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Assessment of community integration following rehabilitation for traumatic brain injury
Abstract
: Community integration is defined as integration into a home-like setting, integration into a social network, and integration into productive activities such as employment, school, or volunteer work. For the purpose of evaluating outcomes for individuals with traumatic brain injury (TBI) who are provided with rehabilitation services in model systems programs, community integration was assessed using the Community Integration Questionnaire (CIQ). The CIQ was found to have good test-retest reliability and internal consistency. It could also discriminate between individuals with TBI and individuals who have no apparent disabilities. Individuals treated in model systems programs revealed significantly better scores on home integration and social integration when compared to a large community sample of individuals with TBI. Although these findings are preliminary, it appears that the CIQ is a useful measure for rehabilitation program evaluation.
(C) Williams & Wilkins 1993. All Rights Reserved.
... En lo que respecta a las escalas utilizadas para evaluar la participación social, se identificaron cuatro diferentes (Tabla 1): Participation Assessment With Recombined Tools-Objective (PART-O; Whiteneck et al., 2011), Community Integration Questionnaire (CIQ; Willer et al., 1993), Impact on Participation and Autonomy (IPA; Cardol et al., 1999), y Sydney Psychosocial Reintegration Scale, Version 2 (SPRS-2; Tate et al., 2012). La mayoría de esas escalas, excepto una (IPA), tienen como unidad de medida para la evaluación de la participación la frecuencia con que se realizan actividades sociales. ...
... En lo que respecta a la evaluación de la participación social, se destaca que todos los estudios revisados utilizaron escalas que fueron diseñadas para identificar cambios en la participación en personas con patologías o discapacidades. Las escalas PART-O (Whiteneck et al., 2011) y CIQ (Willer et al., 1993) fueron diseñadas específicamente para pacientes con TCE, la escala SPRS-2 (Tate et al., 2012) para pacientes con daño cerebral adquirido y la IPA (Cardol et al., 1999) para personas con discapacidades en general. Todas las escalas, excepto el cuestionario IPA, tienen como unidad de la evaluación a la frecuencia con la que se realizan actividades sociales. ...
Objetivo. La participación social es el acto de involucrarse en actividades que proporcionan interacciones con otras personas, y puede verse afectada en personas que han sufrido un traumatismo craneoencefálico (TCE). Este trabajo propone identificar qué factores influyen en dicha afectación. Método. Se realizó una revisión sistemática de artículos disponibles en PubMed, EBSCO y SCOPUS, publicados desde 2010 hasta 2020. Resultados. Los artículos revisados concuerdan que la participación social de los pacientes adultos con TCE se ve afectada por las siguientes variables: síntomas depresivos, edad, nivel educativo, alteraciones cognitivas y calidad de vida. Finalmente, se observó que la evaluación de la participación social está focalizada en la frecuencia con que los pacientes realizan actividades sociales y no indagan en la satisfacción personal con el nivel de participación.
... The Social Participation Questionnaire was preferred to assess the extent the subjects actively took part in life activities and how active they were [17]. The Social Participation Questionnaire consists of 15 items. ...
Purpose: The aim of this study was to evaluate how surgical and medical treatments affect the quality of life, depression status and social participation of women with Stress Urinary Incontinence (SUI). Materials and Methods: The study included 32 women with diagnoses of SUI. Among these women, 16 were designated as the medical treatment group (MTG), and the other 16 were designated as the surgical treatment group (STG). Before the treatment and 8 weeks after its completion, the patients were evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Quality of Life Questionnaire (I-QOL), World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), Beck Depression Inventory (BDI) and Social Participation Questionnaire (SPQ). Results: The mean age of the subjects was 54.31±11.48 years in MTG and 48.38±10.01 years in STG. The mean body mass index (BMI) values of the groups were respectively 27.56±2.79 and 26.56±2.25 kg/m2. Following the treatment, statistically significant improvements were observed in urinary incontinence, depression, social participation and overall and disease-specific quality of life in both groups (p<0.05). Comparative analysis of the post-treatment changes in both groups showed statistically significant differences in the BDI score, the total work activity and household activity scores in the Social Participation Questionnaire and the psychosocial subgroups of both WHOQOL-BREF and I-QOL (p<0.05). Conclusion: Both treatments proved to be effective and usable to reduce the severity of SUI and depression, prevent social isolation and improve the quality of life. However, extensive research is required on the effects of SUI treatment methods on larger patient groups.
... 6 Different SP outcome measures are available (for a review, see Chung and colleagues 7 ), but there is no consensus yet on one accepted metrically sound tool to measure SP such as that defined by the ICF, for example. According to Sander and colleagues, 3 three tools are most widely used to measure SP outcome: the Community Integration Questionnaire (CIQ), 8 the Craig Handicap Assessment and Reporting Technique (CHART) 9 and the Participation subscale of the Mayo-Portland Adaptability Inventory (MPAI-4). 10,11 The Participation Assessment with Recombined Tools-Objective (PART-O), 12,13 derived from the CIQ, CHART, and Participation Objective, Participation Subjective instruments, is also used for evaluating functioning at the societal level. ...
Social participation (SP) is one of many objectives in the rehabilitation of patients with traumatic brain injury (TBI). Studies on predictors of SP specific to post-acute universally accessible specialized rehabilitation pathways following TBI are scarce. Our objectives were to: 1) characterize SP, as well as a set of pre-injury, injury-related, and post-injury variables in individuals participating in inpatient-outpatient or outpatient rehabilitation pathways within a universally accessible and organized trauma continuum of care, and 2) examine the ability of pre-injury, injury-related, and post-injury variables in predicting SP outcome after TBI according to rehabilitation path. Participants (N = 372) were adults admitted to an inpatient-outpatient rehabilitation pathway or an outpatient rehabilitation pathway after sustaining a TBI between 2016 and 2020, and for whom Mayo-Portland Adaptability Intentory-4 (MPAI-4) outcomes were prospectively obtained at the start and end of rehabilitation. Additional data was collected from medical files. For both rehabilitation pathways, predicted SP outcome was MPAI-4 Participation score at discharge from outpatient rehabilitation. Multiple regression models investigated the predictive value of each variable for SP outcome, separately for each care pathway. Main findings show that for the inpatient-outpatient sample, three variables (education years, MPAI-4 Ability and Adjustment scores at rehabilitation intake) significantly predicted SP outcome, with the regression model accounting for 49% of the variance. For the outpatient sample, five variables (premorbid hypertension and mental health diagnosis, total indirect rehabilitation hours received, MPAI-4 Abilities and Adjustment scores at rehabilitation intake) significantly predicted SP outcome, with the regression model accounting for 47% of the variance. In conclusion, different premorbid and post-injury variables are involved in predicting SP, depending on the rehabilitation path followed. The predictive value of those variables could help clinicians identify patients more likely of showing poorer SP at discharge and who may require additional or different interventions.
... 1 The other administered rating scales were the AUDIT Alcohol Consumption Questions (AUDIT-C; Bush et al., 1998), Community Integration Questionnaire (Willer et al., 1993), Numeric Pain Scale (McCaffery & Beebe, 1993), Physical Activity Questionnaire (Kohl et al., 1988), Pittsburgh Sleep Quality Index -PTSD Version (Buysse et al., 1989;Germain et al., 2005), and UCLA Loneliness Scale (Russell, 1996). ...
Despite significant treatment advances, many military veterans continue to suffer from posttraumatic stress disorder ( PTSD ) and associated symptoms, suggesting a need for new interventions. This pilot trial examined the change in psychological symptoms of 19 veterans in treatment for PTSD who were randomized either to adopt a dog immediately from a Humane Society shelter ( n = 9) or to a three-month waitlist followed by dog adoption ( n = 10). The dogs were companion dogs, not service animals. The investigators analyzed quantitative assessments using mixed regression models with repeated measures. All veterans also participated in periodic semi-structured interviews. The study results showed companion dog adoption to be a feasible adjunctive intervention that helped improve PTSD and depressive symptoms for most participants. These findings suggest that this is a promising approach that is worthy of further study.
Background
Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available.
Purpose
To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions.
Methods
PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy.
Results
Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22).
Conclusions
This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.
Background
Decreased participation and life satisfaction are common post-stroke. Exploratory studies have indicated associations between these outcomes and personal factors. Information remains limited and experiences of people with stroke are not well-represented or understood.
Aims/Objectives
The aim of this study was to explore how personal factors influence experiences of participation and life satisfaction for people with stroke living in the community.
Material and Methods
Qualitative in-depth semi-structured interviews were conducted with eight participants living in the community post-stroke, chosen purposively based on participation and life satisfaction levels. Data were interrogated using interpretative phenomenological analysis.
Results
Three themes were identified: (1) What does participation mean to me? (2) Looking forward or looking back, and (3) Appraisals, avoidance, and “getting on with it”. The first acknowledged the multifaceted nature of participation, although it was typically viewed as incorporating active involvement and social interaction. The additional two themes explored impacts of pre/post-stroke self-discrepancies and threat appraisals on participation and life satisfaction outcomes.
Conclusions and Significance
Relationships between participation and personal factors seem to be bidirectional. Life satisfaction appeared to be influenced by rumination on negative self-discrepancies based on difference in pre/post-stroke participation. Findings suggest there may be value in examining the influence of personal factor-related interventions on post-stroke outcomes.
Introduction
Individuals with acquired brain injury may find it difficult to self-manage and live independently. Brain-in-Hand is a smartphone app designed to support psychological problems and encourage behaviour change, comprised of a structured diary, reminders, agreed solutions, and traffic light monitoring system.
Aim
To evaluate the potential use and effectiveness of Brain-in-Hand for self-management in adults with acquired brain injury.
Methods
A-B mixed-methods case-study design. Individuals with acquired brain injury ( n = 10) received Brain-in-Hand for up to 12 months. Measures of mood, independence, quality of life, cognition, fatigue, goal attainment, participation administered at baseline, 6 and 12 months. Semi-structured interviews conducted with acquired brain injury participants ( n = 9) and healthcare workers ( n = 3) at 6 months.
Results
Significant increase in goal attainment after 6 months use (t(7) = 4.20, p = .004). No significant improvement in other outcomes. Qualitative data suggested improvement in anxiety management. Contextual (personal/environmental) factors were key in influencing the use and effectiveness of Brain-in-Hand. Having sufficient insight, appropriate support and motivation facilitated use.
Conclusions
Brain-in-Hand shows potential to support acquired brain injury, but further work is required to determine its effectiveness. Context played a pivotal role in the effectiveness and sustained use of Brain-in-Hand, and needs to be explored to support implementation.
Purpose: The aim of this study is to examine the activities of daily living and community integration of individuals with presbycusis. Material and Methods: The study included 90 individuals (65+) in total (30 with hearing loss and refusing to use device, 30 with hearing loss, 30 without hearing loss). The individuals participating in the study were evaluated using the Canadian Occupational Performance Measure (COPM), Mayers' Lifestyle Questionnaire (MYQ3), Hearing Handicap Inventory for Elderly (HHIE) and Community Integration Questionnaire (CIQ-R). Results: In HHIE, the results of individuals without hearing loss were found higher than those who used or refused to use devices (p>0.05). There wasn’t difference between the groups in the performance and satisfaction scores in the COPM and the MYQ3 sub-parameters (p>0.05). While there wasn’t significant difference in home participation and social participation in CIQ-R (p>0.05), the results of individuals without hearing loss in productivity, electronic and social networking were found higher than individuals using devices (p>0.05). Discussion: Among the groups, it was observed that the two groups with hearing impairment had more difficulty in using technological products in COPM. Supporting individuals with presbycusis with correct device use and occupational therapy approaches is important in terms of independence.
Background
Various factors affect the community integration (CI) of persons experiencing traumatic brain injury (TBI). To ensure positive outcomes in terms of life at home, social activities, and productive work among persons suffering TBI, it is necessary to understand the factors that facilitate or impede CI.
Purpose
To compare CI by looking at demographic and clinical characteristics and determine significant predictors of CI among TBI Nepalese persons.
Methods
120 participants were selected using a stratified random sampling technique. A questionnaire was used to identify the participants’ demographic and clinical characteristics, and the Community Integration Questionnaire was used to measure CI. Univariate and multivariate analyses were performed for demographic and clinical factors associated with community integration.
Results
Using univariate analysis, male, employed, living with family, and independence in performing activities of daily living had significantly higher CI scores than female (t = −4.18, p<.000), unemployed (t = −10.52, p<.000), living with friends (t = −3.30, p<.001), and those with moderate to slight dependence (t = −2.83, p<.005). The multivariate analysis revealed that employment status, living with family, and length of hospital stay were significant predictors of CI among TBI Nepalese persons.
Conclusion
Employment status, living with family, and length of hospital stay were significant predictors of CI. These findings suggest that rehabilitation efforts should focus on minimizing hospital stay and promoting both productive and social activities among people surviving TBI.
Objective
To evaluate the correlation between self-reported balance confidence and community integration related to home management for community-dwelling adults with acquired brain injury (ABI).
Methods
This is a study of 141 participants over the age of 18 with a history of ABI, living in the community, who completed an online survey. The survey included a series of demographic questions followed by the Activities-Specific Balance Confidence Scale (ABC) and the Home Integration subscale of the Community Integration Questionnaire (CIQ-H).
Results
Data from 119 completed surveys were included in the analysis. Significant positive correlations were found between the ABC and the CIQ-H total scores ( r s = 0.241, p = 0.008). There was no significant difference between CIQ-H total scores in individuals by injury type (traumatic vs non-traumatic) or by level of severity (mild, moderate, severe) ( p > 0.05). There was no significant difference between ABC total scores by injury type ( p > 0.05).
Conclusions
Higher levels of balance confidence may be associated with improved community integration related to home management for individuals with traumatic and non-traumatic BI. This study’s results support future research to evaluate the integration of strategies to improve balance confidence as a component of interdisciplinary assessment and rehabilitation to maximize community integration in community-dwelling adults with ABI.
Investigated whether traumatic brain injury patients (TBIPs) with persistent cognitive deficits could achieve successful community readaptation following outpatient retraining or residential treatment. 18 TBIPs (aged 16–53 yrs) were assigned to cognitive retraining, and a control group of 9 TBIPs received no intervention. 14 male TBIPs (aged 18–52 yrs) also completed residential treatment. Ss completed a disability rating scale and a psychosocial rating scale. All TBIPs achieved a reduction in disability related to cognitive deficits, although some did not benefit sufficiently from either readaptation approach. (PsycINFO Database Record (c) 2012 APA, all rights reserved)