Background information
Traumatic brain injuries (TBI) occur suddenly and without warning.

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The effect may be limited to the individual and the immediate family or may have a ripple effect from the immediate family to friends, work, social status and standing, insurers and the economy.

The consequences of TBI generally include dramatic change in the individual’s life course, profound disruption of the family, vast loss of income or earning potential and costly lifetime expenses. One of the most discouraging consequences of TBI is unemployment.

The value of employment to an individual is well documented. It is associated not only with the person’s ability to lead a certain lifestyle, but is also a means of deploying their potential.

Little available data
In South Africa, the occurrence of TBI is between 200 and 316 for every 100 000 people. This means that there are in excess of 80 000 new cases of TBI in this country each year.

There is very little data in SA detailing the effect of unemployment among people who have acquired TBI.

However, given the importance of employment to most people and the statistics of TBI in the country, it would be a valid deduction that the effect is significant. Assessing re-employability then becomes an important aspect of rehabilitation.

Many factors affect ability to work
Many individual factors influence return to work after brain injury. These factors include age, severity of injury, physical disability, motivation, cognition, intelligence and emotional and behavioural status.

The level of executive functioning that a person has, following TBI, dictates how successfully he or she can initiate goal-directed activity, complete the steps necessary to obtain a goal, control thoughts and emotions and learn from feedback.

In addition to the limitations faced as a result of the severity and type of injury, there are other stumbling blocks in the return to work initiative including the attitudes of employers, unavailability of transportation, need for assisted technology etc.

Apart from this, the need to determine the re-employability of persons with TBI is critical not only for the individual and their quality of life and sustainability but also for economic and social reasons.

Re-employment studies important
For this reason, studies and research pertaining to the re-employability following TBI has become important. TBI may affect the employability of individuals at all employment levels. To ensure a manageable study the writer has selected TBI and the supervisory and management level of employment.

Many rehabilitation programmes focus on return to work activities. However, other than the occupational therapy and neuropsychological assessments, there is limited data in predicting re-employability or the level of employment that an individual with TBI may return to and successfully hold.

There are a number of assessment tools predicting workplace potential and capability for normal individuals. The writer has proposed utilising one such assessment tool to determine its validity and reliability in assessing workplace potential of people with TBI.

Initial recruitment interview schedule
The selected tool is known as the IRIS (initial recruitment interview schedule). The IRIS is a capability assessment tool based on the work of Elliot Jaques, the validity and reliability of which has been well documented.

The IRIS is a semi-structured interview which takes approximately one hour to administer. Candidates are required to provide responses to set questions about work previously done. With this, it is possible to determine the current level of functioning of the individual as it relates to workplace capability. It also provides a 15 year prediction of future potential and development.

Given that the prospective study focuses on re-employability following TBI, the assessment tool can still be used given that examples of work done previously will be consistent with the standard assessment process.

If the IRIS can be proven to be valid and reliable in assessing workplace capability of persons with TBI, it will become a critical element of the rehabilitation programme and return to work activities.

The results can be used to prove the ability to return to work, proper placements can be made by matching capability with suitable positions and re-integration into the workplace will be facilitated with the associated benefits for the individual, family, society and economy.

Participants needed
In order to test the use of the IRIS in predicting workplace potential among people with TBI, the researchers are requesting participation in the study.

Participants need to meet the following criteria:
1. The TBI must have occurred at least six months ago.
2. The TBI must have been categorised as mild or moderate.
3. The verbal/linguistic ability of the participant must be sufficient to verbally respond to questions and adequately express descriptions of work done prior to the TBI.
4. The person must have held a supervisory or management position prior to the TBI.
5. Preferably neuropsychological reports including Glasgow Coma scale ratings or Disability rating scale scores should be available.

Thirty participants, who meet the criteria mentioned above and who are now re-employed in any position (not necessarily the same position as prior to the TBI), are required. A further 30 participants, who meet the criteria and who have not returned to the workplace at all, are also required.

All interested parties are urged to contact Cindy Erasmus to determine eligibility to participate in the study and for further information on the process and research results. The contact number is 078 237 9496 or email c.erasmus@bowman.co.za.
 

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