Michitaka Funayama, PhD, MD, is Doctor, Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Yobe, Ashikaga-City, Japan;
Yoshitaka Nakagawa, MS, is Speech-Language Pathologist, Department of Rehabilitation, Edogawa Hospital, Higashikoiwa, Edogawa-Ward, Tokyo, Japan.
Am J Occup Ther. 2022 Mar 1;76(2). doi: 10.5014/ajot.2022.047456.
An understanding of the potential prognostic factors as they relate to the employment status of people with traumatic brain injury (TBI) is necessary so that occupational therapy practitioners can provide the most effective treatment.
To examine the impact of apathy, disinhibition, and psychiatric conditions on employment status after TBI.
An observational study conducted from March 2015 to March 2020.
Cognitive dysfunction clinics associated with two general hospitals in Japan.
Japanese people of working age (N = 110, ages 18-65 yr) with TBI. Outcomes and Measures: As an outcome indicator, each participant's employment status was rated on a 3-point scale (i.e., 3 = regular employment, 2 = welfare employment [employed as a person with disabilities or undergoing vocational training in the Japanese welfare employment system, for which a worker is paid under either system], 1 = unemployment). Psychiatric, neuropsychological, and physical assessments were measured as explanatory variables. The impact of various factors on employment status was investigated using linear discriminant regression analysis.
The level of apathy, disinhibition, and incidence of psychiatric conditions after TBI, as well as age and years postinjury, were related to employment status. Conclusion and Relevance: Although this is a cross-sectional study, interventions for apathy and disinhibition, as well as management of psychiatric conditions, are recommended to help improve employment status among people with TBI. What This Article Adds: The employment status of people with TBI is related more to apathy, disinhibition, and psychiatric conditions than to intelligence, memory function, or executive function.
了解与创伤性脑损伤（TBI）患者就业状况相关的潜在预后因素非常重要，以便职业治疗师能够提供最有效的治疗。
研究淡漠、去抑制和精神状况对 TBI 后就业状况的影响。
2015 年 3 月至 2020 年 3 月进行的观察性研究。
日本两家综合医院的认知功能障碍诊所。
日本工作年龄（18-65 岁）TBI 患者（N=110）。结局和测量：作为结局指标，根据 3 分制对每位参与者的就业状况进行评分（即 3=正常就业，2=福利就业[作为残疾人就业或在日本福利就业系统中接受职业培训，两种制度下工人都有报酬]，1=失业）。将精神、神经心理学和身体评估作为解释变量进行测量。使用线性判别回归分析研究各种因素对就业状况的影响。
TBI 后淡漠、去抑制的程度以及精神状况的发生率，以及年龄和受伤后时间，与就业状况相关。
尽管这是一项横断面研究，但建议对淡漠和去抑制进行干预，并对精神状况进行管理，以帮助改善 TBI 患者的就业状况。
与智力、记忆功能或执行功能相比，TBI 患者的就业状况与淡漠、去抑制和精神状况的关系更为密切。
