HSR&D Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital, Tampa, Florida; Mental Health and Behavioral Sciences Service, James A. Haley Veterans Hospital, Tampa, Florida; Department of Medicine, University of South Florida, Tampa, Florida.
OBJECTIVE: To examine incidence and predictors of employment stability in Veterans and Military Service Members (V/SM) with traumatic brain injury (TBI) who return to work.
DESIGN: Prospective observational cohort study. SETTING: Four Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs). PARTICIPANTS: 110 V/SM with mild (26%), moderate (22%), or severe (52%) TBI enrolled in the VA PRC TBI Model Systems database within 2 years of injury who were discharged between January 2009 and June 2015. MAIN OUTCOME MEASURES: Employment stability as reflected by competitive employment at 1- and/or 2-year follow-up.
RESULTS: Over half (n=61, 55%) had stable employment at the time the first competitive employment date was recorded. Individuals with stable employment were more likely to be Caucasian (79%) and to have slightly higher cognitive and motor discharge scores on the Functional Independence Measure (FIM(TM)). Based on univariate analysis, more severe TBI and higher FIM(TM) motor scores at discharge were significantly associated with employment stability. At follow up, compared with V/SM who had unstable employment, those with stable employment had higher scores on motor and cognitive FIM(TM) and lower scores of self-report symptoms on the Neurobehavioral Symptom Inventory, the 9-item Patient Health Questionnaire-Depression , the 7-item Generalized Anxiety Disorder Questionnaire, and the PTSD Checklist-Civilian version.
CONCLUSIONS: A number of unique factors affect employment stability in V/SM with TBI. Study findings identify V/SM who have stable employment and predictors of employment stability.