Scoping review of return-to-work interventions for persons with traumatic brain injury.

PURPOSE: The study approach sought to understand which vocational rehabilitation (VR) strategies are available for individuals seeking return to work (RTW) following traumatic brain injury (TBI). Secondly, the review aimed to identify how these RTW interventions and outcomes are evaluated. MATERIALS AND METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the scoping review began by identifying relevant English language articles via PubMed, CINAHL, PsycINFO, and Embase databases for peer-reviewed journal articles published from January 2013 to September 2021. The review focused on identifying studies with a sample population of people with moderate to severe TBI. RESULTS: A total of 23 studies met the search criteria. For each included study, the following data were extracted: (a) country of origin, (b) sample size, (c) civilian or military sample population, (d) age, (e) participant gender, (f) RTW definition, (g) intervention approach, and (h) RTW outcome. The results were synthesized by placement into one of four categories as a function of the study's underlying methodological approach. CONCLUSIONS: The development of effective RTW approaches has largely been neglected in the rehabilitation literature for persons with TBI in civilian and military populations. Effective strategies do exist to help guide efforts to return this population to productive activity, including work.Implications for RehabilitationLack of productive engagement in work and school among persons with traumatic brain injury (TBI) presents a chronic challenge in rehabilitation systems internationally.Rehabilitation professionals should utilize multidisciplinary and integrated return-to-work (RTW) interventions given the varied areas of function that can result from TBI.Rehabilitation professionals should apply RTW interventions that promote on-site training and workplace integration.Given the idiosyncratic nature of TBI, RTW interventions should be tailored to meet the specific needs of the person seeking support.

Return to School Outcomes among Adults with TBI One Year After Rehabilitation Discharge: A TBIMS Study.

OBJECTIVE: To examine return to school outcomes 1 year after traumatic brain injury (TBI) rehabilitation discharge. DESIGN: Longitudinal observational study using Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) data at 1-year post-TBI. SETTING: Inpatient rehabilitation centers using follow-up telephone calls. INDIVIDUALS: Individuals (n = 237) enrolled in the TBIMS-NDB since 2001 between the ages of 18 and 59 years who were engaged in postsecondary education (full or part-time) before recorded TBI. MAIN MEASURES: Return to school, categorized as in a postsecondary setting at first follow-up (reported hours in school greater than zero at one-year follow-up). RESULTS: Using an alpha level of 0.05 binary logistic regression analysis identified four predictive variables. Significant predictors of return to school include being of lower age, possessing a higher level of functioning at discharge, reporting lower ratings of disability at discharge, and being able to use a vehicle independently for transportation. CONCLUSION: Pursuit of higher education is a viable means of community reintegration after TBI. Some individuals with TBI face a myriad of barriers and challenges when returning to school. Study findings may facilitate understanding of how TBI affects return to school and community reintegration outcomes.

Regaining equilibrium: Understanding the process of sibling adjustment to pediatric acquired brain injury.

OBJECTIVE: This study developed a comprehensive framework for understanding the process of sibling adjustment to pediatric acquired brain injury (ABI). PARTICIPANTS: Grounded theory methodology was employed to inductively explore the issues siblings perceived to be their main concerns and how they managed these concerns. Fifty-three interviews (N = 28) were conducted recursively with 20 child and adolescent siblings of individuals with an ABI, 4 adult siblings of individuals with an ABI, and 4 child and adolescent siblings of individuals with congenital disability. Observational and secondary data from hospital staff and parents were also analyzed. The framework was developed and verified through simultaneous data collection and analysis that continued to the point of data saturation. RESULTS: The main concern for siblings was the loss of equilibrium in their lives as defined by the concepts of vulnerability and emotional turmoil. Losing equilibrium was enduring and threatened siblings' sense of security, safety, predictability and control many years post injury. To manage these concerns, siblings employed a variety of interrelated strategies to regain equilibrium. These strategies were conceptualized by the concepts navigating and sacrificing to restore safety, predictability, and control. Like the nonfinite nature of losing equilibrium, regaining equilibrium was an ongoing cyclical process. CONCLUSIONS: Rather than focusing on adjustment outcomes only, this study extends previous research by offering a framework for understanding the process of sibling adjustment, and thus providing a set of integrated categories, concepts, hypotheses, and propositions to inform future research and practice. (PsycINFO Database Record

A Clarion Call for Social Work Attention: Brothers and Sisters of Persons With Acquired Brain Injury in the United States.

This article presents a clarion call for increased social work attention to the needs of siblings of persons with acquired brain injury (ABI) in the United States. The article overviews how siblings are psychosocially affected, how they provide care to the injured brothers and sisters, and how they personally develop as a result of their experiences. The article highlights the fact that social workers and other professionals often overlook the needs of siblings of persons with ABI and makes an appeal for social workers to advance clinical practice and research to benefit this often neglected population.

Quality of professional services following traumatic brain injury: adult sibling perspectives.

This study examined the quality and availability of professional supports provided to individuals with traumatic brain injury (TBI) and their families from the perspective of a national sample of 267 adult siblings. Using a constant comparative approach to text analysis, the authors analyzed what siblings perceived to have been beneficial or in need of improvement with regard to the TBI professional services provided to their injured brother or sister and their family. The siblings' comments suggested that the system-level response to TBI serving injured people and their families was inadequate, that many professionals lacked the skills and understanding to provide effective services, and that professionals did not provide sufficient information to the people with TBI or their families. However, most siblings endorsed a positive view of at least one of the professional services provided. Clinical, advocacy, and research implications of these findings are discussed.

Development and validation of the Caregiver Empowerment Scale: a resource for working with family caregivers of persons with traumatic brain injury.

OBJECTIVE: To use multitrait analysis to determine the measurement structure of the Caregiver Empowerment Scale (CES). PARTICIPANTS: An American sample of 87 adult primary family caregivers of persons with traumatic brain injury (TBI). RESULTS: A four-factor structure was identified including factor 1 (Advocacy Self-Efficacy), factor 2 (Community Self-Efficacy), factor 3 (Caregiver Self-Efficacy), and factor 4 (Personal Self-Efficacy). CONCLUSIONS: The CES provides clinicians and researchers a means to assess self-perceived coping abilities of family caregivers of persons with TBI.

'We are the forgotten victims': Perspectives of adult siblings of persons with traumatic brain injury.

PRIMARY OBJECTIVE: This study determined how the lives of a cross-national sample of adult siblings had changed since their brothers and sisters incurred a traumatic brain injury. RESEARCH DESIGN: A total of 272 participants provided responses to the question, 'How is your life different since your sibling had a TBI?' Responses were analysed through the constant comparative method of textual analysis. METHODS AND PROCEDURES: Responses were collected through a mailed-survey. The analysed question appeared at the end of a 243-item quantitatively-based survey containing five open-ended questions. OUTCOMES AND RESULTS: Three themes emerged: (1) 'Family impacts' such as growing up with a sibling with TBI and impact on family closeness; (2) 'Caring' including caring for and about the family member; and (3) 'Making sense of the experience' through adjustment and personal development. CONCLUSIONS: The study demonstrates that having a sibling with a TBI can result in profound and enduring negative and positive life changes for non-injured siblings. Professionals need to attend to the needs of siblings for support and guidance and should be considered as key informants about their injured family members during intake and service planning.

What is Catholic about Catholic Charities?

Sectarian social services agencies play an important and increasing role in contemporary social welfare. Among sectarian social welfare organizations, Catholic Charities USA has emerged as the largest private provider of social welfare services. This article reviews the history, services, and practice controversies of Catholic Charities USA and examines issues regarding the ability of sectarian social services organizations to provide nonbiased and fair services. Through an analysis of this organization, the authors raise and discuss questions of accountability and philosophical approaches.