A vocational intervention that enhances return to work after severe acquired brain injury: A pragmatic trial - 05/12/23
, Philippa McRae a, d, Thomas M. Gates a, Maysaa Daher a, d, Deborah Johnston b, c, Ian D. Cameron b, c
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | A partnership model helped return to work post-acquired brain injury. |
• | Brain injury mentors helped vocational providers provide return to work services. |
• | Partnership model was as effective as a specialist brain injury vocational service. |
• | Both models were more successful than treatment as usual. |
Abstract |
Background |
Following a severe acquired brain injury, individuals often have low return to work rates. The Vocational Intervention Program (VIP), a partnership of Brain Injury Rehabilitation Program community rehabilitation centres with external vocational rehabilitation providers in New South Wales, Australia, was developed to facilitate a return to competitive employment for working-age people.
Objectives |
To evaluate the efficacy of the VIP partnership model, this intervention was compared to outcomes from a health-based brain injury vocational rehabilitation centre (H-VR) or community brain injury rehabilitation centres (“treatment as usual”; TAU).
Methods |
A 3-arm non-randomized controlled trial was conducted among the 12 adult rehabilitation centres of the NSW Brain Injury Rehabilitation Program. The VIP arm was delivered by 6 community rehabilitation centres in partnership with 3 external private Vocational Rehabilitation providers. The H-VR arm was delivered by 1 health-based vocational rehabilitation centre and the 5 remaining centres delivered TAU. Competitive employment status (“Yes”/“No”) and clinician ratings of disability and participation were collected pre- and post-intervention, and at 3-month follow-up. Multilevel models were conducted to investigate change over time by treatment arm.
Results |
In total, 148 individuals with severe brain injury were included in the trial: n = 75 (VIP), n = 33 (H-VR) and n = 40 (TAU). Sixty-five people (of 108, 60%) completed the VR intervention. A significant arm-by-time interaction was found, with higher return to work rates from pre- to post-intervention in VIP and H-VR arms compared to TAU (P = 0.0002). Significant arm-by-time interactions also indicated improved work-related participation and independent living skills from pre- to post-intervention in VIP and H-VR compared to the TAU arm (P < 0.05). These improvements were maintained at 3-month follow-up.
Conclusions |
The VIP improved return to competitive employment at comparable rates to the specialist H-VR. Larger-scale adoption of the VIP model could provide significant improvements in vocational rehabilition sevices to support people in their return to work following severe brain injury.
ANZCTR Trial Registry Number |
ACTRN12622000769785
Le texte complet de cet article est disponible en PDF.Keywords : Acquired brain injury, Clinical trial, Employment, Return to work, Traumatic brain injury, Vocational rehabilitation
Abbreviations : ABI, BIRP, CONSORT, DEX, DRS, H-VR, HoNOS-ABI, LTFU, ML, NSW, PTA, REML, RTW, SPRS-2, TAU, TBI, VCC, VIP, VR
Plan
Vol 66 - N° 8
Article 101787- novembre 2023 Retour au numéro
Article précédent
- Editorial board
- Combined visual and auditory cues do not improve virtual spatial navigation after traumatic brain injury
- Mélanie Cogné, Arthur Delayre, Pauline Coignard, Jean-Luc Le Guiet, Pierre-Alain Joseph, Isabelle Bonan, Eric Sorita, Claire Le Gall, Philippe Azouvi
Bienvenue sur EM-consulte, la référence des professionnels de santé.