Abstract
Objectives
Design
Setting
Participants
Interventions
Main Outcome Measures
Results
Conclusions
Keywords
List of abbreviations:
CCHS (Canadian Community Health Survey), GCS (Glasgow Coma Scale), OR (odds ratio), TBI (traumatic brain injury), W-TBI (women with traumatic brain injury)Methods
Study population
Data collection
Statistics Canada. Canadian Community Health Survey (CCHS). Questionnaire for Cycle 2.1, January 2003 to November 2003. Revised July 2005. [Date modified 2007-10-24.] Available at: http://www23.statcan.gc.ca/imdb-bmdi/pub/instrument/3226_Q1_V2-eng.pdf. Accessed February 2, 2015.
Statistics Canada. Joint Canada/United States Survey of Health: findings and public-used microdata file. Cat. #82M0022XIE. Ottawa: Statistics Canada, 2004. Available at: http://www.statcan.gc.ca/pub/82m0022x/82m0022x2003001-eng.htm. Accessed February 2, 2015.
Data analysis
Results
Sociodemographic and injury characteristics
Variable | W-TBI (n=105) | Controls (n=105) | OR | CI | P | ||
---|---|---|---|---|---|---|---|
n | % | n | % | ||||
Country of birth | |||||||
Canada | 88 | 83.8 | 94 | 89.5 | 0.57 | 0.24–1.36 | .2167 |
Foreign | 17 | 16.2 | 11 | 10.5 | |||
Ethnicity | |||||||
European descent | 86 | 81.9 | 88 | 83.8 | 0.88 | 0.43–1.79 | .7152 |
Aboriginal descent (partial/full) | 8 | 7.6 | 6 | 5.7 | |||
Asian/mixed/other | 11 | 10.5 | 11 | 10.5 | |||
Partner status | |||||||
Single/separated/divorced/widowed | 56 | 53.3 | 21 | 20.0 | 4.18 | 2.17–8.07 | <.0001 |
Married/partnered | 49 | 46.7 | 84 | 80.0 | |||
Living situation | |||||||
Alone | 20 | 19.1 | 7 | 6.7 | 3.60 | 1.343–9.70 | .0113 |
With family/friends | 85 | 81.0 | 98 | 93.3 | |||
Level of education | |||||||
Postsecondary | 74 | 70.5 | 81 | 77.1 | 0.63 | 0.32–1.27 | .19 |
Secondary | 23 | 21.9 | 17 | 16.2 | |||
Primary/some secondary | 8 | 7.6 | 7 | 6.7 | |||
Employment status | |||||||
Employed | 62 | 59.0 | 90 | 85.7 | 0.28 | 0.14–0.55 | .0002 |
Total household income ($) | |||||||
<20,000 | 17 | 16.4 | 0.70 | 0.59–0.84 | <.0001 | ||
20,000–29,999 | 6 | 5.8 | 10 | 10.0 | |||
30,000–39,999 | 15 | 14.4 | |||||
40,000–49,999 | 8 | 7.7 | 7 | 7.0 | |||
50,000–59,999 | 10 | 9.6 | 11 | 11.0 | |||
60,000–69,999 | 9 | 8.7 | 8 | 8.0 | |||
≥70,000 | 32 | 30.8 | 60 | 60.0 | |||
Mean | SD | Mean | SD | ||||
Age at TBI (y) | 27.5 | 7.5 | |||||
Age at interview (y) | 35.2 | 7.5 | 35.3 | 8.0 | 0.98 | 0.87–1.10 | .6997 |
Family physician and community-based health services
Health Service Variable | W-TBI (n=105) | Controls (n=105) | OR | CI | P | ||
---|---|---|---|---|---|---|---|
n | % | n | % | ||||
Family physician | |||||||
Utilization | |||||||
Pre-TBI | 103 | 98.1 | 98 | 93.3 | NA | NA | .0253 |
Post-TBI | 103 | 98.1 | 103 | 98.1 | 1.00 | 0.14–7.100 | 1.0000 |
Frequency of visits pre-TBI | |||||||
Very frequently | 29 | 28.7 | 31 | 32.0 | 0.87 | 0.59–1.29 | .4870 |
Frequently | 42 | 41.8 | 43 | 44.3 | |||
Infrequently | 30 | 29.7 | 23 | 23.7 | |||
Frequency of visits post-TBI | |||||||
Very frequently | 74 | 72.6 | 47 | 45.6 | 2.077 | 1.33–3.245 | .0014 |
Frequently | 18 | 17.7 | 37 | 35.9 | |||
Infrequently | 10 | 9.8 | 19 | 18.5 | |||
Quality of care pre-TBI | |||||||
Excellent | 57 | 55.3 | 49 | 50.0 | 0.81 | 0.54–1.22 | .3048 |
Good | 34 | 33.0 | 35 | 35.7 | |||
Fair/poor | 12 | 11.7 | 14 | 14.3 | |||
Quality of care post-TBI | |||||||
Excellent | 66 | 64.7 | 54 | 52.4 | 0.72 | 0.48–1.08 | .1140 |
Good | 24 | 23.5 | 36 | 35.0 | |||
Fair/poor | 12 | 11.8 | 13 | 12.6 | |||
Satisfaction with interpersonal care pre-TBI | |||||||
Very satisfied | 63 | 61.2 | 56 | 57.1 | 0.87 | 0.61–1.23 | .4268 |
Somewhat satisfied | 25 | 24.3 | 29 | 29.6 | |||
Neither satisfied/dissatisfied | 11 | 10.7 | 6 | 6.1 | |||
Somewhat dissatisfied/dissatisfied | 7 | 7.1 | |||||
Satisfaction with interpersonal care post-TBI | |||||||
Very satisfied | 68 | 66.7 | 62 | 60.2 | 0.82 | 0.56–1.19 | .3047 |
Somewhat satisfied | 19 | 18.6 | 29 | 28.2 | |||
Neither satisfied/dissatisfied | 13 | 12.8 | 5 | 4.9 | |||
Somewhat dissatisfied/dissatisfied | 7 | 6.8 | |||||
Community-based health care providers | |||||||
Utilization post-TBI | 95 | 90.5 | 68 | 64.8 | 4.86 | 2.15–10.96 | .0001 |
Quality of care post-TBI | |||||||
Excellent | 46 | 48.4 | 21 | 30.9 | 1.49 | 0.84–2.62 | .1712 |
Good | 38 | 40.0 | 41 | 60.3 | |||
Fair/poor | 11 | 11.6 | 6 | 8.9 | |||
Satisfaction of interpersonal care post-TBI | |||||||
Very satisfied | 57 | 60.0 | 28 | 41.2 | 0.89 | 0.58–1.36 | .5929 |
Somewhat satisfied | 35 | 26.3 | 33 | 48.5 | |||
Neither satisfied/dissatisfied | 6 | 8.8 | |||||
Somewhat dissatisfied/dissatisfied | 10 | 10.5 |
Maternity/conception health services
Barriers to receiving care when needed
Health Service Variable | W-TBI (n=105) | Controls (n=105) | OR | CI | P | ||
---|---|---|---|---|---|---|---|
n | % | n | % | ||||
Care needed post-TBI and | |||||||
Not Received | 42 | 40.0 | 15 | 14.3 | 3.70 | 1.84–7.44 | .0002 |
Received | 63 | 60.0 | 90 | 85.7 | |||
(n=42) | (n=15) | ||||||
Types of barriers experienced | |||||||
Structural | 23 | 54.8 | 15 | 100 | .0014 | ||
Financial | 17 | 40.5 | .0025 | ||||
Cognitive | 22 | 52.4 | 7 | 46.7 | .7696 | ||
No. of barriers experienced | |||||||
≥3 | 16 | 38.1 | 6 | 40.0 | 1.0000 | ||
2 | 9 | 21.4 | 1.0000 | ||||
1 | 17 | 40.5 | 6 | 40.0 | 1.0000 | ||
Type of care needed | |||||||
Treatment of physical problem | 26 | 61.9 | 10 | 66.7 | .8965 | ||
Treatment of emotional/mental health problem | 22 | 52.4 | .0135 | ||||
Support services | 12 | 28.6 | .0245 | ||||
Care of injury | 5 | 11.9 | .2230 | ||||
Regular checkup | .5990 |
Perceived access to social support
Social Support Variables | W-TBI (n=105) | Controls (n=105) | OR | CI | P | ||
---|---|---|---|---|---|---|---|
n | % | n | % | ||||
Emotional support | |||||||
Available | 95 | 90.5 | 103 | 98.1 | 0.11 | .01–.88 | .0371 |
Support from | .0102 | ||||||
Professional | 5 | 5.3 | |||||
Family/friends | 50 | 52.6 | 69 | 67.7 | |||
Both | 40 | 42.1 | 33 | 32.4 | |||
Help with daily tasks | |||||||
Available | 100 | 95.2 | 100 | 95.2 | 1.000 | .29–3.45 | 1.000 |
Support from | .1265 | ||||||
Professional | |||||||
Family/friends | 74 | 79.6 | 82 | 89.1 | |||
Both | 18 | 19.4 | 10 | 10.9 | |||
Financial support | |||||||
Available | 91 | 86.7 | 104 | 99.1 | 0.071 | .009–.54 | .0108 |
Support from | 1.0000 | ||||||
Professional | |||||||
Family/friends | 74 | 92.5 | 85 | 91.4 | |||
Both | 6 | 7.5 | 8 | 8.6 | |||
Information | |||||||
Available | 97 | 92.4 | 103 | 98.1 | 0.250 | .05–1.18 | .0795 |
Support from | .0131 | ||||||
Professional | 19 | 22.1 | 5 | 6.3 | |||
Family/friends | 24 | 27.9 | 30 | 38.0 | |||
Both | 43 | 50.0 | 44 | 55.7 |
Discussion
Use of and satisfaction with health care services
Barriers to receiving timely needed services
Statistics Canada. Joint Canada/United States Survey of Health: findings and public-used microdata file. Cat. #82M0022XIE. Ottawa: Statistics Canada, 2004. Available at: http://www.statcan.gc.ca/pub/82m0022x/82m0022x2003001-eng.htm. Accessed February 2, 2015.
Study strengths
Study limitations
Implications for future research
Conclusions
Supplier
- a.Statistical Analysis System version 9.2; SAS Institute.
Acknowledgments
References
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Article Info
Publication History
Footnotes
Supported by the Canadian Institutes of Health Research (CIHR) (grant no. 200903MOP); the Toronto Rehabilitation Institute–University Health Network (UHN); a grant from the Ministry of Health and Long Term Care to the Toronto Rehabilitation Institute-UHN; a CIHR Fellowship Award and CIHR Strategic Training Fellowship in Health Care, Technology and Place (award no. FRN: STP 53911); a Canadian Institutes of Health Research Strategic Team Grant in Applied Injury Research (grant no. TIR-103946); the Ontario Neurotrauma Foundation; the Saunderson Family Chair at the Toronto Rehabilitation Institute-UHN; and a Canadian Institutes of Health Research Research Chair in Gender, Work and Health (grant no. CGW-126580) from the Institute of Gender and Health.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.