Abstract
Reinstatement of employment is an important problem for stroke patients with higher brain dysfunction, especially among young people. One hundred forty-six hospitalized patients, ranging from 18 years to 64 years of age, with higher brain dysfunction were evaluated by using neuropsychological test batteries. Their employment status after discharge was classified as competitive employment, sheltered employment and non-employment. The competitive employment group showed significantly higher scores in performance IQ and total IQ on the WAIS-3rd (or -R), visual and delayed recall memory quotients on the WMS-R and standardized scores on Behavioural Assessment of the Dysexecutive Syndrome than the non-employment group. The competitive employment group showed significantly higher scores in verbal and general memory quotients on the WMS-R and standardized profile score on Rivermead Behavioural Memory Test than the sheltered employment group and the non-employment group. Therefore, the patients’ performance on neuropsychological tests was related to their employment status. However, other personal factors including emotional control, social skills, and metacognition are important for successful reinstatement, in addition to the cognitive functions measured by neuropsychological tests. In addition, the employers and society strongly influences reinstatement. Patients with higher brain dysfunction usually have attention deficits and tire easily. It is necessary to watch for signs of fatigue and to encourage such patients to get rest in order to maintain continuous employment. Returning to work is not a goal but a start for patients with higher brain dysfunction. The rehabilitation team should focus their support to maintain continuous employment, while conferring with related organizations.
