Change in quality of life in relation to returning to work after acquired brain injury: a population-based register study

Abstract

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 followup 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.

Predictive factors of quality of life in acquired brain injury

“…Fourth, in line with previous research (Andelic et al, 2009, Forslund et al, 2013, Jacobsson et al, 2010, Soberg et al, 2013), those who were employed/studying (i.e., active) at the time of the injury showed significantly higher QoL scores, reflecting the importance of a productive lifestyle to QoL (Jacobsson et al, 2010, Soberg et al, 2013). Fifth, living more independently is significantly related to a better QoL (Alcedo et al, 2017, Claes et al, 2012), contrary to Matérne et al (2018) and Kalpakjian et al (2004), who did not find differences regarding living arrangements. Sixth, as expected, the greater the level of support needs, the lower the QoL (González et al, 2016).…”

“…This finding is widely supported by previous ABI research, which reports that QoL decreases as age increases, possibly due to the slow recovery of the elderly (Forslund et al, 2013, Scholten et al, 2015). Second, those with a partner or in a relationship showed a better QoL, reflecting the importance attributed to having a close relationship in the satisfaction of the person (Steadman-Pare et al, 2001, Vieira et al, 2013), although there are also studies that do not find any association (Forslund et al, 2013, Jacobsson et al, 2010, Kalpakjian et al, 2004, Matérne et al, 2018, Sharma et al, 2015). Third, a better QoL was found in those who had completed secondary or higher education compared with those who had no studies, possibly due to the greater opportunities that the education level can generate in access to employment and economic resources (Forslund et al, 2013, Matérne et al, 2018), although this was inconsistent with results by Kalpakjian et al, 2004, Sharma et al, 2015, and Vieira et al (2013).…”

“…Second, those with a partner or in a relationship showed a better QoL, reflecting the importance attributed to having a close relationship in the satisfaction of the person (Steadman-Pare et al, 2001, Vieira et al, 2013), although there are also studies that do not find any association (Forslund et al, 2013, Jacobsson et al, 2010, Kalpakjian et al, 2004, Matérne et al, 2018, Sharma et al, 2015). Third, a better QoL was found in those who had completed secondary or higher education compared with those who had no studies, possibly due to the greater opportunities that the education level can generate in access to employment and economic resources (Forslund et al, 2013, Matérne et al, 2018), although this was inconsistent with results by Kalpakjian et al, 2004, Sharma et al, 2015, and Vieira et al (2013). Fourth, in line with previous research (Andelic et al, 2009, Forslund et al, 2013, Jacobsson et al, 2010, Soberg et al, 2013), those who were employed/studying (i.e., active) at the time of the injury showed significantly higher QoL scores, reflecting the importance of a productive lifestyle to QoL (Jacobsson et al, 2010, Soberg et al, 2013).…”

“…This implies that females are at risk of poorer outcomes than males in several aspects, the QoL among them. The etiology of the ABI did not have a significant impact on the QoL (Matérne et al, 2018), possibly because, regardless of the cause the injury, the consequences will have a serious impact on the person's life.…”

“…Moreover, they analyze the association between QoL outcomes and certain variables that are expected to influence these results, identifying potentially predictive factors of a better QoL. Because of these contributions, we know that aspects such as absence of depressive symptoms (Andelic et al, 2018, Forslund et al, 2013, Soberg et al, 2013), a satisfactory community integration (Andelic et al, 2018, Forslund et al, 2013, Kalpakjian et al, 2004), and the return to work (Matérne et al, 2018, Steadman-Pare et al, 2001), have a strong relationship with and a great predictive capacity for a better QoL. However, less is known about the relationships between this construct and the sociodemographic and injury-related aspects.…”