A comparison of acute and postdischarge predictors of employment 2 years after traumatic brain injury
Felmingham, KL and Baguley, IJ and Crooks, J, A comparison of acute and postdischarge predictors of employment 2 years after traumatic brain injury, Archives of Physical Medicine and Rehabilitation, 82, (4) pp. 435-439. ISSN 0003-9993 (2001) [Refereed Article]
Objective: To examine whether adding postdischarge psychosocial
predictors to premorbid and injury-related variables
improved the capacity to predict employment 2 years after
rehabilitation for traumatic brain injury (TBI).
Design: Data were collected prospectively at 6 and 24
months after discharge from rehabilitation. Logistic regression
analyses examined predictors of employment status.
Setting: Inpatient and community TBI rehabilitation service
attached to a major Australian teaching hospital.
Participants: Fifty-five patients with TB1, aged 16 or older,
who were consecutively admitted to a brain injury unit with
complete longitudinal data and who agreed to participate in the
Intervention: Measured injury severity (Glasgow Coma Scale
scores, posttraumatic amnesia); functional independence (Functional
Assessment Measure cognitive subscale) at admission
and discharge from rehabilitation: self-report of employment
(premorbid, postdischarge); postdischarge psychosocial status
at 6 months and 2 years (Community Integration Questionnaire,
General Health Questionnaire, Trauma Complaints List,
Overt Aggression Scale, Alcohol Use Disorders Inventory
Test, Satisfaction with Life Scale).
Main Outcome Measures: Employment status (employed,
unemployed) was used to reflect vocational outcome. Predictor
variables comprised premorbid work status, injury-related variables
(age, injury severity), and postdischarge variables (employment,
community integration, psychologic, cognitive status).
Results: Adding postdischarge predictors to premorbid and
acute variables significantly improved the ability to predict
work status 2 years after rehabilitation. Age at the time of
injury, premorbid employment status, work status, and psychologic
distress 6 months postdischarge were significant predictors
Conclusions: It is important to consider postdischarge psychologic
well-being, in conjunction with premorbid and acute
factors, in vocational interventions after TBI.