Posttraumatic confusion predicts patient cooperation during traumatic brain injury rehabilitation.
Scant research has examined the relationship between posttraumatic confusion (PTC) and cooperation during rehabilitation from moderate to severe traumatic brain injury. In this study, PTC and cooperation were examined in a prospective cohort of 74 inpatients with traumatic Brain Injury. Confusion was measured using the Confusion Assessment Protocol. Cooperation was rated on a 0-100 scale by rehabilitation therapists. Using multiple regression analysis, PTC significantly predicted cooperation (R(2) = 0.33, P < 0.001). Age at injury, education, days since injury, and Glasgow Come Scale scores were not significant predictors. Bivariate analyses indicated that four PTC symptoms significantly predicted poorer cooperation: daytime hypersomnolence (ρ = -0.42, P < 0.001), agitation (ρ = -0.39, P = 0.001), psychosis (ρ = -0.39, P = 0.001), and cognitive impairment (ρ = -0.24, P = 0.04). Results provide empirical support that PTC is associated with poorer cooperation and empirical justification for interventions to manage confusion during early recovery from traumatic brain injury.
Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, Florida, USA.
Marc A
MA
Silva
Risa
R
Nakase-Richardson
Mark
M
Sherer
Scott D
SD
Barnett
Clea C
CC
Evans
Stuart A
SA
Yablon
D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015331:Cohort Studies; D003221:Confusion / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012047:Rehabilitation Centers; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome