Exploring employment following traumatic brain injury in persons who completed an insurer funded vocational rehabilitation program in Australia

Abstract

Purpose

To extend the authors’ previous research by investigating the maintenance of work performance over time and the long-term experience of employment following traumatic brain injury (TBI).

Materials and methods

Semi-structured interviews were conducted with a sample of 72 individuals with predominantly severe TBI, up to 10-years post-injury. Thematic analysis of transcribed interviews was conducted.

Results

Four key themes were identified: brain injury influences on work performance and long-term employment; factors optimising long-term employment; and need for compromise and acceptance, which all impacted the final theme, quality of life outcome. While TBI-related difficulties such as fatigue, cognitive, and emotional difficulties still impacted work many years post-injury, work modifications and employer and vocational rehabilitation (VR) support were important factors optimising long-term employment. The timing of return to work (RTW) was also an important and potentially modifiable factor influencing work performance, which appeared to have long-term effects on the maintenance of employment. Support for acceptance of altered career goals is needed.

Conclusion

Findings support the need for early VR to facilitate employer contact, to maximise adjustment and preparation time before RTW, to educate both employees and employers and to implement work modifications to support continuing employment after TBI.

Implications for rehabilitation

• The maintenance of employment following TBI is of critical importance for financial independence, psychological and social well-being, and improved quality of life.

• Injury-related difficulties still impact work performance many years after injury requiring individuals with TBI to continue working in modified roles and for reduced hours over the long-term.

• Ongoing VR and employer support is needed to facilitate long-term work modifications and compensatory strategies to support work performance.

• Early VR involvement to facilitate employer contact and maximise adjustment and preparation time before returning to work is necessary to avoid the negative and potentially dire consequences of returning too early.

• Psychological support to facilitate acceptance of role changes and career compromises is also important.

Keywords:

• Traumatic brain injury
• vocational rehabilitation
• employment
• return to work
• employment stability

Disclosure statement

The authors report no conflicts of interest.