Berufliche Reintegration nach Hirnschädigung

Return to work after brain injury is at high risk for failure. It is of critical interest for rehabilitation clinicians to know which key factors influence successful reintegration in working conditions. The vast majority of outcome studies focus solely on injury-related facts. Despite profound knowledge concerning the importance of individual psychological processes they are often neglected in scientific investigations. The aim of the present study was to identify the influence of those psychological processes, e.g. coping strategies, cognitive beliefs, and adaptation skills on successful return to work after neuropsychological rehabilitation. A hierarchical model is presented consisting of the components Potential , Psychic Executive , and Performance . Potential , subsuming demographic, clinical and functional data, is not supposed to directly influence Performance . Performance , the capability of a person to perform sufficiently in work, activities of daily living and therapy is presumed to be strongly determined by Psychic Executive . A cohort of 30 patients (mainly suffering from TBI and Stroke) from an outpatient clinic was comprehensively investigated. Psychic Executive at therapy onset showed a high predictive capability concerning patients Performance at the end of therapy. The self-ratings of activities of daily living turned out to be another important predictor for successful work re-entry. Due to the relatively small study sample the results can only be interpreted as temporary and heuristic. Despite this critique future outcome studies on return to work after brain injuries should urgently include psychological factors related to the rehabilitation process.