Adaptation Following Serious Brain Injury: An Assessment After One Year

1988 ◽  
Vol 19 (3) ◽  
pp. 3-8 ◽  
Author(s):  
Steven P. Kaplan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Return To Work ◽  
Clinical Usefulness ◽  
Psychosocial Variables ◽  
Post Injury ◽  
Adjustment Problems ◽  
One Year ◽  
Major Adjustment

This study's major purposes were to identify preinjury psychosocial variables effecting social and vocational adjustment to serious traumatic brain injury (TBI) and to test the reliability and clinical usefulness of The Portland Adaptability Inventory (PAI). Twenty-five individuals with serious TBI served as subjects. Results showed the participants major adjustment problems at 13 months post-injury were psychosocial and family oriented, and that return to work or school was heavily dependent upon an individual's ability to engage in socially appropriate interactions. Predisability family functioning was associated with both the subject's return to work or school and with post-disability family functioning. The PAI was shown to be a reliable and useful measure of post TBI problem areas.

scholarly journals Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe

2020 ◽  
Vol 9 (6) ◽  
pp. 2007
Author(s):  
Juan Arango-Lasprilla ◽  
Marina Zeldovich ◽  
Laiene Olabarrieta-Landa ◽  
Marit Forslund ◽  
Silvia Núñez-Fernández ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Employment Status ◽  
Injury Severity ◽  
European Countries ◽  
Post Injury ◽  
Early Predictors ◽  
One Year ◽  
Prospective Longitudinal ◽  
Psychiatric Problems

Sustaining a traumatic brain injury (TBI) often affects the individual’s ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014–2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.

scholarly journals Post-Traumatic Headache After Mild Traumatic Brain Injury In A One-Year Follow Up Study – Risk Factors And Return To Work

2021 ◽  
Author(s):  
Yvonn Kraemer ◽  
Kaisa Mäki ◽  
Ivan Marinkovic ◽  
Taina Nybo ◽  
Harri Isokuortti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Outpatient Clinic ◽  
Post Traumatic ◽  
One Year

Abstract Background: Post-traumatic headache (PTH) is a common symptom following mild traumatic brain injury (mTBI). Patients at risk to develop acute PTH (aPTH) and further persistent PTH (pPTH) need to be recognized. Methods: This is a one-year follow-up of 127 patients with mTBI, aged 18 to 68, referred to outpatient clinic in the Helsinki University Hospital. Symptoms were assessed at the emergency department (ED), with structured interview at outpatient clinic visit and with Rivermead post-concussion symptom questionnaire at one, three, and 12 months after injury. Psychiatric disorders were assessed with Structured Clinical Interview for DSM-IV Axis I disorders at 3-4 months and return to work (RTW) from patient records. Results: At one month, 77/127 patients (61%) had aPTH. According to multiple logistic regression analysis, risk factors for aPTH were headache at the emergency department (ED) (OR 5.43), other pain (OR 3.19), insomnia (OR 3.23), and vertigo (OR 5.98). At three months, 17 patients (22% of aPTH patients) had developed pPTH, and at one year, 4 patients (24% of pPTH patients) still presented with pPTH. Risk factors for pPTH at three months were older age (OR 1.06) and current insomnia (OR 12.3). The frequency of psychiatric disorders did not differ between the groups. pPTH patients performed worse on their RTW. Conclusions: Risk factors for aPTH were insomnia, headache at ED, other pain, and vertigo and for pPTH, insomnia and older age. RTW rate was lower among pPTH patients.

scholarly journals Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Eirik Vikane ◽  
Torgeir Hellstrøm ◽  
Cecilie Røe ◽  
Erik Bautz-Holter ◽  
Jörg Aßmus ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Psychological Distress ◽  
Brain Injury ◽  
Sick Leave ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Self Report ◽  
University Hospitals ◽  
Global Functioning ◽  
One Year

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury.Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles.Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury.Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

scholarly journals Predictors of six-month inability to return to work in previously employed subjects after mild traumatic brain injury: A TRACK-TBI pilot study

2021 ◽  
Vol 5 ◽  
pp. 205970022110072
Author(s):  
John K Yue ◽  
Ryan RL Phelps ◽  
Debra D Hemmerle ◽  
Pavan S Upadhyayula ◽  
Ethan A Winkler ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pilot Study ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Full Time ◽  
Emotional Symptoms ◽  
Post Injury

Introduction Return to work (RTW) is an important milestone of mild traumatic brain injury (mTBI) recovery. The objective of this study was to evaluate whether baseline clinical variables, three-month RTW, and three-month postconcussional symptoms (PCS) were associated with six-month RTW after mTBI. Methods Adult subjects from the prospective multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with mTBI (Glasgow Coma Scale 13–15) who were employed at baseline, with completed three- and six-month RTW status, and three-month Acute Concussion Evaluation (ACE), were extracted. Univariate and multivariable analyses were performed for six-month RTW, with focus on baseline employment, three-month RTW, and three-month ACE domains (physical, cognitive, sleep, and/or emotional postconcussional symptoms (PCS)). Odds ratios (OR) and 95% confidence intervals [CI] were reported. Significance was assessed at p < 0.05. Results In 152 patients aged 40.7 ± 15.0 years, 72% were employed full-time at baseline. Three- and six-month RTW were 77.6% and 78.9%, respectively. At three months, 59.2%, 47.4%, 46.1% and 31.6% scored positive for ACE physical, cognitive, sleep, and emotional PCS domains, respectively. Three-month RTW predicted six-month RTW (OR = 19.80, 95% CI [7.61–51.52]). On univariate analysis, scoring positive in any three-month ACE domain predicted inability for six-month RTW (OR = 0.10–0.11). On multivariable analysis, emotional symptoms predicted inability to six-month RTW (OR = 0.19 [0.04–0.85]). Subjects who scored positive in all four ACE domains were more likely to be unable to RTW at six months (4 domains: 58.3%, vs. 0-to-3 domains: 9.5%; multivariable OR = 0.09 [0.02–0.33]). Conclusions Three-month post-injury is an important time point at which RTW status and PCS should be assessed, as both are prognostic markers for six-month RTW. Clinicians should be particularly vigilant of patients who present with emotional symptoms, and patients with symptoms across multiple PCS categories, as these patients are at further risk of inability to RTW and may benefit from targeted evaluation and support.

Return to Pre-Injury Work Following Mild Traumatic Brain Injury

2018 ◽  
Vol 19 (2) ◽  
pp. 153-165 ◽  
Author(s):  
Michael Kahan ◽  
Kelly M. Jones ◽  
Shivanthi Balalla ◽  
Kathryn McPherson ◽  
Elisabeth Stedman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Population Based ◽  
Post Injury ◽  
Mild Tbi ◽  
Prospective Longitudinal Study ◽  
Younger Workers ◽  
Younger Age ◽  
Prospective Longitudinal

Objective: Adults are at risk for unemployment following a moderate-severe traumatic brain injury (TBI). Less is known about employment patterns following mild TBI. This study aims to examine patterns of return to pre-injury job in adults following mild TBI over a 12-month post injury period, and to investigate factors associated with return to work. Methods: It is a prospective longitudinal study of 205 adults (aged ≥16 years at injury) identified as part of a larger population-based incidence study in the Waikato, New Zealand. In-person assessments were completed at baseline (within 14 days) and 1-, 6-, and 12-month post-injury. Results: A total of 159 (77.6%) adults returned to their pre-injury job at baseline and 185 (90.2%) returned within 12 months. Of those who did not return to their pre-injury job at baseline (n= 46), younger age at injury (≤30 years,p= .02) and poor overall neurocognitive functioning at 1-month (p= .02) was associated with non-return to pre-injury job at 12 months. Conclusion: In a sample of employed adults, the majority returned to their pre-injury job shortly after injury. Cognitive functioning and younger age at time of injury may be associated with delayed return to work. Interventions to support younger workers may facilitate their return to work.

Return to work after severe traumatic brain injury: a national study with a one-year follow-up of neurocognitive and behavioural outcomes

2018 ◽  
Vol 30 (2) ◽  
pp. 281-297 ◽  
Author(s):  
Solrun Sigurdardottir ◽  
Nada Andelic ◽  
Eike Wehling ◽  
Audny Anke ◽  
Toril Skandsen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Return To Work ◽  
Severe Traumatic Brain Injury ◽  
National Study ◽  
One Year

Family functioning and emotional state two and five years after traumatic brain injury

2010 ◽  
Vol 16 (2) ◽  
pp. 306-317 ◽  
Author(s):  
JENNIE PONSFORD ◽  
MICHAEL SCHÖNBERGER
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Emotional State ◽  
Significant Proportion ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Post Injury ◽  
Family Assessment Device ◽  
Group A

AbstractPrevious studies have documented poor family functioning, anxiety, and depression in relatives of individuals with traumatic brain injury (TBI). However, few studies have examined family functioning over extended periods after injury. The present study aimed to investigate family functioning and relatives’ emotional state 2 and 5 years following TBI, predictive factors, and their interrelationships. Participants were individuals with TBI and their relatives, with 301 seen at 2 years and 266 at 5 years post-injury. Measures included a Structured Outcome Questionnaire, Family Assessment Device (FAD), Hospital Anxiety and Depression Scale, and the Craig Handicap Assessment and Reporting Technique. Results showed that while the group did not differ greatly in family functioning from a normative group, a significant proportion showed unhealthy functioning across most FAD subscales. Both TBI participants and their relatives showed elevated rates of anxiety and depression. There was little difference between family functioning or relatives’ anxiety or depression levels at 2 and 5 years post-injury. Path analysis indicated that neurobehavioral changes in the injured individual have an impact on family functioning and distress in relatives even at 5 years post-injury. These findings indicate the need for long-term support of families with a brain-injured member. (JINS, 2010,16, 306–317.)

A prospective study of prevalence and characterization of headache following mild traumatic brain injury

Cephalalgia ◽  
2013 ◽  
Vol 34 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Sylvia Lucas ◽  
Jeanne M Hoffman ◽  
Kathleen R Bell ◽  
Sureyya Dikmen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Post Injury ◽  
Persistent Symptoms ◽  
Primary Headache Disorders ◽  
Significant Difference ◽  
Probable Migraine ◽  
One Year ◽  
Tension Type Headaches

Background Headache is one of the most common and persistent symptoms following traumatic brain injury (TBI). The current study examines the prevalence and characteristics of headache following mild TBI (mTBI). Methods We prospectively enrolled 212 subjects within one week of mTBI who were hospitalized for observation or other system injuries in a single level 1 US trauma center and followed by telephone at three, six, and 12 months after injury for evaluation of headache. Headaches were classified according to ICHD-2 criteria as migraine, probable migraine, tension-type, cervicogenic, or unclassifiable headache. Results Subjects were 76% male and 75% white, and 58% were injured in vehicle-related crashes. A follow-up rate of 90% (190/212) occurred at 12 months post-injury. Eighteen percent (38/212) of subjects reported having a problem with headaches pre-injury while 54% (114/210) of subjects reported new or worse headaches compared to pre-injury immediately after injury, 62% (126/203) at three months, 69% (139/201) at six months, and 58% (109/189) at one year. Cumulative incidence was 91% (172/189) over one year. Up to 49% of headaches met criteria for migraine and probable migraine, followed by tension-type headaches (up to 40%). Age (≤ 60) was found to be a risk factor, but no significant difference was found in persistence of new or worse headache compared to pre-injury between males and females. More than one-third of the subjects reported persistent headache across all three follow-up time periods. Conclusions Headache after mTBI is very common and persistent across the first year after injury. Assertive, early treatment may be warranted to avoid chronicity and disability. Further research is needed to determine whether post-traumatic headache (PTH) responds to headache treatment used in the primary headache disorders and whether chronic PTH is preventable.

The Development of Insight following Severe Traumatic Brain Injury: Three Case Studies

1997 ◽  
Vol 60 (7) ◽  
pp. 295-300 ◽  
Author(s):  
J M Fleming ◽  
J Strong
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Acquired Brain Injury ◽  
First Year ◽  
Self Awareness ◽  
Good Recovery ◽  
Post Injury ◽  
One Year

A longitudinal study of 55 adults with severe traumatic brain injury was conducted to investigate the development of self-awareness, emotional distress and motivation during the first year after injury. Cluster analysis was performed on data gathered at one year post-Injury. Three clusters labelled ‘high self-awareness’, ‘low self-awareness’ and ‘good recovery’ were retrieved. A case study is presented from each cluster, contrasting the stages in the development of self-awareness of deficits over the year. This research suggests that clients with acquired brain injury can be classified on the basis of level of self-awareness. Issues for the rehabilitation of and occupational therapy with clients from the three groups are raised.

Psychosocial Quality of Life After Traumatic Brain Injury Among Children in Uganda 

2021 ◽  
Author(s):  
Kadondi Merabu ◽  
Herve Monka Lekuya ◽  
Kiyemba Henry ◽  
John Paul Magala ◽  
Joel Kiryabwire
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Psychosocial Functioning ◽  
Psychosocial Outcomes ◽  
Associated Injuries ◽  
Post Injury ◽  
Cross Sectional ◽  
One Year

Abstract Background: Traumatic Brain Injury (TBI) is a leading cause of sudden death and disability amongst young people. About 28% of children managed for TBI in Uganda report some degree of physical disability one-year post-injury, but little is known about their psychosocial outcomes. We aimed to elucidate the psychosocial outcomes of children with TBI, and associated factors.Methods: A cross-sectional study carried out in the Neurosurgical Unit of Mulago National Referral Hospital (MNRH), Uganda. The Pediatric Quality of Life Inventory version 4.0 parent-proxy was administered to parents/guardians of children aged 6 to 17 years who were previously managed for TBI in MNRH more than a year post-injury; their medical records were also retrieved. Linear regression was used to determine factors associated with psychosocial outcomes.Results: A total of 116 children were recruited. The overall mean psychosocial functioning was 82 ± 22.74. Using a standard deviation below the mean score as a cut-off standard,85.7% of those children had good psychosocial functioning versus 14.3% with poor functioning. A long time of more than 2 years post-TBI (adjusted β = 1.36, p=0.012) and absence of associated injuries (adjusted β= 0.30, p=0.025) were associated with good psychosocial functioning, while TBI severity was negatively associated with poor psychosocial functioning (adjusted β= -0.36, p=0.041).Conclusion: Children managed for TBI continue to have psychosocial dysfunctioning after one year following injury, although continued improvement is observed even after 2 years. The severity of TBI and the presence of associated injuries are important determinants of the psychosocial quality of life of children. Multi-disciplinary supportive care should be very effective during the first 2 years following the injury to improve the quality of life of children with TBI.

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