Journal of Occupational Rehabilitation

, Volume 21, Issue 3, pp 374–394

An Integrated Review of the Processes and Factors Relevant to Vocational Evaluation Following Traumatic Brain Injury

  • Mary Stergiou-Kita
  • Deirdre R. Dawson
  • Susan G. Rappolt


Introduction: In order to develop the evidence base for a clinical practice guideline (CPG) for vocational evaluation following traumatic brain injury (TBI), we undertook a review to identify the key processes evaluators should follow and the key factors they should consider when completing a vocational evaluation. Methods: Processes outlined in the Cochrane Handbook of Systematic Review guided our processes and included: development of review questions, search strategies and selection criteria; quality appraisal; extraction, analysis and data synthesis; drawing conclusions. Four data bases (i.e. Medline; PsychInfo; Embase; The Cochrane Library of Systematic Reviews) were searched for descriptive articles, quantitative and qualitative studies, and nine websites were searched for CPGs (e.g. Scottish Intercollegiate Guideline Network; US National Guideline Clearinghouse; New Zealand Guideline Group). Two reviewers independently appraised methodological quality. Data were extracted into evidence tables which included: study purpose; location; participants; design/method; themes; findings; relevant processes and factors. Directed content analysis was utilized to analyze and synthesize the descriptive process evidence. A constant comparative method was employed to compare study findings in relation to factors associated with successful employment. Results: Results from process and factors syntheses are integrated into the Evidence-based Framework for Vocational Evaluation Following TBI. This framework identifies seven key processes in a vocational evaluation, including: (1) identification of the evaluation purpose and rationale; (2) intake process; (3) assessment of the person; (4) assessment of the environment; (5) assessment of the occupation/job requirements; (6) analysis and synthesis of assessment results; (7) development of evaluation recommendations. Relevant factors are integrated into each key process. Conclusions: This framework outlines the key information evaluators should gather, the domains of the person, environment and occupation they should assess, and elements of rigour they should consider when completing a vocational evaluation and making recommendations for work re-entry following a TBI.


Rehabilitation Vocational Brain injuries Return to work Employment Review 

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Mary Stergiou-Kita
    • 1
    • 2
  • Deirdre R. Dawson
    • 2
    • 3
  • Susan G. Rappolt
    • 2
  1. 1.Department of Rehabilitation ScienceUniversity of TorontoTorontoCanada
  2. 2.Department of Occupational Science and Occupational TherapyUniversity of TorontoTorontoCanada
  3. 3.Kunin-Lunenfeld Applied Research UnitTorontoCanada

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