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  • 1.
    Matérne, Marie
    Örebro University, School of Health Sciences.
    Återgång i arbete efter förvärvad hjärnskada: livskvalitet, möjligheter och hinder2018Doctoral 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.

    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: 2019-03-26Bibliographically 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, Vol. 32, no 13-14, p. 1731-1739Article in journal (Refereed) Published
    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
    Taylor & Francis Group, 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)000453393600016 ()30296173 (PubMedID)2-s2.0-85054574457 (Scopus ID)
    Note

    Funding Agency:

    University Health Care Research Centre, Region Örebro County, Sweden

    Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2019-01-08Bibliographically 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
  • 2.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective2017In: 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)
    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.

  • 3.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden.
    Successful return to work after acquired brain injury: opportunities and barriers from a patient perspective2016In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, no 5-6, p. 516-516Article in journal (Other academic)
    Abstract [en]

    Background: Acquired brain injury (ABI) is often a lifelong disability that entails a marked change in a person’s life. It involves biopsychosocial levels and return to work (RTW) is one of the main goals for the person. Several of those suffering an ABI are of working age. The society and the individuals are both winners if the person could get back to work and sustain working.

    Objective: The aim of this study was to increase knowledge about the opportunities and barriers for successful RTW among individuals with ABI.

    Methods: Adults who have ABI and had participated in work rehabilitation were interviewed in regard to their experiences of the process. The informants (five females, five males) had participated in work rehabilitation, had successfully RTW and had worked at least 50% in at least a year after the injury. The interviews were transcribed, structured and analysed by latent content analysis with a hermeneutic approach.

    Results: Three main themes that influenced RTW after ABI were identified: (i) individually adapted rehabilitation process, (ii) motivation for RTW and (iii) cognitive abilities and inabilities. The results indicate that an individually adapted vocational rehabilitation (VR) process was an important issue. The individuals with ABI actively involved in their own rehabilitation process also required continuous support from the society, the specialists, their employers and colleagues; this support has to be designed for each individual. A moderate level of motivation for RTW was necessary for the best result to RTW, in other words it was important to achieve a balance between too high and too low motivation. Finally, a comprehensive knowledge about the cognitive abilities and inabilities of the individual after ABI helped the individuals and their employers to find compensatory strategies to handle their work tasks. One implication of the findings was the necessity of a good support system and a good VR that functions well and lasts for a longer period. When there are obstacles in the VR process, it is important to have strategies and awareness of how to proceed further.

    Conclusions: Consequently, the support built for a person individually, with a balanced motivation, knowledge about the cognitive abilities and awareness of how to proceed further in the process will help to build a successful and sustainable RTW.

  • 4.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. Region Örebro County.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. Region Örebro County.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Successful return to work after acquired brain injury: support person’s perception of supporting2017Conference paper (Other academic)
    Abstract [en]

    Introduction and aim:

    Return to work (RTW) after acquired brain injury (ABI) is a demanding process for the client and need support. This study’s aim was to understand the support person’s perception of supporting clients with ABI to a successful RTW.

    Method:

    Nine persons who acted as support persons in the vocational rehabilitation (VR) process were chosen by clients with ABI participating in a previous study. Three of the support persons had a formal mandate to support the client by the employer and six of them were characterized as providing informal support. All the support persons had different kind of work. Semi structured interviews were conducted and analyzed by latent content analysis.

    Findings:

    The analysis elicited three themes describing the support person’s perception in the assistance for the client to successfully RTW: (i) Commitment, (ii) Adaptation and (iii) Cooperation. Within each of the theme multiple mechanisms were identified, reflecting the complexity that the VR process had for the client. The mechanisms were about strategic issues, reflection and decision making. The support persons experienced that their role was extra valuable for the client in contexts where adaptation and cooperation was required. Commitment built on social relations is linked to sustainability of the support.

    Conclusion:

    Support persons play a multi-dimensional role which is important for client with ABI to successfully RTW.

  • 5.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center (UFC), Faculty of Medicine and Health, Örebro University, Örebro, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center (UFC), Faculty of Medicine and Health, Örebro University, Örebro, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center (UFC), Faculty of Medicine and Health, Örebro University, Örebro, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Successful return to work after acquired brain injury: support persons’ perception of supporting2017Conference paper (Refereed)
  • 6.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Support Persons’ Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden: 2018In: Contemporary Perspectives on Social Work in Acquired Brain Injury / [ed] Grahame K. Simpson, Francis K. Yuen, Routledge , 2018, 1, p. 183-201Chapter in book (Refereed)
  • 7.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. The Swedish Institute for Disability Research.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. The Swedish Institute for Disability Research.
    Support Persons' Perceptions of Giving Vocational Rehabilitation Support to Clients With Acquired Brain Injury in Sweden2016In: 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)
    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.

  • 8.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study2018In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 32, no 13-14, p. 1731-1739Article in journal (Refereed)
    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.

  • 9.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. Centre for Rehabilitation Research, Region Örebro County, Örebro, Sweden; .
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. Centre for Rehabilitation Research, Region Örebro County, Örebro, Sweden .
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    Opportunities and barriers for successful return to work after acquired brain injury: A client perspective2015Conference paper (Other academic)
    Abstract [en]

    Research aim

    The aim of this study was to increase our knowledge about the opportunities and barriers for successfully return to work (RTW) among individuals with acquired brain injury (ABI).

    Methodology

    Adults who have ABI were interviewed in regard to their experiences of the work rehabilitation process. The informants (5 females, 5 males) had participated in a work rehabilitation, had successfully RTW and had worked at least 50 % in at least a year after the injury. The interviews were transcribed, structured and analyzed by latent content analysis with a hermeneutic approach.

    Findings and conclusions

    Three main themes that influenced RTW after ABI were identified: (i) individually adapted rehabilitation process, (ii) motivation for RTW and (iii) cognitive abilities and inabilities.

    The findings indicated that an individually adapted vocational rehabilitation (VR) process was important because the individuals with ABI involved actively in their own rehabilitation process and they required continuous support from the society, the specialists, their employers and colleagues. A moderate level of motivation for RTW was necessary to achieve the best result for RTW and it was important to achieve a balance between too high and too low motivation. Finally, a comprehensive knowledge about the cognitive abilities and inabilities of the individual after ABI helped the individuals and their employers to find compensatory strategies to handle their work tasks.

    One implication of the findings was the necessity of a good support system and a good VR that functions well and lasts for a longer period. When there are obstacles in the VR process, it is important to have strategies and awareness of how to proceed further.

    Consequently the support built for a person individually, with a balanced motivation, a high knowledge about the cognitive abilities and awareness of how to proceed further in the process will help to build a successful and sustainable RTW.

     

  • 10.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Örebro University Hospital, Örebro, Sweden; The Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. The Swedish Institute for Disability Research (SIDR).
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center, Örebro University Hospita, Örebro, Sweden; The Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden.
    Patients experiences of opportunities and barriers for successful return to work after acquired brain injury2015Conference paper (Refereed)
  • 11.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. 1University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Risk markers for not returning to work among patients with acquired brain injury: a population-based register studyManuscript (preprint) (Other academic)
  • 12.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health.
    Strandberg, Thomas
    Örebro University, School of Law, Psychology and Social Work.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Risk Markers for Not Returning to Work Among Patients with Acquired Brain Injury: A Population-Based Register Study2019In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study is to investigate person-related, injury-related, activity-related and rehabilitation-related risk markers for not return to work among patients with acquired brain injury (ABI).

    Methods: Retrospective data from the Quality register, WebRehab Sweden, on an ABI cohort of 2008 patients, was divided into two groups: those who had returned to work (n = 690) and those who had not returned to work (n = 1318) within a year of the injury.

    Results: Risk ratio analyses showed that several factors were risk markers for not returning to work: personal factors, including being a woman, being born outside of Sweden, having a low education level, and not having children in the household; injury-related factors, including long hospital stay (over 2 months), aphasia, low motor function, low cognitive function, high pain/discomfort, and high anxiety/depression; activity-related factors, including low function in self-care, inability to perform usual activities, and not having a driver's license; and rehabilitation-related factors, including being dissatisfied with the rehabilitation process and the attentiveness of the staff having limited influence over the rehabilitation plan, or not having a rehabilitation plan at all. Conclusion Several factors in different aspects of life were risk markers for not returning to work among patients with ABI. This suggests that rehabilitation and interventions need to address not only direct injury-related issues, but also person-related, activity-related, and rehabilitation-related factors in order to increase the patient's opportunities to return to work.

  • 13.
    Strandberg, Thomas
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Matérne, Marie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Rehabil Res Ctr, Swedish Inst Disabil Res, Örebro Univ Hosp, Örebro, Sweden.
    Returning to working life after acquired brain injury: The rehabilitation-process, possibilities and hindrance for participation2014In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 28, no 5-6, p. 754-754Article in journal (Other academic)
  • 14.
    Strandberg, Thomas
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Matérne, Marie
    Habiliteringens forskningscentrum, HFC, Örebro läns landsting, Örebro, Sweden.
    Återkomst i arbetslivet efter förvärvad hjärnskada2013In: Hjärnskadeforum 2013, 2013Conference paper (Refereed)
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