Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective

Matérne, Marie; Lundqvist, Lars–Olov; Strandberg, Thomas

doi:10.3233/wor-162468

Cited by 44 publications

(32 citation statements)

References 30 publications

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“…Detailed information from payroll data allowed us to calculate daily time-varying exposures thereby reducing misclassification. Moreover, by using a one year wash-out period prior to entry and only the first injury, we reduced the risk of reverse causation due to previous injuries, which may alter work patterns afterwards (44). All injuries (occupational, commuting and leisure time injuries) were included from national emergency room and death registers reducing the risk of bias from underreporting (45,46).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Risk of injury after evening and night work – findings from the Danish Working Hour Database

Nielsen¹,

Larsen²,

Dyreborg³

et al. 2018

Scand J Work Environ Health

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Objectives Evening and night work have been associated with higher risk of injury than day work. However, previous findings may be affected by recall bias and unmeasured confounding from differences between day, evening and night workers. This study investigates whether evening and night work during the past week increases risk of injury when reducing recall bias and unmeasured confounding. Methods We linked daily working hours at the individual level of 69 200 employees (167 726 person years from 2008-2015), primarily working at hospitals to registry information on 11 834 injuries leading to emergency room visits or death. Analyses were conducted with Poisson regression models in the full population including permanent day, evening and night workers, and in two sub-populations of evening and night workers, with both day and evening or night work, respectively. Thus, the exchangeability between exposure and reference group was improved in the two sub-populations. Results Risk of injury was higher after a week with evening work [incidence rate ratio (IRR) 1.32, 95% confidence interval (CI) 1.26-1.37] and night work (IRR 1.33, 95% CI 1.25-1.41) compared with only day work. Similar, although attenuated, estimates were found for evening work among evening workers (IRR 1.18, 95% CI 1.12-1.25), and for night work among night workers (IRR 1.10, 95% CI 1.01-1.20). Conclusion There is an overall increased risk of injury after a week that has included evening or night work compared with only day work. Though attenuated, the higher risk remains after reducing unmeasured confounding.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Risk of injury after evening and night work – findings from the Danish Working Hour Database

Nielsen¹,

Larsen²,

Dyreborg³

et al. 2018

Scand J Work Environ Health

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“…Such factors can affect the person's ability to regain functional independence and return to work (7). Return to work is an important rehabilitation goal for many survivors of TBI (8). Employment provides economic security, but supports physical, psychological and social health (9).…”

Section: Introductionmentioning

confidence: 99%

Can a Complex Vocational Rehabilitation Intervention Be Delivered With Fidelity? Fidelity Assessment in the Fresh Feasibility Trial

Holmes

Fletcher-Smith

Merchán-Baeza

et al. 2020

Preprint

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Background:Determining whether complex rehabilitation interventions are delivered with fidelity is important as differences can occur between sites, therapists delivering the intervention and over time; threatening trial outcomes and increasing the risk of Type II and Type III errors. Aims: to (1) evaluate implementation fidelity of vocational rehabilitation delivered in FRESH, a multi-centre feasibility randomised controlled trial; and (2) understand factors affecting delivery. Methods:Mixed methods evaluation. Fidelity was measured quantitatively using intervention case report forms, fidelity checklists and clinical records. Qualitative data from mentoring records, interviews with the intervention therapists, participants and their employers and NHS staff at each site explored moderators of implementation fidelity. The quantitative and qualitative data informed data collection tools and analysis. Data were examined against a logic model and benchmarked against an earlier cohort study. Results:Analysis of 38 clinical records (one per participant), 699 content CRFs (42-248 per therapist) and 12 fidelity checklists suggest intervention was delivered as intended. The core intervention process was followed in each case despite therapist variation. Qualitative data from clinical records, fidelity checklists, 183 mentoring records and 38 interviews (4 therapists, 15 trial participants, 6 employers and 13 NHS staff) explained factors affecting intervention fidelity. Fidelity moderators were similar across sites. Facilitators included therapists’ community rehabilitation experience, expert mentoring, and ability to individually tailor intervention. Barriers involved a lack of access to NHS systems no backfill and limited line-manager support. Factors that both helped or hindered intervention delivery were effective communication with participants, intervention acceptability, participants’ changing needs and interagency working. Different fidelity measures answered different questions. Fidelity checklists determined whether intervention processes were followed and explained moderators. Interviews provided insights into acceptability. Adherence was determined by content forms. Mentoring records described implementation barriers and how they were overcome.Conclusions:Mixed methods fidelity assessments enable trialists to identify factors likely to affect intervention fidelity in a definitive trial and longer-term clinical implementation. Mentoring provided insight into engagement and fidelity deviations that could be addressed in real-time, facilitating fidelity and offering a window on trial processesTrial registration: ISRCTN Registry, ISRCTN38581822 (Registered: 02/01/2014) (https://doi.org/10.1186/ISRCTN38581822)

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“…Physical impairment (3) as well as reduced cognitive function such as fatigue, memory and concentration problems are common, affecting the patient's functioning in everyday life (4,5). With reduced cognitive function, it becomes harder to manage social life, living independently (6,7), getting a job or returning to work (8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…One of the most important factors for improving QoL is being able to return to work (8)(9)(10)(11)(12)(13). Studies show that people who had returned to work rated their QoL higher than those who had not returned to work (8,9,11,12).…”

Section: Introductionmentioning

confidence: 99%

Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study

2018

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Purpose: This study investigated changes in quality of life (QoL) in relation to return to work among patients with acquired brain injury (ABI). Method: The sample consisted of 1487 patients with ABI (63% men) aged 18-66 years (mean age 52) from the WebRehab Sweden national quality register database. Only patients who worked at least 50% at admission to hospital and were on full sick leave at discharge from hospital were included. QoL was measured by the EuroQol EQ-5D questionnaire. Results: Patients who returned to work perceived a larger improvement in QoL from discharge to followup one year after injury compared to patients who had not returned to work. This difference remained after adjustment for other factors associated with improved QoL, such as having a university education, increased Extended Glasgow Outcome Scale scores and getting one's driving licence reinstated. Conclusion: Return to work is an important factor for change in QoL among patients with ABI, even after adjusting for other factors related to QoL. This is consistent with the hypothesis that having employment is meaningful, increases self-esteem and fosters participation in society. Thus, helping patients with ABI return to work has a positive influence on QoL.

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Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective

Cited by 44 publications

References 30 publications

Risk of injury after evening and night work – findings from the Danish Working Hour Database

Risk of injury after evening and night work – findings from the Danish Working Hour Database

Can a Complex Vocational Rehabilitation Intervention Be Delivered With Fidelity? Fidelity Assessment in the Fresh Feasibility Trial

Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study

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