Psychosocial outcomes 1-7 years after comprehensive milieu-oriented neurorehabilitation: the role of pre-injury status.
OBJECTIVE
To explore pre-injury variables related to post-discharge psychosocial status and identify factors related to work and driving outcomes.


METHODS
Ninety-three brain-injured patients attended a holistic milieu-oriented neurorehabilitation program and were contacted 1-7 years post-discharge.


METHODS
Questionnaire data addressing pre-injury and post-injury work, driving, income, marital status and living situation.


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.
Klonoff
Pamela S
PS
Catholic Healthcare West, Barrow Neurological Institute, Center for Transitional Neurorehabilitation, Phoenix, AZ 85013, USA. pamela.klonoff@chw.edu
Watt
Lisa M
LM
Dawson
Lauren K
LK
Henderson
Steven W
SW
Gehrels
Jo-Ann
JA
Wethe
Jennifer Voreis
JV
D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving; D001930:Brain Injuries / Q000534:rehabilitation*; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012046:Rehabilitation / Q000458:organization & administration; D013997:Time Factors