Education and Human Sciences, College of (CEHS)


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A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy, Major: Interdepartmental Area of Human Sciences (Communication Disorders), Under the Supervision of Professor Karen Hux. Lincoln, Nebraska: November, 2011

Copyright 2011 Erin J. Bush


Employment status is a salient outcome following traumatic brain injury (TBI). A return to productive activity relates in complex ways to quality of life, and loss of employment competence has potentially devastating effects on survivors. Currently, inadequate information exists about the distribution of occupations held by survivors, post-injury employment stability, and the frequency that survivors return to their pre-injury occupations. The research presented herein addressed these issues. This study consisted of two phases. Through Phase 1, the researcher gathered quantitative employment data regarding a pool of 283 survivors of severe TBI. She then conducted telephone interviews of family members of 20 survivors who had post-injury employment experiences, and obtained employment distribution data. Phase 2 consisted of qualitative data collection through in-depth interviews with 6 family members of a survivor of TBI, 5 survivors themselves, and 1 job supervisor of a survivor participant. The database search of 283 TBI survivors revealed that 156 (55%) returned either to paid or volunteer work positions immediately post-discharge. The researcher also obtained quantitative results from the 20 target participants. These distribution results detailed demographic and educational information, pre-injury and post-injury employment types, post-injury work statuses, survivor profiles, and post-injury employment success (PIES) scores. The researcher derived the latter two results from measures she developed for the purpose of this study. Phase 2 data included themes and subthemes derived from participant interview transcripts. The researcher used a multiple case study format to display the results, and then conducted a cross-case analysis of the 5 survivors and gleaned from it cross-case themes. The 5 cross-case themes were (a) Challenges, (b) Strategies, (c) Work-related Issues, (d) Social and Personality Changes, and (e) Effect on the Family. After comparing Phase 1 and Phase 2 data sets, the researcher obtained mixed results regarding job satisfaction and employment success.

Advisor: Karen Hux