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Titre : | Interrelationships Between Post-TBI Employment and Substance Abuse: A Cross-lagged Structural Equation Modeling Analysis (2020) |
Auteurs : | Nabil Awan ; Dominic DiSanto ; Shannon B. Juengst |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 101, n° 5, 2020) |
Article en page(s) : | p. 797-806 |
Note générale : | https://doi.org/10.1016/j.apmr.2019.10.189 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Emploi ; Lésions traumatiques de l'encéphale ; Réadaptation ; Troubles liés à une substance |
Résumé : |
Objective
To describe the interrelationship of postinjury employment and substance abuse (SA) among individuals with traumatic brain injury. Design Structural equation model (SEM) and logistic regression analytic approach using a merged database of the National Trauma Data Bank (NTDB) and Traumatic Brain Injury Model Systems (TBIMS) National Database, with acute care and rehabilitation hospitalization data and 1, 2, and 5 year follow-up data. Setting United States Level I/II trauma centers and inpatient rehabilitation centers with telephone follow-up. Participants Individuals in the TBIMS National Database successfully matched to their NTDB data, aged 18-59 years, with trauma severity, age, sex, employment, and SA data at 1, 2, and/or 5 years postinjury (N=2890). Interventions Not applicable. Main Outcome Measure Employment status (employed/unemployed) and SA (present/absent) at year 1, year 2, and year 5 postinjury. Results SEM analysis showed older age at injury predicted lower likelihood of employment at all time points postinjury (βYR1=−0.016; βYR2=−0.006; βYR5=−0.016; all P<.001 while higher injury severity score predicted lower likelihood of employment p=".027)" and sa at year male sex each follow-up all despite associations preinjury unemployment with postinjury during the previous period subsequent respectively.> Conclusions Employment and SA have unique longitudinal interrelationships and are additionally influenced by age, sex, and ISS. The present work suggests the need for more research on causal, confounding, and mediating factors and appropriate screening and intervention tools that minimize SA and facilitate successful employment-related outcomes. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999319314327 |