Article

PURPOSE: To address the content of work-related difficulties and explore which
variables are associated to or determinants of these difficulties in persons that
suffered from Traumatic Brain Injury (TBI). METHOD: Papers published between 1993
and February 2015 were included. Quality was judged as poor, acceptable, good or
excellent. Determinants were extracted from longitudinal data, associated
variables from cross-sectional data; variables were grouped by similarity.
Evidence was judged as strong if the same results were reported by two or more
good studies; limited if reported by one good and some acceptable studies.
RESULTS: Forty-two papers were selected (25,756 patients). Work-related
difficulties were referred as unemployment, job instability or job cessation.
Strong evidence of impact was found for: low educational level, pre-injury
unemployment, Glasgow Coma Scale score and TBI severity, length of stay in acute
and rehabilitation settings, lower Functional Independence Measure scores and
presence of cognitive disturbances. DISCUSSION: Evidence on the effect of
rehabilitation interventions on TBI patients' work-related difficulties exists,
but is poorly measured. Future studies should address the sustainability of
holistic and tailored interventions targeting employees, employers and workplaces
and aimed to reduce the gap between work duties and worker's abilities, using
appropriate assessment instruments measuring difficulties in work activities.
Implications for rehabilitation Traumatic Brain Injury (TBI) primarily affects
young persons of working age causing a broad range of motor, sensory and
cognitive impairments. A combination of variables related both to pre-morbid and
to injury-related factors predict and are associated to work-related
difficulties. While demographic and injury characteristics cannot be modified,
some TBI outcomes (e.g. cognitive impairments or functional status) may be
addressed by specific rehabilitative interventions: the knowledge of the specific
work-related difficulties of TBI patients is of importance to tailor
rehabilitation programs that maximize vocational outcomes. Rehabilitation
researchers should give attention to vocational issues and use assessment
instruments addressing the difficulties in work-related activities, in order to
demonstrate the benefits of rehabilitative interventions on TBI patients' ability to work.

Langue : ANGLAIS