Fure Silje Christine Reistad, Howe Emilie Isager, Andelic Nada, Brunborg Cathrine, Olsen Alexander, Rike Per-Ola, Spjelkavik Øystein, Enehaug Heidi, Røe Cecilie, Løvstad Marianne
Department of Physical Medicine and Rehabilitation (Drs Fure, Howe, Andelic, and Røe), and Oslo Centre for Biostatistics and Epidemiology, Research Support Services (Ms Brunborg), Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society (Drs Fure, Andelic, and Røe), Institute of Clinical Medicine, Faculty of Medicine (Drs Howe and Røe), and Department of Psychology (Dr Løvstad), University of Oslo, Oslo, Norway; Department of Psychology, Norwegian University of Technology and Science, Trondheim, Norway (Dr Olsen); Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Dr Olsen); Department of Research, Sunnaas Rehabilitation Hospital Trust, Nesoddtangen, Norway (Drs Rike and Løvstad); Work Research Institute, Oslo Metropolitan University, Oslo, Norway (Mr Spjelkavik and Dr Enehaug).
J Head Trauma Rehabil. 2023;38(1):E1-E9. doi: 10.1097/HTR.0000000000000772. Epub 2022 Mar 15.
Sociodemographic and injury-related predictors for return to work (RTW) after mild-to-moderate traumatic brain injury (TBI) have been extensively explored. However, there is a knowledge gap regarding work-related predictors of RTW. The main aim of this study was to explore work-related predictors of work participation 6 and 12 months after mild-to-moderate TBI.
Data were collected at baseline 8 to 12 weeks after injury, and 3, 6, and 12 months after baseline, at a specialized TBI rehabilitation outpatient clinic at Oslo University Hospital, Oslo, Norway.
Eligible patients had suffered a mild-to-moderate TBI 8 to 12 weeks previously, were employed 50% or more at time of injury, were between 18 and 60 years of age, and sick listed 50% or more at time of inclusion due to symptoms of TBI (based on the Rivermead Post-Concussion Symptoms Questionnaire). In total, 116 patients were included in a randomized controlled trial, of whom 113 were included in the 1-year analysis.
Patients were originally included in a randomized controlled trial. There were no between-group differences in RTW after 1 year. Thus, the participants were evaluated as one cohort in this study.
The primary outcome measure was work participation 1 year after study inclusion. Work-related predictors were chosen on the basis of previous research and expert opinion and entered into a multivariable linear regression model. The model controlled for sociodemographic and injury-related factors.
The best-fitting model explained 25% of variation in work participation at 1 year. Significant predictors were predictability, quantitative demands and rewards (recognition) at the workplace, private or public employment, symptom burden at baseline, and sex.
In this study, several work-related predictors outperformed some of the established sociodemographic and injury-related predictors of RTW after TBI, thus stressing the need for further focus and research on amendable predictors of RTW after mild-to-moderate TBI.
已经广泛探讨了轻至中度创伤性脑损伤（TBI）后恢复工作（RTW）的社会人口统计学和损伤相关预测因素。然而，关于RTW的工作相关预测因素存在知识空白。本研究的主要目的是探讨轻至中度TBI后6个月和12个月工作参与的工作相关预测因素。
在挪威奥斯陆大学医院的一家专门的TBI康复门诊，于受伤后8至12周的基线期以及基线期后的3、6和12个月收集数据。
符合条件的患者在8至12周前遭受了轻至中度TBI，受伤时就业比例达50%或更高，年龄在18至60岁之间，且因TBI症状（基于Rivermead脑震荡后症状问卷）在纳入时病假比例达50%或更高。共有116名患者纳入一项随机对照试验，其中113名纳入1年分析。
患者最初纳入一项随机对照试验。1年后RTW在组间无差异。因此，本研究将参与者作为一个队列进行评估。
主要结局指标是纳入研究1年后的工作参与情况。基于先前研究和专家意见选择工作相关预测因素，并纳入多变量线性回归模型。该模型对社会人口统计学和损伤相关因素进行了控制。
最佳拟合模型解释了1年时工作参与情况变异的25%。显著的预测因素是可预测性、工作场所的定量要求和奖励（认可）、私人或公共就业、基线时的症状负担以及性别。
在本研究中，一些工作相关预测因素优于TBI后RTW的一些既定社会人口统计学和损伤相关预测因素，从而强调了对轻至中度TBI后RTW的可修正预测因素进一步关注和研究的必要性。
