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Abstract
Three hundred and twenty-six persons with light, moderate, or severe diffuse traumatic
brain injury (TBI) were assessed during initial hospitalization in Johannesburg. One
hundred and forty-four were followed up at approximately six months, 83 at 12 months,
and 71 at 24 months posttrauma. The sample attrition rate was high. When patients
could not be found, data were obtained from their caregivers. Recovery was measured
in five different areas of functioning: family relationships, psychologic problems,
activities of daily living (ADL), employment status, and physical status. Psychologic
problems and family relationships worsened with time, but proficiency in ADL improved;
physical and employment status remained relatively stable during the survey period.
Severity of injury was significantly correlated with outcome in each functional area
at some point in the follow-up period. Discrepancies between patients' and caregivers'
perceptions of outcome were noted, particularly in the area of psychologic functioning.
Caregivers tended to rate the recovery made by the patients as better than the outcome
patients perceived themselves to have made. These differences in perception diminished
with time. The multifactorial nature of recovery after TBI is indicated by the improvement
seen in some functional areas and the worsening of outcome in other areas. These findings
suggest that rehabilitation programs for persons with TBI should (1) include caregivers,
(2) focus on the adjustment of both parties to their new circumstances, and (3) facilitate
a convergence in their perceptions. Adequately defining recovery is a first step to
estimating the prevalence of TBI, but necessitates further work. Epidemiology awaits
a better understanding of the recovery process after TBI.
Keywords
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Article info
Publication history
Accepted:
July 1,
1991
Received:
September 29,
1990
Identification
Copyright
© 1992 Published by Elsevier Inc.
