Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury

Dominic DiSanto, Raj G. Kumar, Shannon B. Juengst, Tessa Hart, Therese M. O'Neil-Pirozzi, Nathan D. Zasler, Thomas A. Novack, Christina Dillahunt-Aspillaga, Kristin M. Graham, Bridget A. Cotner, Amanda R. Rabinowitz, Sureyya Dikmen, Janet P. Niemeier, Matthew R. Kesinger, Amy K. Wagner

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically addressed. Design: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI. Setting: Inpatient rehabilitation centers with telephone follow-up. Participants: Individuals enrolled in the TBIMS-NDB since 2001, aged 18-59, with employment data at 2 or more follow-up interviews at years 1, 2, and 5 (N=5683). Interventions: Not applicable. Main Outcome Measure: Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed. Results: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, preinjury employment, higher annual earnings, male sex, higher education, transportation independence postinjury, and no anxiety or depression at 1 year post-TBI. Conclusions: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as the presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

Original languageEnglish (US)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Jan 1 2018

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Anxiety
Traumatic Brain Injury
Databases
Depression
Rehabilitation Centers
Sex Education
Telephone
Observational Studies
Longitudinal Studies
Inpatients
Regression Analysis
Demography
Outcome Assessment (Health Care)
Interviews
Wounds and Injuries

Keywords

  • Employment
  • Mental health
  • Neuropsychology
  • Rehabilitation
  • Traumatic brain injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury. / DiSanto, Dominic; Kumar, Raj G.; Juengst, Shannon B.; Hart, Tessa; O'Neil-Pirozzi, Therese M.; Zasler, Nathan D.; Novack, Thomas A.; Dillahunt-Aspillaga, Christina; Graham, Kristin M.; Cotner, Bridget A.; Rabinowitz, Amanda R.; Dikmen, Sureyya; Niemeier, Janet P.; Kesinger, Matthew R.; Wagner, Amy K.

In: Archives of Physical Medicine and Rehabilitation, 01.01.2018.

Research output: Contribution to journalArticle

DiSanto, D, Kumar, RG, Juengst, SB, Hart, T, O'Neil-Pirozzi, TM, Zasler, ND, Novack, TA, Dillahunt-Aspillaga, C, Graham, KM, Cotner, BA, Rabinowitz, AR, Dikmen, S, Niemeier, JP, Kesinger, MR & Wagner, AK 2018, 'Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury', Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2018.06.022
DiSanto, Dominic ; Kumar, Raj G. ; Juengst, Shannon B. ; Hart, Tessa ; O'Neil-Pirozzi, Therese M. ; Zasler, Nathan D. ; Novack, Thomas A. ; Dillahunt-Aspillaga, Christina ; Graham, Kristin M. ; Cotner, Bridget A. ; Rabinowitz, Amanda R. ; Dikmen, Sureyya ; Niemeier, Janet P. ; Kesinger, Matthew R. ; Wagner, Amy K. / Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury. In: Archives of Physical Medicine and Rehabilitation. 2018.
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abstract = "Objective: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically addressed. Design: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI. Setting: Inpatient rehabilitation centers with telephone follow-up. Participants: Individuals enrolled in the TBIMS-NDB since 2001, aged 18-59, with employment data at 2 or more follow-up interviews at years 1, 2, and 5 (N=5683). Interventions: Not applicable. Main Outcome Measure: Employment stability, categorized using post-TBI employment data as no paid employment (53.25{\%}), stably (27.20{\%}), delayed (10.24{\%}), or unstably (9.31{\%}) employed. Results: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, preinjury employment, higher annual earnings, male sex, higher education, transportation independence postinjury, and no anxiety or depression at 1 year post-TBI. Conclusions: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as the presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.",
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AU - DiSanto, Dominic

AU - Kumar, Raj G.

AU - Juengst, Shannon B.

AU - Hart, Tessa

AU - O'Neil-Pirozzi, Therese M.

AU - Zasler, Nathan D.

AU - Novack, Thomas A.

AU - Dillahunt-Aspillaga, Christina

AU - Graham, Kristin M.

AU - Cotner, Bridget A.

AU - Rabinowitz, Amanda R.

AU - Dikmen, Sureyya

AU - Niemeier, Janet P.

AU - Kesinger, Matthew R.

AU - Wagner, Amy K.

PY - 2018/1/1

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N2 - Objective: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically addressed. Design: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI. Setting: Inpatient rehabilitation centers with telephone follow-up. Participants: Individuals enrolled in the TBIMS-NDB since 2001, aged 18-59, with employment data at 2 or more follow-up interviews at years 1, 2, and 5 (N=5683). Interventions: Not applicable. Main Outcome Measure: Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed. Results: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, preinjury employment, higher annual earnings, male sex, higher education, transportation independence postinjury, and no anxiety or depression at 1 year post-TBI. Conclusions: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as the presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

AB - Objective: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically addressed. Design: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI. Setting: Inpatient rehabilitation centers with telephone follow-up. Participants: Individuals enrolled in the TBIMS-NDB since 2001, aged 18-59, with employment data at 2 or more follow-up interviews at years 1, 2, and 5 (N=5683). Interventions: Not applicable. Main Outcome Measure: Employment stability, categorized using post-TBI employment data as no paid employment (53.25%), stably (27.20%), delayed (10.24%), or unstably (9.31%) employed. Results: Multinomial regression analyses identified predictive factors of employment stability, including younger age, white race, less severe injuries, preinjury employment, higher annual earnings, male sex, higher education, transportation independence postinjury, and no anxiety or depression at 1 year post-TBI. Conclusions: Employment stability serves as an important measure of productivity post-TBI. Psychosocial, clinical, environmental, and demographic factors predict employment stability post-TBI. Notable predictors include transportation independence as well as the presence of anxiety and depression at year 1 post-TBI as potentially modifiable intervention targets.

KW - Employment

KW - Mental health

KW - Neuropsychology

KW - Rehabilitation

KW - Traumatic brain injury

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