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Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury

The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects o...

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Autores principales: Sashika, Hironobu, Takada, Kaoruko, Kikuchi, Naohisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287971/
https://www.ncbi.nlm.nih.gov/pubmed/28121947
http://dx.doi.org/10.1097/MD.0000000000005968
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author Sashika, Hironobu
Takada, Kaoruko
Kikuchi, Naohisa
author_facet Sashika, Hironobu
Takada, Kaoruko
Kikuchi, Naohisa
author_sort Sashika, Hironobu
collection PubMed
description The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects. A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department. Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and <70 years at the time of injury; a score of 0–3 on the Modified Rankin Scale at discharge and that of 4–5 due to physical or severe aggressive behavioral comorbid disorders. Study details were sent, via mail, to 84 suitable candidates, of whom 36 replied. Thirty-one subjects (median age: 33.4 years; male: 17; and average time since injury: 48.1 months), who had consented to study participation, were participated. Cognitive function, social participation, QOL, psychosocial factors/problems, rehabilitation needs, and chronic-phase rehabilitation outcomes were evaluated using the Wechsler Adult Intelligence Scale, Third Edition, the Wechsler Memory Scale-Revised, the Zung Self-Rating Depression Scale, the Sydney Psychosocial Reintegration Scale, Version 2, and the Short Form 36, Version 2, qualitative analysis of semistructured interviews, etc. Participants were classified into achieved-social-participation (n = 11; employed: 8), difficult-social-participation (n = 12; unemployed: 8), and no-cognitive-dysfunction groups (n = 8; no social participation restriction). Relative to the achieved-social-participation group, the difficult-social-participation group showed greater injury and cognitive dysfunction and lower Sydney Psychosocial Reintegration Scale and Short Form 36 role/social component summary scores (64.9/49.1 vs 44.3/30.4, respectively, P < 0.05). Linear regression analysis showed that the social participation status was greatly affected by the later cognitive disorders and psychosocial factors/problems not by the severity of TBI. No changes were observed in these scores following chronic-phase rehabilitation intervention. Chronic-phase TBI with cognitive disorder led to rehabilitation needs, and improvement of subjects’ psychosocial problems and QOL was difficult.
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spelling pubmed-52879712017-02-08 Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury Sashika, Hironobu Takada, Kaoruko Kikuchi, Naohisa Medicine (Baltimore) 6300 The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects. A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department. Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and <70 years at the time of injury; a score of 0–3 on the Modified Rankin Scale at discharge and that of 4–5 due to physical or severe aggressive behavioral comorbid disorders. Study details were sent, via mail, to 84 suitable candidates, of whom 36 replied. Thirty-one subjects (median age: 33.4 years; male: 17; and average time since injury: 48.1 months), who had consented to study participation, were participated. Cognitive function, social participation, QOL, psychosocial factors/problems, rehabilitation needs, and chronic-phase rehabilitation outcomes were evaluated using the Wechsler Adult Intelligence Scale, Third Edition, the Wechsler Memory Scale-Revised, the Zung Self-Rating Depression Scale, the Sydney Psychosocial Reintegration Scale, Version 2, and the Short Form 36, Version 2, qualitative analysis of semistructured interviews, etc. Participants were classified into achieved-social-participation (n = 11; employed: 8), difficult-social-participation (n = 12; unemployed: 8), and no-cognitive-dysfunction groups (n = 8; no social participation restriction). Relative to the achieved-social-participation group, the difficult-social-participation group showed greater injury and cognitive dysfunction and lower Sydney Psychosocial Reintegration Scale and Short Form 36 role/social component summary scores (64.9/49.1 vs 44.3/30.4, respectively, P < 0.05). Linear regression analysis showed that the social participation status was greatly affected by the later cognitive disorders and psychosocial factors/problems not by the severity of TBI. No changes were observed in these scores following chronic-phase rehabilitation intervention. Chronic-phase TBI with cognitive disorder led to rehabilitation needs, and improvement of subjects’ psychosocial problems and QOL was difficult. 2017-01-27 /pmc/articles/PMC5287971/ /pubmed/28121947 http://dx.doi.org/10.1097/MD.0000000000005968 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 6300
Sashika, Hironobu
Takada, Kaoruko
Kikuchi, Naohisa
Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title_full Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title_fullStr Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title_full_unstemmed Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title_short Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
title_sort rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury
topic 6300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287971/
https://www.ncbi.nlm.nih.gov/pubmed/28121947
http://dx.doi.org/10.1097/MD.0000000000005968
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