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Återgång i arbete efter förvärvad hjärnskada: livskvalitet, möjligheter och hinder
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-7048-1925
2018 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In Sweden, about 35–40 percent of people who acquire a brain injury can return to work. To be able to help people with acquired brain injury to return to work, it is important to know about experiences and factors that facilitate return to work and how they affect quality of life. The overall aim of this thesis is to investigate the opportunities and barriers for people with acquired brain injury to return to work, as well as the importance of returning to work for their quality of life. Four studies were conducted: two interview studies and two register studies, giving qualitative and quantitative data.The major finding in this thesis was that people with acquired brain injury who could return to work had high functioning in all levels of the biopsychosocial model. The opportunities increased if the return to work was individually adapted in all phases of the process and if the person was motivated and supported by support persons with commitment, cooperation and adaptation. Those who had a university education, got their driver’s license reinstated, had high motor function and could return towork showed the greatest increase in their quality of life.Return to work is a complex process for people with acquired brain injury that could be successful if they are motivated, can balance the internal and external demands to return to work, get individual adaptation, and receive committed support. Their quality of life also increased more if theywere able to return to work.

Place, publisher, year, edition, pages
Örebro: Örebro University , 2018. , p. 120
Series
Studies from The Swedish Institute for Disability Research, ISSN 1650-1128 ; 94
Keywords [en]
Return to work, acquired brain injury, rehabilitation, quality of life, quality inference, register analysis
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-69352ISBN: 978-91-7529-267-0 (print)OAI: oai:DiVA.org:oru-69352DiVA, id: diva2:1254009
Public defence
2018-12-14, Örebro universitet, Prismahuset, Hörsal P1, Fakultetsgatan 1, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-10-08 Created: 2018-10-08 Last updated: 2018-11-19Bibliographically approved
List of papers
1. Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective
Open this publication in new window or tab >>Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective
2017 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 56, no 1, p. 125-134Article in journal (Refereed) Published
Abstract [en]

Background: Many people who suffer an acquired brain injury (ABI) are of working age. There are benefits, for the patient, the workplace, and society, to finding factors that facilitate successful return to work (RTW).

Objective: The aim was to increase knowledge of opportunities and barriers for a successful RTW in patients with ABI.

Method: Five men and five women with ABI participated. All had successfully returned to work at least 20 hours a week. Their experiences were gathered by semi-structured interviews, which were subsequently subjected to qualitative content analysis.

Results: Three themes that influenced RTW were identified: individually adapted rehabilitation; motivation for RTW; and cognitive and social abilities. An individually adapted rehabilitation was judged important because the patients were involved in their own rehabilitation and required individually adapted support from rehabilitation specialists, employers, and colleagues. A moderate level of motivation for RTW was needed. Awareness of the person's cognitive and social abilities is essential, in finding compensatory strategies and adaptations.

Conclusions: It seems that the vocational rehabilitation process is a balancing act in individualized planning and support, as a partnership with the employer needs to be developed, motivation needs to be generated, and awareness built of abilities that facilitate or hinder RTW.

Place, publisher, year, edition, pages
Amsterdam, The Netherlands: IOS Press, 2017
Keywords
Content analysis, vocational rehabilitation, qualitative interviews
National Category
Occupational Therapy Other Medical Sciences
Research subject
Disability Science
Identifiers
urn:nbn:se:oru:diva-54393 (URN)10.3233/WOR-162468 (DOI)000396547500014 ()28035941 (PubMedID)2-s2.0-85012225058 (Scopus ID)
Note

Funding Agencies:

University Health Care Research Center

Region Örebro County Sweden

Swedish Association of Brain Injured and Families

Available from: 2017-02-07 Created: 2017-01-10 Last updated: 2018-11-19Bibliographically approved
2. Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden
Open this publication in new window or tab >>Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden
2016 (English)In: Journal of Social Work in Disability & Rehabilitation, ISSN 1536-710X, E-ISSN 1536-7118, Vol. 15, no 3-4, p. 351-369Article in journal (Refereed) Published
Abstract [en]

The aim is to explore the perception of being a support person for clients with acquired brain injury undergoing vocational rehabilitation. Nine support persons, identified by clients with brain injury, were interviewed. Interviews were analyzed using qualitative content analysis, resulting in three themes for assisting the client: (i) commitment; (ii) adaptation; and (iii) cooperation. Within each theme, multiple dimensions were identified, reflecting the complexity of vocational rehabilitation following acquired brain injury. Commitment built on social relations is linked to sustainability of support. The included support persons' role was especially valuable in contexts where adaptation and cooperation were required.

Place, publisher, year, edition, pages
Routledge, 2016
Keywords
Acquired brain injury, content analysis, empathy and support, inclusion, rehabilitation, return to work, support person, vocational rehabilitation
National Category
Social Work Other Health Sciences
Research subject
Social Work; Disability Science
Identifiers
urn:nbn:se:oru:diva-51616 (URN)10.1080/1536710X.2016.1220880 (DOI)000387348600010 ()27494552 (PubMedID)2-s2.0-84987662485 (Scopus ID)
Available from: 2016-08-09 Created: 2016-08-09 Last updated: 2018-11-19Bibliographically approved
3. Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study
Open this publication in new window or tab >>Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study
2018 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, p. 1-9Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: This study investigated changes in quality of life (QoL) in relation to return to work among patients with acquired brain injury (ABI).

METHOD: The sample consisted of 1487 patients with ABI (63% men) aged 18-66 years (mean age 52) from the WebRehab Sweden national quality register database. Only patients who worked at least 50% at admission to hospital and were on full sick leave at discharge from hospital were included. QoL was measured by the EuroQol EQ-5D questionnaire.

RESULTS: Patients who returned to work perceived a larger improvement in QoL from discharge to follow-up one year after injury compared to patients who had not returned to work. This difference remained after adjustment for other factors associated with improved QoL, such as having a university education, increased Extended Glasgow Outcome Scale scores and getting one's driving licence reinstated.

CONCLUSION: Return to work is an important factor for change in QoL among patients with ABI, even after adjusting for other factors related to QoL. This is consistent with the hypothesis that having employment is meaningful, increases self-esteem and fosters participation in society. Thus, helping patients with ABI return to work has a positive influence on QoL.

Place, publisher, year, edition, pages
Informa Healthcare, 2018
Keywords
Stroke, life satisfaction, rehabilitation, traumatic brain injury, vocational rehabilitation
National Category
Neurology Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-69466 (URN)10.1080/02699052.2018.1517224 (DOI)30296173 (PubMedID)
Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2018-11-19Bibliographically approved
4. Risk markers for not returning to work among patients with acquired brain injury: a population-based register study
Open this publication in new window or tab >>Risk markers for not returning to work among patients with acquired brain injury: a population-based register study
(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-70255 (URN)
Available from: 2018-11-19 Created: 2018-11-19 Last updated: 2018-11-20Bibliographically approved

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Matérne, Marie

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