title: Sentinel Events During the Transition From Hospital to Home: A Longitudinal Study of Women With Traumatic Brain Injury.
abstract: OBJECTIVE
  To describe the occurrence of sentinel events and their influence on community integration of women with traumatic brain injury (TBI) transitioning from hospital to home.
  
  
  METHODS
  A longitudinal study was completed with data collected before and at 1, 3, and 6 months after hospital discharge.
  
  
  METHODS
  Brain injury rehabilitation unit and acute neuroscience ward.
  
  
  METHODS
  Women (N=25) with severe TBI (aged between 17 and 50 years; duration of posttraumatic amnesia ranged from 1 to 123d). Sixteen family caregivers also participated.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Community integration was measured using the Mayo-Portland Adaptability Inventory. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scale. The Sentinel Events Questionnaire was used to record life events that potentially influence the transition process.
  
  
  RESULTS
  Most women (>16 at each time point) experienced mild to moderate impairments in psychosocial integration. A third of the sample reported symptoms of depression (n=8), anxiety (n=9), and stress (n=7) that exceeded clinical cutoff levels on at least 1 occasion. At 6 months, 3 women reported clinically significant depression and anxiety (12%) and 2 reported significant stress levels (8%). Positive sentinel events such as return to meaningful occupation were common (n=14). Negative sentinel events were also quite common. For example, reduced access to therapy, reported by 10 women, was associated with poorer participation levels.
  
  
  CONCLUSIONS
  These findings suggest that the presence of sentinel events influences the transition experiences of women with TBI in this sample. Rehabilitation should consider the occurrence and impact of sentinel events because this may facilitate successful transitions.
authors: Baycrest, Rotman Research Institute, Toronto, Ontario, Canada; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: Emily.nalder@utoronto.ca.
authors: Emily
authors: E
authors: Nalder
authors: School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Metro South Hospital and Health Service, Centre for Functioning and Health Research, Brisbane, Queensland, Australia.
authors: Jennifer
authors: J
authors: Fleming
authors: Metro North Hospital and Health Service, Brisbane, Queensland, Australia; Behavioural Basis of Health Program, Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia.
authors: Petrea
authors: P
authors: Cornwell
authors: School of Social Work & Human Services, The University of Queensland, Brisbane, Queensland, Australia.
authors: Michele
authors: M
authors: Foster
authors: School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
authors: Elizabeth
authors: E
authors: Skidmore
authors: School of Rehabilitation, University of Montreal, Montréal, Canada.
authors: Carolina
authors: C
authors: Bottari
authors: Baycrest, Rotman Research Institute, Toronto, Ontario, Canada; Department of Occupational Science and Occupational Therapy and the Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada.
authors: Deirdre R
authors: DR
authors: Dawson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000647:Amnesia / Q000453:epidemiology / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D017028:Caregivers; D062309:Community Integration / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010351:Patient Discharge; D011446:Prospective Studies; D062707:Return to Work; D018571:Sentinel Surveillance; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D000069341:Transitional Care / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Community integration; Rehabilitation; Traumatic brain injuries; Women