Experience of participation after brain injury related to sick leave

• Experience of participation after brain injury related to sick leave Larsson Jerry, Esbjörnsson Eva, Björkdahl Ann, Nilsson Michael, Sunnerhagen KS Department of Clinical Neuroscience and Rehabilitation Medicine Institute if Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Sweden Introduction: In Europe, traumatic brain injury (TBI) is one of the main causes of death and handicap. Several studies have shown problems with return to work (RTW) after a traumatic brain injury and a lower level of activity and participation in society. In Sweden, social insurance and sickness benefit are central to people's welfare after all illness. We have not so far found any studies looking at the specific sick-leave pattern prior to a TBI or activity/participation related to sick leave. The aim of this study was to explore the relation between sick leave and participation. Method The study was carried out in Sweden and data were collected from three different hospitals in the Sahlgrenska University Hospital complex in Gothenburg. The cohort was made up of all patients (129 in total) aged between 18 and 65 admitted to the emergency room during a two year period (1999-2000) with a traumatic brain injury classified as S06.2 and S06.3 (International Classification of Diseases 10). The patients were asked to reply to a questionnaire concerning participation (IPA) four years after trauma, to explore their participation in society, related to sick leave at the date for trauma and four years after. Results Of the cohort, 31% were on sick leave the day for trauma, 63% were not on sick leave. There were no differences in severity of injury between the groups measured with RLS (Reaction Level Scale) or in days at hospital after trauma Four years after trauma there was a significant difference in participation, measured with the questionnaire IPA, regarding movement, activity in the home, social contacts and work. The group who were on sick leave at the date for trauma experienced a lower level of participation in society four years after trauma than the group not on sick leave the day for trauma. When analyzing the group not on sick leave the day for trauma considering participation four years after trauma, there was a significant difference in participation if they still were on sick leave or not. The group still on sick leave experienced a significant lower level of participation in activity, leisure time, social contacts, work and helping others than the group not on sick leave. The group on sick leave four years after TBI also had a more difficult brain injury measured with RLS. Conclusions We can in our study se that other factor than the pathology and severity of TBI are predictors for less participation in society after a brain injury. This indicate the necessity to consider premorbid and social factors in rehabilitation. As often stated, the importance is not the diagnose, but who has got the diagnosis.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

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