965），且仅在1年随访时。
女性和无合并症损伤的患者比男性和有多种损伤的患者更早重返工作岗位。即使在控制了认知损伤水平和合并症之后，高强度和长期参与重返工作岗位计划与首次重返工作岗位时间延长之间似乎也存在关联。康复启示已知获得性脑损伤（ABI）具有严重致残性，ABI患者在重返工作岗位方面往往存在困难。本研究提供了有关预后因素的信息，这些因素可能有助于获得性脑损伤患者重返工作岗位，无论是在个体层面，还是在服务和时间特征方面。了解这些因素为康复专业人员提供了有关有效服务组成部分的信息，这些信息可能有助于ABI患者重返工作岗位，从而使服务能够根据患者的情况进行调整。此外，更多地了解有助于重返工作岗位的因素使诊所能够选择可能从这些服务中受益最大的患者，从而提高服务效率。
