NQPC-7 Rehabilitation program toward reinstatement support based on network construction among related departments for the patients after treatment of brain disease including brain tumor

Introduction: We have conducted a rehabilitation program to support a return to work for patients with brain disease since 2019. The program focuses on independence in the home environment; physical ability for desk work, commuting and conversation; and concentration and executive ability in the office. The “Promotion of Health and Employment Support” document of the Ministry of Health, Labour and Welfare has been used to update the program since May 2021. Here, we report the status of this program.Methods: Patients desiring employment reinstatement attended the program. A doctor first gave an overview. Social workers then used the QLQ-C30/BN-20 questionnaire to assess mental and physical health, a therapist evaluated physical and higher cognitive function, and nurses advised on work-life balance and mental state. This information was used to develop suitable rehabilitation for each patient. The employment situation was surveyed after discharge. Results: The program included 77 patients (55 men, 22 women, mean age 54) from January 2019 to July 2021, after treatment for stroke (n=55), brain tumor (n=14), and traumatic brain injury or other conditions (n=8). FIM (94.2) and MMSE (26.3) at admission indicated that almost all patients were independent in ADL. A return to work was achieved by 25 (83%) of the 30 patients that could be investigated, including all 4 with brain tumors. The period until reinstatement was <1 month in 16 cases, but >1 month in 3 with brain tumors. The program was found useful by 26 patients (86%). Employment reinstatement was not achieved due to company reasons and family circumstances. Only 4 patients were interviewed by an industrial physician. Conclusion: The physical and cognitive functions of patients wishing for employment reinstatement were relatively well maintained. Cooperation with the company, information sharing with an industrial physician, and adjustment to the home environment were also important for reinstatement.