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轻度创伤性脑损伤患者的重返工作质量:对脑震荡后症状、神经心理功能、工作状态和稳定性之间关联的前瞻性调查。

Quality of return to work in patients with mild traumatic brain injury: a prospective investigation of associations among post-concussion symptoms, neuropsychological functions, working status and stability.

作者信息

Chu Shao-Ying, Tsai Yi-Hsin, Xiao Sheng-Huang, Huang Sheng-Jean, Yang Chi-Cheng

机构信息

a Division of Clinical Psychology, Master of Behavioral Science, Department of Occupational Therapy, College of Medicine , Chang-Gung University , Taoyuan , Taiwan.

b Department of Neurosurgery , Far-Eastern Memorial Hospital , New Taipei City , Taiwan.

出版信息

Brain Inj. 2017;31(12):1674-1682. doi: 10.1080/02699052.2017.1332783. Epub 2017 Sep 5.

DOI:10.1080/02699052.2017.1332783
PMID:28872344
Abstract

PRIMARY OBJECTIVE

Although 'return to work' (RTW) has been always emphasized for patients with mild traumatic brain injury (MTBI), methodological drawbacks weakened its representativeness. This study thus aims to evaluate the 'work quality' (WQ) which originated from 'working status' and 'working stability' simultaneously, and to further explore the associations among post-concussion symptoms (PCS), neuropsychological functions and WQ.

METHODS AND PROCEDURES

A total of 179 participants, which included 132 patients with MTBI and 47 healthy participants, were prospectively recruited. The work quality index (WQI) was developed to evaluate WQ. All patients were evaluated for their PCS, neuropsychological functions and WQ at two weeks post-injury (T1), while PCS and WQ were recorded by one month post-injury (T2).

RESULTS

More than half of the patients were not able to retain their pre-injury jobs at T1, while 26% of the patients still failed to regain previous works at T2. Interestingly, WQ was significantly associated with educational levels and physical PCS, such as headache and dizziness.

CONCLUSIONS

Simultaneously considering working status and stability to reveal the quality of RTW is merited. A higher educational level might be a protective factor for successful RTW, and ameliorating physical symptoms is also necessary to get favourable WQ by one month after MTBI.

摘要

主要目标

尽管一直强调轻度创伤性脑损伤(MTBI)患者要“重返工作岗位”(RTW),但方法上的缺陷削弱了其代表性。因此,本研究旨在评估源自“工作状态”和“工作稳定性”的“工作质量”(WQ),并进一步探讨脑震荡后症状(PCS)、神经心理功能与WQ之间的关联。

方法与步骤

前瞻性招募了179名参与者,其中包括132名MTBI患者和47名健康参与者。制定了工作质量指数(WQI)来评估WQ。所有患者在受伤后两周(T1)评估其PCS、神经心理功能和WQ,而PCS和WQ在受伤后一个月(T2)记录。

结果

超过一半的患者在T1时无法保住受伤前的工作,而26%的患者在T2时仍未能恢复之前的工作。有趣的是,WQ与教育水平和身体PCS(如头痛和头晕)显著相关。

结论

同时考虑工作状态和稳定性以揭示RTW的质量是值得的。较高的教育水平可能是成功RTW的保护因素,并且在MTBI后一个月改善身体症状对于获得良好的WQ也是必要的。

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