Stephanie A Kolakowsky-Hayner

Publications (13)27.48 Total impact

• Source

  Available from: Tamara Bushnik

  Article: Psychometric Properties of the Multidimensional Assessment of Fatigue Scale in Traumatic Brain Injury: An NIDRR Traumatic Brain Injury Model Systems Study.

  Anthony Lequerica, Tamara Bushnik, Jerry Wright, Stephanie A Kolakowsky-Hayner, Flora M Hammond, Marcel P Dijkers, Joshua Cantor
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  ABSTRACT: OBJECTIVE:: To investigate the psychometric properties of the Multidimensional Assessment of Fatigue (MAF) scale in a traumatic brain injury (TBI) sample. DESIGN:: Prospective survey study. SETTING:: Community. PARTICIPANTS:: One hundred sixty-seven individuals with TBI admitted for inpatient rehabilitation, enrolled into the TBI Model Systems national database, and followed up at either the first or second year postinjury. INTERVENTIONS:: Not applicable. MAIN OUTCOME MEASURE(S):: Multidimensional Assessment of Fatigue. RESULTS:: The initial analysis, using items 1 to 14, which are based on a 10-point rating scale, found that only 1 item ("walking") misfit the overall construct of fatigue in this TBI population. However, this 10-point rating scale was found to have disordered thresholds. When ratings were collapsed into 4 response categories, all MAF items used to calculate the Global Fatigue Index formed a unidimensional scale. CONCLUSION(S):: Findings generally support the unidimensionality of the MAF when used in a TBI population but call into question the use of a 10-point rating scale for items 1 to 14. Further study is needed to investigate the use of a 4-category rating scale across all items and the fit of the "walking" item for a measure of fatigue among individuals with TBI.
  The Journal of head trauma rehabilitation 11/2012; 27(6):E28-E35. · 2.39 Impact Factor
• Source

  Available from: Tamara Bushnik

  Article: Insomnia, Fatigue, and Sleepiness in the First 2 Years After Traumatic Brain Injury: An NIDRR TBI Model System Module Study.

  Joshua B Cantor, Tamara Bushnik, Keith Cicerone, Marcel P Dijkers, Wayne Gordon, Flora M Hammond, Stephanie A Kolakowsky-Hayner, Anthony Lequerica, Michael Nguyen, Lisa A Spielman
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  ABSTRACT: OBJECTIVE:: To determine the prevalence of insomnia and posttraumatic brain injury (TBI) fatigue (PTBIF) in individuals with moderate to severe TBI, to explore the relationship between PTBIF and insomnia and their association with outcomes. DESIGN:: Cross-sectional study. SETTING:: Five National Institute of Disability and Rehabilitation Research TBI Model Systems. PARTICIPANTS:: Three hundred thirty-four individuals with TBI who completed 1-year (n = 213) or 2-year (n = 121) follow-up interviews between 2008 and 2012. MAIN OUTCOME RESULTS:: Insomnia occurred in 11% to 24% and PTBIF in 33% to 44% of the individuals. Insomnia and fatigue were both related to sleep disturbance, sleep hygiene, satisfaction with life, anxiety, and depression. PTBIF was associated with greater disability and sleepiness. Insomnia without fatigue was rare (2%-3%) but PTBIF without insomnia occurred in 21% to 23% of the individuals. Comorbidity occurred in 9% to 22% of the individuals. CONCLUSIONS:: Although PTBIF and insomnia are closely related and both associated with poorer quality of life, they are affected independently by a variety of factors, especially psychopathology and sleep quality. A majority of individuals with PTBIF do not have insomnia; and PTBIF appears to be related to disability severity and daytime sleepiness, where insomnia is not. Demographic and injury variables are not strong predictors of insomnia or PTBIF.
  The Journal of head trauma rehabilitation 11/2012; 27(6):E1-E14. · 2.39 Impact Factor
• Source

  Available from: Tamara Bushnik

  Article: Traumatic Brain Injury With and Without Late Posttraumatic Seizures: What Are the Impacts in the Post-Acute Phase: A NIDRR Traumatic Brain Injury Model Systems Study.

  Tamara Bushnik, Jeffrey Englander, Jerry Wright, Stephanie A Kolakowsky-Hayner
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  ABSTRACT: : To compare and contrast the levels of impairment, disability, and community participation of individuals with traumatic brain injury (TBI) with or without late posttraumatic seizures (LPTS). : Prospective survey study. : Community. : Two groups of 91 individuals with TBI, with and without LPTS, were enrolled in the TBI Model Systems National Database between 1989 and 2002 and interviewed at years 1, 2, and 5 postinjury. : Not applicable. : Demographic, injury severity, productivity, and psychosocial outcomes. : The majority of the demographic and productivity outcomes up to 5 years postinjury were similar between individuals in the LPTS and non-LPTS groups. Both the LPTS and non-LPTS groups showed an increasing percentage of individuals who began to live alone after the first year postinjury and a decreasing percentage of individuals who were living with family members at 5 years postinjury compared with the first year post-TBI. A higher percentage of individuals in the LPTS group reported using more dependent forms of transportation such as riding with others or using public transportation. Individuals in the LPTS group had higher Disability Rating Scale scores at all time points, denoting greater functional disability, than individuals in the non-LPTS group, despite the 2 groups having similar Disability Rating Scale scores at discharge from rehabilitation. Satisfaction With Life Scale scores showed no changes over time but were significantly different between both groups at all time points, with individuals in the LPTS group reporting lower Satisfaction With Life Scale score than individuals in the non-LPTS group. : It does appear that the development of LPTS following a TBI is associated with poorer functional and psychosocial outcomes in the first 5 years after injury. It remains to be determined whether there are other factors that also may account for these differences and that may be amenable to intervention.
  The Journal of head trauma rehabilitation 11/2012; 27(6):E36-44. · 2.39 Impact Factor
• Article: Mayo-Portland Adaptability Inventory-4.

  Kimberly Bellon, James F Malec, Stephanie A Kolakowsky-Hayner
  The Journal of head trauma rehabilitation 07/2012; 27(4):314-6. · 2.39 Impact Factor
• Article: A brief overview of the Patient Competency Rating Scale: updates and additions to the COMBI.

  Stephanie A Kolakowsky-Hayner, Jerry Wright, Kimberly Bellon
  The Journal of head trauma rehabilitation 01/2012; 27(1):83-5. · 2.39 Impact Factor
• Article: Acceptance rates in state-federal vocational rehabilitation of clients with brain injury: Is racial disparity an issue?

  Stephanie A Kolakowsky-Hayner
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  ABSTRACT: To utilize Aday and Andersen's Framework for the Study of Access to examine racial disparity within the State-Federal vocational rehabilitation system, among clients with brain injury. Research questions included: Do pre-disposing characteristics such as age, race, ethnicity, gender, marital status and education influence vocational rehabilitation acceptance rates in the US? Do enabling characteristics such as referral source, insurance coverage and primary source of support at application influence vocational rehabilitation acceptance rates in the US? Is there a difference, based on race, in the reason for case closure for vocational rehabilitation services? Exhaustive CHAID analysis was conducted with acceptance for rehabilitation as the criterion variable and pre-disposing characteristics as predictor variables. Chi-square analysis was calculated with regard to reason for closure. Descriptive findings are presented. Of the pre-disposing factors, the most significant predictor of acceptance rate was education level. Pearson Chi-square analyses revealed significant differences between White and non-White clients with brain injury with regard to reason for closure. The data indicate that racial differences were only a small part of the overall equation and again that distinct disparity by race is not evidenced in the RSA-911 data for persons with a primary or secondary diagnosis of brain injury.
  Brain Injury 01/2010; 24(12):1428-47. · 1.36 Impact Factor
• Article: The relationship between therapy intensity and rehabilitative outcomes after traumatic brain injury: a multicenter analysis.

  David X Cifu, Jeffrey S Kreutzer, Stephanie A Kolakowsky-Hayner, Jennifer H Marwitz, Jeffrey Englander
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  ABSTRACT: To identify factors relating to the intensity of rehabilitation services received and to ascertain the relation between injury outcomes, demographics, types of therapy, and the intensity of rehabilitation services provided. A multicenter, prospective, nonrandomized study with inpatient rehabilitation data collected between 1989 and 1996. Three medical centers in the federally sponsored Traumatic Brain Injury Model Systems. In each setting, the continuum of care includes emergency medical services, intensive and acute medical care, and inpatient rehabilitation. A total of 491 consecutively enrolled patients with a mean age +/- standard deviation of 34.3+/-15.88 years recruited from 3 medical centers. To be included in the study, patients must have been at least 16 years of age, have presented to the emergency department within 24 hours of injury, and have received acute care and inpatient rehabilitation. Patients received comprehensive medical care along with a combination of rehabilitative therapies, including physical, occupational, psychologic, and speech therapy. Therapy intensity; levels of functional independence, cognitive function, functional gain, and treatment efficiency, as indicated by the FIM instrument; rehabilitation length of stay (LOS); and charges. Age predicted the intensity of both psychologic (P<.001) and total therapy (P<.01) services. Acute care LOS was also a significant predictor of psychologic services (P<.01). Only admission motor FIM was relevant in predicting speech services intensity (P<.01). Therapy intensity was predictive of motor functioning at discharge (P<.001). However, therapy intensity did not predict cognitive gain (P<.05). This study is among the first multicenter efforts to examine the potential benefits of individual therapy services. Findings support assertions that increased therapy intensity, particularly physical and psychologic therapies, enhances functional outcomes.
  Archives of Physical Medicine and Rehabilitation 11/2003; 84(10):1441-8. · 2.28 Impact Factor
• Article: Ethnographic analysis of traumatic brain injury patients in the national Model Systems database.

  Derek M Burnett, Stephanie A Kolakowsky-Hayner, Dan Slater, Anthony Stringer, Tamara Bushnik, Ross Zafonte, David X Cifu
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  ABSTRACT: To compare demographics, injury characteristics, therapy service and intensity, and outcome in minority versus nonminority patients with traumatic brain injury (TBI). Retrospective analysis. Twenty medical centers. Two thousand twenty patients (men, n=1,518; women, n=502; nonminority, n=1,168; minority, n=852) with TBI enrolled in the Traumatic Brain Injury Model Systems database. Not applicable. Age, gender, marital status, education, employment status, injury severity (based on Glasgow Coma Scale [GCS] admission score, length of posttraumatic amnesia, duration of unconsciousness), intensity (hours) of therapy rendered, rehabilitation length of stay (LOS), rehabilitation charges, discharge disposition, postinjury employment status, FIM instrument change scores, and FIM efficiency scores. Independent sample t tests were used to analyze continuous variables; chi-square analyses were used to evaluate categorical data. Demographics: overall, minorities were found to be mostly young men who were single, unemployed, and less well educated, with a longer work week if employed when injured. Etiology: motor vehicle crashes (MVCs) predominated as the cause of injury for both groups; however, minorities were more likely to sustain injury from acts of violence and auto-versus-pedestrian crashes. Minorities also had higher GCS scores on admission and shorter LOS. Rehabilitation services: significant differences were found in the types and intensity of rehabilitation services provided; these included physical therapy, occupational therapy, and speech-language pathology, but not psychology. Minority patients who sustain TBI generally tend to be young men with less social responsibility. Although MVCs predominate as the primary etiology, acts of violence and auto-versus-pedestrian incidents are more common in the minority population. Minorities tend to have higher GCS scores at admission. Also, the type and intensity of rehabilitation services provided differed significantly for the various interdisciplinary subspecialties. Rehabilitation charges, discharge disposition, and postinjury employment status were similar for the 2 groups, even though LOS is typically 3 to 4 days shorter for the minority group. A more detailed investigation is warranted to explain these findings.
  Archives of Physical Medicine and Rehabilitation 03/2003; 84(2):263-7. · 2.28 Impact Factor
• Article: A structured approach to family intervention after brain injury.

  Jeffrey S Kreutzer, Stephanie A Kolakowsky-Hayner, Sarah R Demm, Michelle A Meade
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  ABSTRACT: Given the limitations of the literature, a structured approach to helping families after brain injury is clearly needed. On the basis of considerable clinical experience and research review, this article describes the Brain Injury Family Intervention (BIFI), developed to address common issues, concerns, and challenges. The foundation of the BIFI is a curriculum that includes 16 intervention topics, self-evaluation tools, and treatment strategies. Despite individual differences, families often encounter similar problems in their attempts to resume normal lives. A structured approach to family intervention can help mitigate commonly encountered problems.
  Journal of Head Trauma Rehabilitation 09/2002; 17(4):349-67. · 3.33 Impact Factor
• Article: Post-injury substance abuse among persons with brain injury and persons with spinal cord injury.

  Stephanie A Kolakowsky-Hayner, Eugene V Gourley, Jeffrey S Kreutzer, Jennifer H Marwitz, Michelle A Meade, David X Cifu
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  ABSTRACT: PRIMARY OBJECTIVE: To identify the patient population at greatest risk for post-injury adjustment problems, the present study independently examines and compares alcohol and drug use rates in patients with traumatic brain injury (TBI) and patients with spinal cord injury. Research design: The two samples were matched with regard to age, gender and mechanism of injury. The study provides a description of post-injury use rates for each population, and describes similarities and differences between the two groups. Methods and procedures: Participants included 30 consecutive Model Systems spinal cord injury (SCI) patients seen for follow-up neuropsychological testing between October 1996-June 1999. An equivalent number of Model Systems TBI patients were matched from a larger sample comprised of 440 consecutive hospital admissions, that returned for a 1-year follow-up neuropsychological evaluation between February 1989-December 1998. All participants were treated in an urban Level I trauma centre and associated inpatient rehabilitation programmes. Information regarding patient demographics, as well as pre- and post-injury psychiatric, employment, academic, criminal, and medical history was obtained via the General Health and History Questionnaire. Main outcomes and results: With regard to post-injury alcohol use rates, persons with spinal cord injury were more likely to drink on a daily basis. Although not statistically significant, pre-injury drinking rates differed from post-injury rates for both groups. With regard to illicit drug use, persons with TBI differed significantly from persons with SCI. A significant difference was also noted between pre-injury drug use and post-injury drug use for both groups. CONCLUSIONS: Persons who drink post-injury are unlikely to be 'light' or social drinkers. Either people choose to abstain completely or appear to use alcohol frequently.
  Brain Injury 08/2002; 16(7):583-92. · 1.36 Impact Factor
• Article: Impact of minority status following traumatic spinal cord injury.

  Derek M Burnett, Stephanie A Kolakowsky-Hayner, Joy M White, David X Cifu
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  ABSTRACT: To interpret the data from the Spinal Cord Injury-Model Systems as it applies to demographics, incidence and functional outcomes of minority patients with spinal cord injury. Retrospective analysis of patients admitted to acute inpatient rehabilitation Spinal Cord Injury Model Systems Centers. Descriptive statistics including means, standard deviations, and proportions were computed for all relevant variables. Participants were grouped into two categories for purposes of analysis, non-minorities (white) and minorities, who were >90% African American. Differential statistics were used for comparisons with regard to demographics, etiology, sponsor of care, length of stay, charges, ASIA Motor Index scores, and FIM scores. Categorical data was analyzed using chi-square analyses while continuous data were analyzed using ANOVA procedures. Analyses revealed significant differences between minorities and non-minorities in terms of age at injury, gender, marital status, employment status, education level, health insurance provider, injury severity, etiology, and discharge disposition. Analysis of the data indicates that violence is the leading single cause of spinal cord injury in minority patients admitted to the model systems centers. The majority of patients who sustained spinal cord injury secondary to violence were minorities with the following demographics: young, single, unemployed males, with less than a high school education, residing in an urban area.
  Neurorehabilitation 02/2002; 17(3):187-94. · 1.63 Impact Factor
• Article: Laws of the House of Rehab II: Practice fundamentals for improving therapeutic relationships and outcomes.

  Jeffrey S. Kreutzer, Stephanie A. Kolakowsky-Hayner
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  ABSTRACT: Interdisciplinary rehabilitation can be a complex, challenging, and sometimes confusing process. The varying experiences and perspectives of patients and professionals contribute to the diversity of challenging dilemmas. This manuscript is intended to help rehabilitation professionals improve their effectiveness and the quality of their relationships with patients, family members, and colleagues. The manuscript complements a prior publication, Laws of the House of Rehab: A Guide to Managing Psychological Distress and Promoting Benefit from Rehabilitation [2]. The authors have included additional information relating to principles of rehabilitation practice. The principles, labeled as "laws", provide guidance for developing values and practice methods.
  Neurorehabilitation 02/2000; 14(1):41-51. · 1.63 Impact Factor
• Article: Validation of the Service Obstacles Scale for the traumatic brain injury population.

  Stephanie A. Kolakowsky-Hayner, Jeffrey S. Kreutzer, K. Dawn Miner
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  ABSTRACT: Traumatic brain injury is a leading cause of death and disability in the United States. Limited access to specialized medical and rehabilitation services has been linked to poor outcomes. Literature provides little guidance for assessment of service obstacles and satisfaction with community resources. The present investigation describes the development of a specialized scale to evaluate caregivers' perceptions of brain injury services in the community. Results indicate good internal consistency and criterion-related validity of the Service Obstacles Scale. Lack of money for services and lack of adequate community resources were the greatest concerns voiced by respondents, while lack of transportation was the least problematic. Comparisons are made with regard to family needs and respondents' post-injury life quality. Implications for future research are discussed.
  Neurorehabilitation 02/2000; 14(3):151-158. · 1.63 Impact Factor