Employment Stability in Veterans and Service Members with Traumatic Brain Injury:A VA Traumatic Brain Injury Model Systems Study

Publication date: Available online 17 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Christina Dillahunt-Aspillaga, Mary Jo Pugh, Bridget A. Cotner, Marc A. Silva, Adam Haskin, Xinyu Tang, Marie E. Saylors, Risa Nakase-Richardson
ObjectiveTo examine incidence and predictors of employment stability in Veterans and Military Service Members (V/SM) with traumatic brain injury (TBI) who return to work.DesignProspective observational cohort study.SettingFour Department of Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs).Participants110 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 MeasuresEmployment stability as reflected by competitive employment at 1- and/or 2-year follow-up.ResultsOver 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.ConclusionsA 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.



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