THE EFFECT OF EMPLOYMENT ON QUALITY-OF-LIFE AND COMMUNITY INTEGRATIONAFTER TRAUMATIC BRAIN INJURY

Objectives: To investigate the effect of employment on perceived quali ty of life (QOL), social integration, and home and leisure activities for individuals with traumatic brain injuries (TBIs). Design: A number of demographic and injury-related variables (age at injury, time sinc e injury, severity of injury, education, gender, preinjury household i ncome, and marital status) were analyzed for their association first w ith employment and then with the QOL, social integration, and home and leisure activities. Any of these variables showing significant associ ations were then included along with level of employment in three fina l multivariate analyses of variance (MANOVAs), again predicting QOL, s ocial integration, and home and leisure activities. Setting: Urban, su burban, and rural New York state. Participants: 337 adults with TBI wh o resided in New York state and were between the ages of 18 and 65 yea rs. Main Outcome Measures: The Craig Handicap Assessment Capacity Tech nique, the Bigelow Quality of Life Questionnaire, the Flanagan Scale o f Needs (adapted), and a global QOL measure. Results: Employment showe d a strong and consistent relationship with perceived QOL, social inte gration within the community, and home and leisure activities. Part-ti me employment may have been superior to full-time employment for indiv iduals with TBI: part-time workers had fewer unmet needs, were more so cially integrated, and were more engaged in home activities than full- time workers. Loss of consciousness, as a measure of severity, was une xpectedly predictive of diminished sense of QOL for individuals with l ess severe injuries. Conclusions: Being employed contributes to one's sense of well-being, social integration, and pursuit of leisure and ho me activities. Select advantages of working part-time for individuals with TDI were identified.