Psychology Department, University of California, San Diego, La Jolla, CA, USA.
Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
NeuroRehabilitation. 2019;44(3):333-339. doi: 10.3233/NRE-182631.
The effects of traumatic brain injury (TBI) on return to work have been the focus of many clinical studies in recent years. Veterans with a history of TBI may be at increased risk of unemployment.
We sought to understand predictors of work outcomes for Veterans with a history of TBI who received evidence-based supported employment.
Fifty unemployed Veterans with a history of mild-to-moderate TBI and current neuropsychological impairment participated in a 12-month supported employment intervention. Demographic data and baseline assessments of neuropsychological impairment, functional capacity, and psychiatric and post-concussive symptom severity were investigated as predictors of work outcomes (job attainment, weeks worked, and wages earned).
Bivariate analyses showed that lower disability ratings, more recent work history, more months worked in the past 5 years, lower PTSD symptom severity, worse verbal memory, and better cognitive flexibility were all associated with better work outcomes. In multivariate regression analyses, better cognitive flexibility and worse verbal memory performance predicted better work outcomes.
Further research is needed to determine how treatment of cognitive impairments and psychiatric symptoms is related to return to work in Veterans with a history of TBI.
创伤性脑损伤 (TBI) 对重返工作岗位的影响是近年来许多临床研究的重点。有 TBI 病史的退伍军人失业的风险可能更高。
我们试图了解接受循证支持性就业的有 TBI 病史的退伍军人的工作结果的预测因素。
50 名失业的有轻度至中度 TBI 和当前神经认知障碍病史的退伍军人参加了为期 12 个月的支持性就业干预。对人口统计学数据和神经认知障碍、功能能力、精神疾病和脑震荡后症状严重程度的基线评估进行了研究，以作为工作结果（获得工作、工作周数和收入工资）的预测因素。
单变量分析显示，较低的残疾评级、较近的工作史、过去 5 年中工作的月数更多、较低的 PTSD 症状严重程度、较差的言语记忆和更好的认知灵活性都与更好的工作结果相关。在多元回归分析中，更好的认知灵活性和较差的言语记忆表现预测了更好的工作结果。
需要进一步研究如何治疗认知障碍和精神症状与有 TBI 病史的退伍军人重返工作岗位的关系。
