2014-07-01 12:00 - Messages

Recovery from mental conditions

Is it different between TBI/non-TBI
OBJECTIVES: This study aimed to determine the rates of psychological symptoms among those with traumatic brain injury (TBI) and with non-TBI at 3 months and 12 months after occupational injury and to examine the change in psychological status over time.
METHOD: Our study candidates were injured workers in Taiwan who were hospitalised for 3 days or longer and received hospitalisation benefits from the Labour Insurance. A self-reported questionnaire including Brief Symptom Rating Scale (BSRS-50) and Post-traumatic Symptom Checklist (PTSC) was sent to workers at 3 months and 12 months.
RESULTS: Among 853 injured workers who completed the questionnaire at 3 and 12 months, regarding to the severity of BSRS score, 7.8% of those with TBI had recovered at 12 months, comparing with 8.1% in those with non-TBI. On the other hand, approximately11.6% of those with TBI had recovered from post-traumatic stress symptoms at 12 months, comparing with 9.7% among those with non-TBI. Injured workers with TBI had lower rate of recovery from psychological symptoms, comparing with non-TBI.
CONCLUSIONS: A significant proportion of victims with TBI and non-TBI suffered psychological symptoms after injury. The identification and treatment of psychological symptoms are important for optimal adaptation after traumatic injury.

Source: Lin KH, Shu-Chu Shiao J, Liao SC, Kuo CY, Leon Guo Y, Guo NW. Occup. Environ. Med. 2014; 71(Suppl 1): A72.
http://dx.doi.org/10.1136/oemed-2014-102362.224

Troubles mentaux : quelles conséquences sur le maintien dans l'emploi ?

Environ 12 % des femmes et 6 % des hommes âgés de 30 à 55 ans, qui travaillent en 2006, déclarent souffrir au moins d'un trouble mental (trouble anxieux généralisé ou épisode dépressif caractérisé). Parmi ces personnes, plus de 20 % invoquent une limitation d'activité, environ 45 % indiquent souffrir d'une maladie chronique et près de la moitié se considèrent en mauvaise santé.
Ces données statistiques sont issues de l'enquête Santé et itinéraire professionnel (SIP), réalisée conjointement par la DREES et la DARES, en 2006 et 2010.
Les personnes déclarant souffrir de troubles mentaux ont sensiblement moins de chances de garder une activité professionnelle que celles qui n'en ont pas signalé. En effet, 86 % des femmes et 82 % des hommes porteurs de ces troubles ont conservé une activité professionnelle en 2010, contre respectivement 92 % et 93 % des personnes n'en déclarant pas.
Les troubles anxieux généralisés affectent la trajectoire professionnelle des hommes, mais pas celle des femmes. Ce sont les limitations d'activité déclarées qui augmentent le plus le risque de ne pas garder son emploi.
Le rôle propre de la santé mentale (en regard des poids respectifs de l'état de santé général et des comportements à risque) reste, cependant, à apprécier, car les caractéristiques individuelles et professionnelles ont traditionnellement une incidence sur le maintien dans l'emploi.
Ainsi, parmi les variables socio-économiques, l'âge au-delà de 50 ans, la présence d'enfants et le travail à temps partiel (chez les femmes), le niveau de diplôme ainsi que la profession et la catégorie socioprofessionnelle (chez les hommes) ont un effet significatif sur la capacité des personnes à conserver un emploi.

Source: http://www.drees.sante.gouv.fr/IMG/pdf/er885.pdf

Exploring factors facilitating adults with spinal cord injury rejoining the workforce

A pilot study
BACKGROUND: Return-to-work (RTW) rates after spinal cord injury (SCI) in the USA are very low and are continuing to decline. Previous research has attempted to identify factors facilitating RTW; however, the phenomenon of RTW involves many personal factors and predicting RTW success remains difficult.
PURPOSE: The purpose of this pilot study was to explore the factors facilitating adults with SCI rejoining the workforce in an urban area in order to identify items that may be emphasized in the rehabilitation process.
METHODS: The study was completed using qualitative methods. Four adults who had acquired a traumatic SCI in adulthood and were currently employed participated. Their experiences in RTW after injury were collected via semi-structured interviews and photography of assistive devices.
RESULTS: The most common facilitating factor was motivation, with family and rehabilitation professionals serving as extrinsic motivators. Other facilitators were resources and perceived benefits.
CONCLUSIONS: Motivation and resources were important facilitators, including rehabilitation professional's personal influence and therapies, and resource assistance from state agencies. The results indicate that practitioners can play an important role in influencing RTW, and resources from state agencies are helpful when individuals know how to access and utilize them. Implications for Rehabilitation Assistive technology supports successful return to work after SCI. Motivation strongly influences return to work after SCI and can be influenced by rehabilitation professionals, family and community members. Patients should be well informed about how to access assistance programs such as vocational rehabilitation.

Source: Wilbanks SR, Ivankova NV. Disabil. Rehabil. 2014.
http://dx.doi.org/10.3109/09638288.2014.938177

Systematic review of return to work after mild traumatic brain injury

Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis
OBJECTIVE: To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched. STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases. DATA EXTRACTION: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. DATA SYNTHESIS: Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude. CONCLUSIONS: Our findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).

Source: Cancelliere C, Kristman VL, Cassidy JD, Hincapié CA, Côté P, Boyle E, Carroll LJ, Stålnacke BM, Nygren-de Boussard C, Borg J. Arch. Phys. Med. Rehabil. 2014; 95(3S): S201-S209.
http://dx.doi.org/10.1016/j.apmr.2013.10.010

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