TY - JOUR
T1 - Rehabilitation needs at 5 years post-traumatic brain injury
T2 - A VA TBI model systems study
AU - Mahoney, Elaine J.
AU - Silva, Marc A.
AU - Reljic, Tea
AU - Dams-O'Connor, Kristen
AU - Hammond, Flora M.
AU - Monden, Kimberly R.
AU - Chung, Joyce S.
AU - Dillahunt-Aspillaga, Christina
AU - Nakase-Richardson, Risa
N1 - Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Objective: Describe rehabilitation needs and factors associated with unmet needs at 5 years post-traumatic brain injury (TBI). Setting: Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs). Participants: VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI). Design: Prospective observational cohort. Main Measures: Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, and functional needs); Craig Hospital Inventory of Environmental Factors (25-item survey of potential environmental barriers). Results: Participants endorsed a mean of 8 (SD: 6.2) ongoing and 3 (SD: 4.7) unmet rehabilitation needs at 5 years post-TBI. Approximately 65% of participants reported at least 1 rehabilitation need that remained unmet. The number and nature of needs differed across TBI severity groups. In unadjusted and adjusted linear regression models, Black race and environmental barriers (Craig Hospital Inventory of Environmental Factors total score) were predictive of unmet needs (P <.001). Those with greater unmet needs reported the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), and in-home assistance (32%) as the most frequent environmental barriers at 5 years post-TBI. Conclusion: Veterans and Service Members continue to have rehabilitation needs at 5 years post-TBI. Veterans Affairs programs to address ongoing needs and policy to support them are needed.
AB - Objective: Describe rehabilitation needs and factors associated with unmet needs at 5 years post-traumatic brain injury (TBI). Setting: Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs). Participants: VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI). Design: Prospective observational cohort. Main Measures: Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, and functional needs); Craig Hospital Inventory of Environmental Factors (25-item survey of potential environmental barriers). Results: Participants endorsed a mean of 8 (SD: 6.2) ongoing and 3 (SD: 4.7) unmet rehabilitation needs at 5 years post-TBI. Approximately 65% of participants reported at least 1 rehabilitation need that remained unmet. The number and nature of needs differed across TBI severity groups. In unadjusted and adjusted linear regression models, Black race and environmental barriers (Craig Hospital Inventory of Environmental Factors total score) were predictive of unmet needs (P <.001). Those with greater unmet needs reported the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), and in-home assistance (32%) as the most frequent environmental barriers at 5 years post-TBI. Conclusion: Veterans and Service Members continue to have rehabilitation needs at 5 years post-TBI. Veterans Affairs programs to address ongoing needs and policy to support them are needed.
KW - Brain injuries
KW - Military personnel
KW - Rehabilitation
KW - Traumatic
KW - Veterans
UR - http://www.scopus.com/inward/record.url?scp=85102952179&partnerID=8YFLogxK
U2 - 10.1097/HTR.0000000000000629
DO - 10.1097/HTR.0000000000000629
M3 - Article
C2 - 33201036
AN - SCOPUS:85102952179
SN - 0885-9701
VL - 36
SP - 175
EP - 185
JO - Journal of Head Trauma Rehabilitation
JF - Journal of Head Trauma Rehabilitation
IS - 3
ER -