Improving Traumatic Brain Injury Outcomes: The Development of an Evaluation and Referral Tool at Groote Schuur Hospital.
BACKGROUND
The Western Cape Province of South Africa has a great shortage of diagnostic expertise, rehabilitative infrastructure, and support services for patients with traumatic brain injury (TBI). The neurosurgical outpatient setting is busy and often chaotic, and patients are frequently lost to follow-up. This study sought to continue with the design and development of a comprehensive, yet brief tool to aid patient referrals and ensure that no consequence of TBI is left unidentified and unaddressed.


METHODS
There were 47 patients with TBI (mean age, 35 years; range, 18-75 years) assessed. The study was designed in 3 distinct phases, each representing a different stage in the tool's development.


RESULTS
The Groote Schuur Traumatic Brain Injury Evaluation was shortened and simplified. Overall, 81% of the participants indicated cognitive dysfunction. There was a high prevalence of psychological/psychiatric sequelae, with 85% of participants reporting at least 1 such problem.


CONCLUSIONS
The findings further highlight the prevalence of the cognitive, behavioral, and psychological consequences of TBI and shed additional light on the particular types of problems that patients with TBI face. Following the identified changes, the questionnaire and algorithm combination are now ready to be validated in the neurosurgical clinical setting.
Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa. Electronic address: steffi_87@hotmail.com.
Stefanie Frances
SF
Andrew
Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Sally
S
Rothemeyer
Division of Neurosurgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Ross
R
Balchin
D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012017:Referral and Consultation / Q000592:standards* / Q000639:trends; D012047:Rehabilitation Centers / Q000592:standards* / Q000639:trends; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D055815:Young Adult
Algorithm; Cognitive; Neuropsychology; Psychiatric; Screening; Traumatic brain injury