JCPSLP Vol 22 No 1 2020

Table 1. Baseline characteristics of participants.

Table 2. The frequency, n (%), of the assessments and interventions provided in the RTW/S program.

Characteristic

(n = 19)

Program details

Frequency*

Age (yr), mean (SD)

40 (13)

RTW/S Assessment types Impairment-based Qualitative Task analysis

Gender, n males (%)

10 (53)

15 (79) 11 (58) 18 (95) 13 (68) 3 (16) 14 (74) 15 (79) 3 (16) 19 (100) 14 (74) 11 (58) 13 (68) 17 (89)

Diagnoses, n (%) Stroke TBI Tumour Other ABI

10 (53) 6 (32) 2 (11) 1 (5)

Functional Ergonomic

RTW/S Intervention types Impairment-based Compensatory Ergonomics Education Liaison with employer Graded return to work

Work/study data

Occupation pre-ABI, n (%) Managers Professionals Technicians and trades Community and personal service Administration and clerical Sales Machinery/operators and drivers Labourers Unemployed Student Work/study hours pre-ABI, n (%) Full-time study Full-time study, part-time work Part-time study, part-time work

1 (5) 9 (47) 1 (5) 3 (16) 0 (0) 2 (11) 0 (0) 0 (0) 0 (0) 3 (16)

Work simulation Team meetings

*categories not exclusive

score from baseline to the post-intervention assessment, and an increase of 0.4 point (95% CI) in the mean SF-12 Mental Component Summary (MCS). Improvements were trending towards clinical significance, in particular the change in SF-12 PCS from baseline to end of follow-up period (10.7-point change, p = 0.018) (Table 3). This suggests that participants had a higher quality of life immediately after the program and following 3 months after the program. Discussion This study has explored the relationship between provision of an interdisciplinary RTW/S program and work/study status, and quality of life. The results of this study suggest that involvement in an interdisciplinary RTW/S program is associated with successfully returning to work/study after an ABI and a positive improvement in quality of life as measured by the SF-12. Work/study status and quality of life outcomes were similar immediately following program completion and at follow-up 3 months later. This study found that individuals with an ABI who participate in an interdisciplinary RTW/S are likely to return to work/study and experience improved quality of life. At entry to the RTW/S program, 21% of participants were working or studying. At the end of the program and at the time of the 3-month follow-up, 74% of participants were engaged in work/study in a part-time or full-time capacity. These findings are similar to previous research which has identified improvements in work/study status and participation as a result of an interdisciplinary RTW/S program (O’Brien, 2007). As in similar studies, this RTW/S program demonstrated consideration of the physical, emotional and environmental aspects of the workplace alongside the expectations of the employer and the interactions with the employees as paramount for successful RTW/S program outcomes (Donker-Cools, 2016). Additional comparable intervention strategies including: (a) work hardening; (b) commencement of a study or retraining program (including online programs) ranging from within a familiar subject through to more demanding unfamiliar or higher-level program or retraining; (c) repetitive practice of cognitive strategies for the individual; and (d) building confidence, self-esteem and internal motivation,

1 (5) 1 (5)

2 (11) 4 (21) 11 (58)

Part-time work Full-time work

Source of income pre-ABI, n (%) Wage Government benefit

17 (89) 2 (11)

ABI: acquired brain injury

As the type of assessment and intervention within the RTW/S program was individualised, the program comprised different aspects depending on the participant. Intervention program length ranged from 4 weeks to 19 months (median length of program was 5 months). A majority of participants received both occupational therapy and speech-language pathology (n = 11, 58%), although 2 participants received occupational therapy only (10%), and 5 received speech- language pathology only (26%). Three of the participants also received physiotherapy (16%) and 10 received neuro- psychology services (53%). Table 2 describes the specific assessments and interventions that participants received. Outcomes Work/study status (primary outcome) At baseline, there were 79% (n = 15) participants who were not engaged in work or study. Immediately following the program and at 3-months after the cessation of the program, there were 74% (n = 14) participants who were engaged in work or study (Table 3). While n = 5 (26%) participants were not working or studying at the time of follow-up, all but one was actively job seeking 3 months after completion of their programs (Table 3). Income and quality of life (secondary outcomes) There was an increase of 3 points (95% CI –11.3 to 4.6) in the mean SF-12 Physical Component Summary (PCS)

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JCPSLP Volume 22, Number 1 2020

Journal of Clinical Practice in Speech-Language Pathology