Cognitive and self-regulation skills for employment among people with brain injury: A comparison of employed and non-employed people using mixed analysis.

Abstract

BACKGROUND Employment for people with brain injuries is challenging, and identifying the factors that can be improved by rehabilitation and establishing appropriate intervention methods are imperative. OBJECTIVE To examine whether differences in cognitive functions and self-regulation skills exist between employed and non-employed people with brain injuries. In addition, we explored the self-regulation skills characteristic of employed people by qualitatively comparing them to those of non-employed people. METHODS Using a mixed research method, demographic data, neuropsychological tests, self-efficacy, and self-regulation skills were compared between 38 people with brain injuries (16 employed and 22 unemployed) in the community. Subsequently, self-regulation skills were assessed by the Self-Regulation Skills Interview (SRSI), and participants' responses were qualitatively compared. RESULTS No significant differences were observed in demographic data and neuropsychological tests, but employed people showed significantly better SRSI scores than unemployed people (p <  0.01). The qualitative analysis of the SRSI showed that employed people recognised themselves as having more specific symptoms than unemployed people. For example, they recognised the behaviour 'when having more than one errand, forgetting it', whereas non-employed people only recognised the category 'failure of prospective memory'. Furthermore, employed people reviewed their behaviour and developed ingenious coping strategies, such as 'looking back on appointments that have been made', 'writing down as soon as having a schedule', whereas unemployed people only exhibited categories such as 'writing schedules on the cell phone'. CONCLUSIONS Self-regulation skills, such as recognising specific symptoms and developing relevant coping strategies, are effective for gaining employment.