Patterns of community integration 2-5 years post-discharge from brain injury rehabilitation.
Outcome after traumatic brain injury (TBI) is characterized by a high degree of variability which has often been difficult to capture in traditional outcome studies. The purpose of this study was to describe patterns of community integration 2-5 years after TBI. Participants were 208 patients admitted to a Brain Injury Rehabilitation Unit between 1991-1995 in Brisbane, Australia. The design comprised retrospective data collection and questionnaire follow-up by mail. Mean follow-up was 3.5 years. Demographic, injury severity and functional status variables were retrieved from hospital records. Community integration was assessed using the Community Integration Questionnaire (CIQ), and vocational status measured by a self administered questionnaire. Data was analysed using cluster analysis which divided the data into meaningful subsets. Based on the CIQ subscale scores of home, social and productive integration, a three cluster solution was selected, with groups labelled as working (n = 78), balanced (n = 46) and poorly integrated (n = 84). Although 38% of the sample returned to a high level of productive activity and 22% achieved a balanced lifestyle, overall community integration was poor for the remainder. This poorly integrated group had more severe injury characterized by longer periods of acute care and post-traumatic amnesia (PTA) and greater functional disability on discharge. These findings have implications for service delivery prior to and during the process of reintegration after brain injury.
Doig
E
E
Brain Injury Rehabilitation Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia. emmahdoig@optusnet.com.au
Fleming
J
J
Tooth
L
L
D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D006233:Persons with Disabilities / Q000523:psychology*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011788:Quality of Life; D012720:Severity of Illness Index; D012919:Social Behavior