Impact of cognitive and behavioural functioning on vocational outcome following traumatic brain injury: a systematic review

Abstract

Purpose

Individuals with traumatic brain injury (TBI) often present injury-related cognitive and behavioural sequelae hindering a successful professional outcome, even many years after injury. The aim of this study was to investigate cognitive and behavioural factors predicting vocational outcome in the post-acute stages (≥one year) of TBI.

Methods

A systematic review of empirical research about vocational outcome of individuals with TBI was conducted. Studies published in PubMed and PsycINFO from 1 January 1998 to 31 May 2019 were screened. Only studies using the same injury severity criteria (the Glasgow Coma Scale score and/or the duration of post-traumatic amnesia) were selected.

Results

We found that (1) self-reported symptoms, (2) Functional Independence Measure and Mayo-Portland Adaptability Inventory Scores, (3) alcohol abuse and mood disorders, and (4) Differentiated Outcome Scale Cognitive Scores in individuals with TBI were highly predictive of the vocational outcome.

Conclusion

This systematic review emphasized the link between cognitive and behavioural functioning and vocational rehabilitation in individuals with TBI. However, scientific literature lacks cognitive and behavioural models predicting vocational outcome of these individuals, including academic or vocational training. Such models would allow clinicians to improve vocational guidance of these individuals.

Implications for rehabilitation

• Cognitive and behavioural assessment is highly important even many years after traumatic brain injury, especially in a social and professional rehabilitation context.

• Clinicians should integrate objective measures of cognition and behaviour in post-acute phases of traumatic brain injury.

• Identifying vocational outcome related cognitive and behavioural patterns of functioning would allow clinicians to improve vocational guidance of adults with traumatic brain injury.

Keywords:

• Brain injuries
• traumatic
• cognition
• neuropsychology
• rehabilitation
• vocational
• return to work
• systematic review

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the French Public Health Research Institute (IReSP) and National Solidarity Fund for Autonomy (CNSA), including a doctoral contract to Romina Manoli. Funding was also provided by the French Society of Physical and Rehabilitation Medicine (SOFMER), through France Traumatic Brain Injury Prize 2014.