Highlights
- •Survivors of traumatic brain injury report many unmet rehabilitation needs.
- •Unmet rehabilitation needs indirectly influences chronic-stage life satisfaction.
- •Depression and social/community participation are mediators of life satisfaction.
Abstract
Objective
To describe the association between unmet rehabilitation needs and life satisfaction
5 years after traumatic brain injury (TBI).
Design
Prospective observational cohort.
Setting
Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers.
Participants
VA TBI Model Systems participants (N=301); 95% male; 77% white; average age, 39±14y).
Interventions
Not applicable.
Main Outcome Measures
Satisfaction With Life Scale (SWLS).
Results
Average SWLS score was 22±8. Univariable analyses demonstrated several statistically
significant predictors of life satisfaction, including employment status, participation,
psychiatric symptom severity, past year mental health treatment, and total number
of unmet rehabilitation needs (all P<.05). Multivariable analyses revealed that depression and participation were each
associated with life satisfaction. An ad hoc mediation model suggested that unmet
rehabilitation needs total was indirectly related to life satisfaction. Total unmet
rehabilitation needs ranged from 0-21 (mean, 2.0±3.4). Correlational analyses showed
that 14 of the 21 unmet rehabilitation needs were associated with life satisfaction.
Conclusions
Findings support the need for rehabilitation engagement in later stages of TBI recovery.
Ongoing assessment of and intervention for unmet rehabilitation needs in the chronic
phase of recovery have the potential to mitigate decline in life satisfaction.
Keywords
List of Abbreviations:
GAD-7 (Generalized Anxiety Disorder-7), NSI (Neurobehavioral Symptom Inventory), PART-O (Participation Assessment With Recombined Tools-Objective), PCL-C (PTSD Checklist-Civilian version), PHQ-9 (Patient Health Questionnaire-9), PRC (Polytrauma Rehabilitation Center), PTA (posttraumatic amnesia), SWLS (Satisfaction With Life Scale), TBI (traumatic brain injury), TFC (time to follow commands), VA (Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 16, 2020
Footnotes
Supported by VHA Central Office VA TBI Model System Program of Research (Drs Richardson and Silva), Subcontract from General Dynamics Information Technology (GDIT) (W91YTZ-13-C-0015; HT0014-19-C-0004) (Dr Richardson) from the Defense and Veterans Brain Injury Center as official government work (contact [email protected] with questions), and Rocky Mountain Regional Brain Injury System (90DPTB00070) (Dr Monden). The VA TBI Model Systems is a funded collaboration between the Department of Veterans Affairs and the Department of Health and Human Services: National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). This research was conducted with resources and the use of facilities at the Hunter Holmes McGuire Veterans Affairs Medical Center, James A. Haley Veterans’ Hospital, Minneapolis VA Health Care System, Palo Alto VA Health Care System, and South Texas Veterans Health Care System. The views, opinion, and/or findings contained in this article are those of the authors and should not be construed as an official US Department of Defense, Defense Health Agency, Department of Army/Navy/Air Force, Veterans Affairs, or any other federal agency position, policy, or decision unless so designated by other official documentation. No official endorsement should be inferred.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
