[Professional career, disability and dependence after acquired brain injury: a prospective study in the two years following the brain injury]. / Trayectoria laboral, discapacidad y dependencia tras daño cerebral adquirido: estudio prospectivo en los dos años siguientes a la lesion cerebral.

AIMS: The purpose of the current study is to analyze the labor trajectory, grade of disability and degree of dependence ecognized in a group of people with acquired brain injury with difference types and severity of injuries and with memory deficit as the main cognitive sequel, over a period of two years after the injury and to explore which premorbid clinical and demographic variables related to the brain injury are predictors of the return to work. PATIENTS AND METHODS: 129 subjects (aged 18-80 years), who were attended by the Neuropsychology and Neuropsychiatry Department of Navarra's Hospital. Qualitative variables were compared using the Chi square test and means were compared using Student t test and to determine the correlation between continuing variables we used Pearson's correlation coefficient. RESULTS: 17.7% returned to work one year after and 25% two years after. The return to work was related to high levels of education. Disability was recognized by 85% of applicants, to psychological factors or physical and psychological in 89% of them. In 77% of applicants was recognized the level of dependence. CONCLUSIONS: Results confirm the big impact of acquired brain injury on the career path two years later, in their interaction with their environment and in their level of independence. One of the factors that explain this impact is the memory deficits.

TITLE: Trayectoria laboral, discapacidad y dependencia tras daño cerebral adquirido: estudio prospectivo en los dos años siguientes a la lesion cerebral.Objetivos. Analizar la trayectoria laboral, el grado de discapacidad y el grado de dependencia reconocidos en una muestra de sujetos con daño cerebral adquirido de diferentes etiologias y que presentan deficit de memoria como secuela cognitiva principal, durante un periodo de dos años tras la lesion original, y examinar que variables sociodemograficas, datos clinicos premorbidos y relacionados con la lesion cerebral predicen el exito en la incorporacion laboral. Pacientes y metodos. Muestra de 129 pacientes, de 18 a 80 años, atendidos en el Servicio de Neuropsicologia y Neuro­psiquiatria del Complejo Hospitalario de Navarra, con deficits de memoria objetivados con tests psicometricos. Las diferencias entre variables discretas se analizaron con el test de chi al cuadrado, para analizar las existentes entre dos grupos en cuanto a variables cuantitativas, se utilizo el test t de Stutent y para calcular la correlacion entre variables continuas, el coeficiente de correlacion de Pearson. Resultados. El 17,7% retoma la actividad laboral al año y el 25% a los dos años. Lo anterior se relaciono con un mayor nivel educativo. Se reconocio la discapacidad al 85% de los solicitantes, por factores psiquicos o fisicos y psiquicos en el 89% de los mismos. Al 77% de los solicitantes se le reconocio el nivel de dependencia. Conclusiones. El daño cerebral adquirido genera un fuerte impacto en la trayectoria laboral, la interaccion con el ambiente y el nivel de autonomia. Entre los factores que explican este impacto es reseñable el deficit de memoria.

Trayectoria laboral, discapacidad y dependencia tras daño cerebral adquirido: estudio prospectivo en los dos años siguientes a la lesión cerebral / Professional career, disability and dependence after acquired brain injury: a prospective study in the two years following the brain injury

Objetivos. Analizar la trayectoria laboral, el grado de discapacidad y el grado de dependencia reconocidos en una muestra de sujetos con daño cerebral adquirido de diferentes etiologías y que presentan déficit de memoria como secuela cognitiva principal, durante un período de dos años tras la lesión original, y examinar qué variables sociodemográficas, datos clínicos premórbidos y relacionados con la lesión cerebral predicen el éxito en la incorporación laboral. Pacientes y métodos. Muestra de 129 pacientes, de 18 a 80 años, atendidos en el Servicio de Neuropsicología y Neuropsiquiatría del Complejo Hospitalario de Navarra, con déficits de memoria objetivados con tests psicométricos. Las diferencias entre variables discretas se analizaron con el test de chi al cuadrado, para analizar las existentes entre dos grupos en cuanto a variables cuantitativas, se utilizó el test t de Stutent y para calcular la correlación entre variables continuas, el coeficiente de correlación de Pearson. Resultados. El 17,7% retoma la actividad laboral al año y el 25% a los dos años. Lo anterior se relacionó con un mayor nivel educativo. Se reconoció la discapacidad al 85% de los solicitantes, por factores psíquicos o físicos y psíquicos en el 89% de los mismos. Al 77% de los solicitantes se le reconoció el nivel de dependencia. Conclusiones. El daño cerebral adquirido genera un fuerte impacto en la trayectoria laboral, la interacción con el ambiente y el nivel de autonomía. Entre los factores que explican este impacto es reseñable el déficit de memoria (AU)

Aims. The purpose of the current study is to analyze the labor trajectory, grade of disability and degree of dependence recognized in a group of people with acquired brain injury with difference types and severity of injuries and with memory deficit as the main cognitive sequel, over a period of two years after the injury and to explore which premorbid clinical and demographic variables related to the brain injury are predictors of the return to work. Patients and methods.129 subjects (aged 18-80 years), who were attended by the Neuropsychology and Neuropsychiatry Department of Navarra’s Hospital. Qualitative variables were compared using the Chi square test and means were compared using Student t test and to determine the correlation between continuing variables we used Pearson’s correlation coefficient. Results. 17.7% returned to work one year after and 25% two years after. The return to work was related to high levels of education. Disability was recognized by 85% of applicants, to psychological factors or physical and psychological in 89% of them. In 77% of applicants was recognized the level of dependence. Conclusions. Results confirm the big impact of acquired brain injury on the career path two years later, in their interaction with their environment and in their level of independence. One of the factors that explain this impact is the memory deficits (AU)

[Factorial structure of the dysexecutive questionnaire in a sample of the Spanish population with acquired brain injury and memory deficit complaints]. / Estructura factorial del cuestionario disejecutivo en una muestra de población española con daño cerebral adquirido y quejas de déficit de memoria.

INTRODUCTION AND AIMS: The dysexecutive questionnaire (DEX) has been used to study executive deficits in both clinical samples (both psychiatric and neurological) and non-clinical samples, although agreement on its factorial structure is lacking. The aim of this research is to study that structure in the self-administered version in a sample of the Spanish population with acquired brain injury and memory loss complaints, and to compare that solution with those obtained in other studies. PATIENTS AND METHODS: The questionnaire was administered to 119 subjects with acquired brain injury with different aetiologies (traumatic, vascular, tumours, multiple sclerosis, toxic-metabolic and others). RESULTS: The Cronbach's alpha coefficient was 0.88. All the items showed adequate discriminatory power, except item 15. No relation was found between the total score on the DEX and the age, gender and time elapsed since the injury. A negative correlation between total score and level of schooling was confirmed. The total score does not follow a normal distribution. The five-factor solution accounts for a higher percentage of the total variance than those of two, three and four factors (63.76%). CONCLUSIONS: The Spanish version of the DEX is an instrument that is valid for evaluating general dysexecutive symptoms in subjects with acquired brain injury. The five-factor factorial structure (planning, cognitive control, inhibition, social awareness and impulse control) offers a greater wealth of information because it measures more aspects of the dys-executive pathology and therefore appears to be more useful in the clinical setting. It is advisable to use the questionnaire in an early stage of evaluation or screening and to use it as a complement to the proxy-reported version.