| Objective: To investigate the influencing factors of return-to-work (RTW) in patients with mild-to-moderate traumatic brain injury (TBI) in Guangzhou, and the effects of vocational rehabilitation strategies on their work capacity recovery. Methods: A retrospective analysis was conducted on 87 patients with mild-to-moderate TBI treated in Vocational Rehabilitation Department of our hospital between 2020-2023. Data included clinical records, work capacity index, family/social support status, and vocational rehabilitation protocols. Meanwhile, we searched literature and qualitatively analyzed the results of the included studies. Results: The outcome of RTW was significantly correlated with the course of the disease and the injured side (P<0.05), but not significantly correlated with age and gender. Physical function (such as Brunnstrom stages, the muscle strength and flexibility of upper and lower extremities, etc.) had no significant effect on the outcome of RTW. Occupational classification, educational level, and residual symptoms significantly affected the outcome of RTW (P<0.05). Employer attitudes and the patients’ willingness to RTW significantly affected the outcome (P<0.05，0.01), while family support had no significant impact; On-site job analysis/evaluation, job simulation training and community job placement had a significant impact on the outcome of RTW (P<0.05，0.01), while the intervention of the patients’ willingness to RTW had no significant impact. The qualitative description of the included literature showed that the most critical promoting fac-tors included: education level, family and social support, occupational related interventions. The main obstacles were as follows: duration of rehabilitation, sequelae such as headaches, psychological problems. Conclusion: The RTW outcome of patients with mild-to-moderate TBI is mainly affected by the course of the disease, injured side, occupation, educational level, residual symptoms, employer attitudes and the patients’ willingness to RTW, while the age, gender, physical function and fam-ily support have little effect. Among the vocational rehabilitation strategies, on-site job analysis/evaluation, job simulation training and community job placement can improve the matching degree between the patients and the jobs, thus facilitate the patients to RTW. A multidisciplinary collaboration model (doctors, psychologists, vocational therapists, employers) combined with personalized plans developed based on the patient’s social and cultural background can significantly improve the rate of RTW. |
