Work Productivity Loss After Mild Traumatic Brain Injury

被引:49
作者
Silverberg, Noah D. [1 ,2 ,3 ]
Panenka, William J. [4 ,5 ]
Iverson, Grant L. [3 ,6 ,7 ,8 ]
机构
[1] Univ British Columbia, Div Phys Med & Rehabil, Vancouver, BC, Canada
[2] GF Strong Rehab Ctr, Rehabil Res Program, 4255 Laurel St, Vancouver, BC V5Z 2G9, Canada
[3] Harvard Med Sch, Dept Phys Med & Rehabil, Boston, MA USA
[4] British Columbia Neuropsychiat Program, Vancouver, BC, Canada
[5] Univ British Columbia, Dept Psychiat, Vancouver, BC, Canada
[6] Spaulding Rehabil Hosp, Boston, MA USA
[7] A Red Sox Fdn, Home Base, Boston, MA USA
[8] Massachusetts Gen Hosp Program, Boston, MA USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2018年 / 99卷 / 02期
关键词
Craniocerebral trauma; Occupational health; Post-concussion syndrome; Presenteeism; Rehabilitation; Return to work; HEAD-INJURY; TO-WORK; DSM-IV; RETURN; SYMPTOMS; CONCUSSION; DISABILITY; EMPLOYMENT; PREDICTION; COMPLAINTS;
D O I
10.1016/j.apmr.2017.07.006
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objectives: To examine the completeness of return to work (RTW) and the degree of productivity loss in individuals who do achieve a complete RTW after mild traumatic brain injury (MTBI). Design: Multisite prospective cohort. Setting: Outpatient concussion clinics. Participants: Patients (N=79; mean age, 41.5y; 55.7% women) who sustained an MTBI and were employed at the time of the injury. Participants were enrolled at their first clinic visit and assessed by telephone 6 to 8 months postinjury. Interventions: Not applicable. Main Outcome Measures: Structured interview of RTW status, British Columbia Postconcussion Symptom Inventory (BC-PSI), Lam Employment Absence and Productivity Scale (LEAPS), Mini International Neuropsychiatric Interview, and brief pain questionnaire. Participants who endorsed symptoms from >= 3 categories with at least moderate severity on the BC-PSI were considered to meet International Classification of Diseases, 10th Revision criteria for postconcussional syndrome. RTW status was classified as complete if participants returned to their preinjury job with the same hours and responsibilities or to a new job that was at least as demanding. Results: Of the 46 patients (58.2%) who achieved an RTW, 33 (71.7%) had a complete RTW. Participants with complete RTW had high rates of postconcussional syndrome (44.5%) and comorbid depression (18.2%), anxiety disorder (24.2%), and bodily pain (30.3%). They also reported productivity loss on the LEAPS, such as "getting less work done" (60.6%) and "making more mistakes" (42.4%). In a regression model, productivity loss was predicted by the presence of postconcussional syndrome and a comorbid psychiatric condition, but not bodily pain. Conclusions: Even in patients who RTW after MTBI, detailed assessment revealed underemployment and productivity loss associated with residual symptoms and psychiatric complications. (C) 2017 by the American Congress of Rehabilitation Medicine
引用
收藏
页码:250 / 256
页数:7
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