Return-to-work, life-satisfaction and psycho-social outcome five years after the participation in the Ueros-Aquitaine program :comparison between brain-damaged patients included in 1997 and in 2008
Ms Mélanie COGNÉa, Prof Jean-Michel MAZAUXa, Ms Audrey SIMIONa, Dr Laurent WIARTa
a Centre Hospitalo-Universitaire (CHU), Service de Médecine Physique et de Réadaptation
Background. Socio-professional reintegration of brain-injured patients is an important issue of their rehabilitation. The UEROS program reassessment was necessary because of demographic and socio-economic changes since 1997.
Aim.To compare the 5-year outcome of brain-damaged patients included at two-time points (1997, 2008) in the Aquitaine Unit for Evaluation, Training and Social and Vocational Counselling program (UEROS), dedicated to the assessment and socio-professional reintegration.
Method. 75 and 57 patients were recruited in 1997 and 2008, respectively. The initial socio-demographic status, lesional data and the clinical assessment obtained at the inclusion in the UEROS program were collected retrospectively. We assessed the family, medical and professional status, leisure activities, autonomy and life-satisfaction during a phone-structured interview at 5-year follow-up. An UEROS program satisfaction questionnaire was also proposed during the same interview.
Results. The 2008 patient group was significantly older than the 1997 one (mean age=34.7 years, p≤0,05), had higher educational level (p=0,01), higher variablility of brain damages etiologies (p=0,01), lesser rate of traumatic brain injuries (-19%). The number of patients who were employed before the brain injury was significantly higher in 2008 than in 1997 (p=0,002). Median time since injury at UEROS program inclusion was 49 months in 1997 and 72 months in 2008. Patients included in 2008 were significantly less autonomous in daily activities (-23%, p=0,004). However, some of them had a job when being included in the program (12%). The 2008 patient group had less orthopaedic (-16%, p=0,003), sensitive (-19%, p=0,004)) and sensory (-21%, p=0,004) disabilities. They had less behavioural disorders (-16%, p=0,010), but memory and executive impairements were most common (+20%, p=0,014 and +16%, p=0,015 respectively). There was no difference in terms of autonomy and return-to-work five years later between the two groups of patients (p=0,086 and p=0,32 respectively). Patients who have participated in 2008 were mostly satisfied with their quality of life five years later (67%). Patients and their caregivers were mostly satisfied with the UEROS program (93 and 94% respectively). Garegivers’ satisfaction with the UEROS program improved significantly between 1997 and 2008 (p=0,00003).
Conclusions. The UEROS program remains efficient on brain-injured patients’ return-to-work and autonomy improvement.
Keywords : traumatic brain injury – social reintegration – return-to-work – autonomy – life satisfaction