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Psychosocial outcomes 1–7 years after comprehensive milieu-oriented neurorehabilitation: The role of pre-injury status

Primary objective: To explore pre-injury variables related to post-discharge psychosocial status and identify factors related to work and driving outcomes. Methods and procedures: Ninety-three brain-injured patients attended a holistic milieu-oriented neurorehabilitation program and were contacted 1–7 years post-discharge. Experimental interventions: Questionnaire data addressing pre-injury and post-injury work, driving, income, marital status and living situation. Main outcomes and results: 74.3% were involved in competitive work and/or school with 86.0% productive at follow-up. Post-injury income decreased significantly compared with pre-injury levels. Pre-injury relationship status did not differ significantly from post-injury; 81.1% remaining in a stable relationship or married at follow-up. Pre-injury and post-injury accident rates were related; 73.1% drove at follow-up. Higher education, non-right hemispheric injury, shorter treatment length and return to work related to driving. Younger age, higher education, non-right hemispheric injury and driving post-injury related to positive work status. Conclusions: Pre-injury psychosocial data provide an important context for understanding post-discharge outcome after brain injury. Holistic milieu-oriented rehabilitation facilitates long-term successful work, driving and relationship stability.