Christina Dillahunt-Aspillaga1, Mary Jo Pugh2, Bridget A Cotner3, Marc A Silva4, Adam Haskin5, Xinyu Tang6, Marie E Saylors6, Risa Nakase-Richardson7. 1. Rehabilitation and Mental Health Counseling Program, Department of Child and Family Studies, University of South Florida, Tampa, FL; Health Services Research and Development Service Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital, Tampa, FL. 2. Audie L. Murphy Veterans Affairs Hospital, South Texas Veterans Healthcare System, San Antonio, TX. 3. Health Services Research and Development Service Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital, Tampa, FL; Department of Anthropology, University of South Florida, Tampa, FL. Electronic address: Bridget.Cotner@va.gov. 4. Health Services Research and Development Service Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital, Tampa, FL; Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Defense and Veterans Brain Injury Center, Tampa, FL; Mental Health and Behavioral Sciences Service, James A. Haley Veterans Hospital, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL. 5. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Defense and Veterans Brain Injury Center, Tampa, FL; General Dynamics Health Solutions, Tampa, FL. 6. Department of Pediatrics, Biostatistics Program, University of Arkansas for Medical Sciences, Little Rock, AR. 7. Health Services Research and Development Service Center of Innovation on Disability and Rehabilitation Research, James A. Haley Veterans Hospital, Tampa, FL; Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Defense and Veterans Brain Injury Center, Tampa, FL; Mental Health and Behavioral Sciences Service, James A. Haley Veterans Hospital, Tampa, FL; Department of Medicine, University of South Florida, Tampa, FL.
Abstract
OBJECTIVE: To examine incidence and predictors of employment stability in veterans and military service members with traumatic brain injury (TBI) who return to work. DESIGN: Prospective observational cohort study. SETTING: Four rehabilitation centers. PARTICIPANTS: Veterans and military service members (N=110) with mild (26%), moderate (22%), or severe (52%) TBI enrolled in the Department of Veterans Affairs Polytrauma Rehabilitation Centers TBI Model Systems database within 2 years of injury who were discharged between January 2009 and June 2015. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Employment stability as reflected by competitive employment at 1- and/or 2-year follow-up. RESULTS: Over half (n=61, 55%) of the participants had stable employment at the time the first competitive employment date was recorded. Individuals with stable employment were more likely to be white (79%) and to have slightly higher cognitive and motor discharge scores on the FIM. Based on univariate analysis, more severe TBI and higher FIM motor scores at discharge were significantly associated with employment stability. At follow-up, compared with veterans and military service members who had unstable employment, those with stable employment had higher scores on motor and cognitive FIM and lower scores of self-report symptoms on the Neurobehavioral Symptom Inventory, the 9-item Patient Health Questionnaire-Depression, the 7-item Generalized Anxiety Disorder Questionnaire, and the PTSD Checklist-Civilian version. CONCLUSIONS: A number of unique factors affect employment stability in veterans and military service members with TBI. Study findings identify veterans and military service members who have stable employment and predictors of employment stability. Published by Elsevier Inc.
OBJECTIVE: To examine incidence and predictors of employment stability in veterans and military service members with traumatic brain injury (TBI) who return to work. DESIGN: Prospective observational cohort study. SETTING: Four rehabilitation centers. PARTICIPANTS: Veterans and military service members (N=110) with mild (26%), moderate (22%), or severe (52%) TBI enrolled in the Department of Veterans Affairs Polytrauma Rehabilitation Centers TBI Model Systems database within 2 years of injury who were discharged between January 2009 and June 2015. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Employment stability as reflected by competitive employment at 1- and/or 2-year follow-up. RESULTS: Over half (n=61, 55%) of the participants had stable employment at the time the first competitive employment date was recorded. Individuals with stable employment were more likely to be white (79%) and to have slightly higher cognitive and motor discharge scores on the FIM. Based on univariate analysis, more severe TBI and higher FIM motor scores at discharge were significantly associated with employment stability. At follow-up, compared with veterans and military service members who had unstable employment, those with stable employment had higher scores on motor and cognitive FIM and lower scores of self-report symptoms on the Neurobehavioral Symptom Inventory, the 9-item Patient Health Questionnaire-Depression, the 7-item Generalized Anxiety Disorder Questionnaire, and the PTSD Checklist-Civilian version. CONCLUSIONS: A number of unique factors affect employment stability in veterans and military service members with TBI. Study findings identify veterans and military service members who have stable employment and predictors of employment stability. Published by Elsevier Inc.
Authors: Mary Jo Pugh; Eamonn Kennedy; James J Gugger; Jamie Mayo; David Tate; Alicia Swan; Jacob Kean; Hamada Altalib; Shaila Gowda; Alan Towne; Sidney Hinds; Anne Van Cott; Maria R Lopez; Carlos A Jaramillo; Blessen C Eapen; Randall R McCafferty; Martin Salinsky; Joyce Cramer; Katherine K McMillan; Andrea Kalvesmaki; Ramon Diaz-Arrastia Journal: J Neurotrauma Date: 2021-10-15 Impact factor: 4.869