Ulla Johansson

The aim of this study was to describe to what extent individuals of working age, in a late phase after an acquired brain injury, participate in everyday occupations related to home maintenance, work, and leisure. The aim was also to evaluate if participation in different occupations influences their life satisfaction. A sample of 157 people consecutively admitted to a rehabilitation clinic between June 1995 and December 2000 answered a mailed questionnaire. The subjects who were of working age had had a brain injury on average 6 years before this study. The perceived participation was reported using the Reintegration to Normal Living Index (RNL) and life satisfaction according to an expanded version of the LiSat 11. This study showed that in this late phase of recovery after brain injury the subjects still experienced many restrictions in participation in everyday occupations. The area with the lowest reported participation was work activity while most comfort with the situation was reported for self-care. The RNL subscales showed a significant connection with satisfaction with life as a whole. Furthermore an interaction was found between the two subscales "Daily living" and "Perception of self". This study showed restrictions in participation in the community even several years after brain injury, which underlines the need for rehabilitation services long after injury.

Track: Occupational Health, European Journal of Public Health, Volume 16, Issue suppl_1, 1 October 2006, Pages 191–195, https://doi.org/10.1093/eurpub/ckl217

PURPOSE. Research in the field of brain injury rehabilitation has tended to regard return to work as a measure of outcome. Researchers have not paid particular attention to the experiences of people living with a brain injury. The aim of the phenomenological study reported here was to identify and describe what characterizes the meaning of work to those with acquired brain injury. METHODS. Ten participants of working age were interviewed about the meaning of work 1–5 years after being inflicted with a brain injury. Data were analyzed and interpreted using the Empirical Phenomenological Psychological method. RESULTS. The findings revealed a meaning structure consisting of four main characteristics. Work was no longer experienced as the primary event in life and the social dimension had become more important. The perceived competence and work identity were threatened after the injury. A common theme across all interviews was the struggle to return to a state of normality, and working was considered to be evidence of success. CONCLUSION. The findings described the altered meaning of work 1–5 years after brain injury. This knowledge should lead to an increased understanding among occupational therapists engaged in work rehabilitation after brain injury and can serve as a basis for individualized intervention strategies.

Purpose: The aim of this study was to assess the subjective life satisfaction after brain injury and its relation to work re-entry. Method: The research design was a longitudinal study. Thirty-six individuals answered a questionnaire at 3 and 6 years after admittance to a rehabilitation programme. The questionnaire addressed work status, job satisfaction, subjective symptoms of illness and life satisfaction. Results: The reported life satisfaction both for life as a whole and for different domains of life was low. No significant difference between follow-ups was found for satisfaction with life as a whole. For the domain IADL activities, the subjects reported a statistically significant lower satisfaction at the second follow-up than at the first. No correlation between work status and subjective satisfaction with life as a whole was found in this population. At the second follow-up, significantly more people were satisfied with IADL in the group that had returned to work. Conclusions: The results from this study indicate that brain injury has a lasting effect on a person’s life also many years after onset. The decreasing satisfaction with the ability to perform IADL-activities in a long-term perspective should give implications for clinical practice. More research in this area is needed.

Purpose: The aim of this study was to evaluate the value of occupational therapy assessments used in an outreach rehabilitation programme to predict return to work after brain injury. The assessments represent the ICIDH-2 levels of body function and activity. Method: Fifty-six persons in a late phase after brain injury who had been admitted to the rehabilitation programme during 2 years were followed up according to work status. The follow up was made at a minimum of 2 years after injury. Demographic data and scores from the occupational therapy assessments were compared for the two groups who were back to work or studies (BTW) and not back to work or studies (NBTW). Results: Assessments of memory, visual perception and apraxia separated between the two groups BTW and NBTW. Logistic regression showed that memory score in combination with data on PADL made up the best predictive model. In a subgroup with 21 persons where data on IADL were added to memory and PADL the predictive value was even stronger. Conclusions: In this study we found that occupational therapy assessments were valuable in predicting failure to return to work or studies after brain injury.