engleski

Predictors of community integration 1 year after moderate to severe traumatic brain injury

INTRODUCTION: According to recent reviews, the Community Integration Questionnaire (CIQ) is considered to be the most widely used participation measurement tool with patients following traumatic brain injury (TBI). The CIQ consists of three sub-scales: The Home Integration subscale addresses domestic life, Social Integration subscale addresses interpersonal relationship and Productivity subscale addresses major life areas (education and work). In the newly revised version of the Community integration questionnaire (CIQ-R), an Electronic Social Networking (ESN) subscale has been added. OBJECTIVES: The purpose of this study was to determine whether the results of a brief neuropsychological battery predict results on the four domains of the CIQ-R at one year after the moderate to severe TBI, over and above the effects of relevant demographic variables and injury severity as assessed by the length of the post-traumatic amnesia (PTA). METHODS: The CIQ-R consists of 18 questions within the four subscales. Due to the low internal consistency of the Productivity subscale, we decided to use a Job-School variable as a measure of Productivity, according to Sander et al. (1999). The injury severity was determined on the basis of PTA as assessed by the Galveston Orientation and Amnesia Test or retrospectively, by an interview. A short neuropsychological battery including Rey- Ostterieth Complex Figure Test, Controlled Oral Word Association Test (COWAT) and Letter-Digit Substitution Test (LDST) was administered to a group of 127 patients on admission to the hospital rehabilitation, on an average of 3 months after moderate to severe TBI. The CIQ-R was sent to the participants by post 1 year after TBI. A total of 104 individuals responded to the questionnaire. A hierarchical multiple regression analysis was employed to predict four domains of the CIQ-R. Predictors were entered in order of actual time precedence. RESULTS: The full seven predictor model accounted for 43% of the Productivity variance, F (7, 96) = 10.24, p< .001, R2 = .43. As we can see from table 3 demographic factors accounted for 17% of the total variance in Productivity score, and PTA showed a further statistically significant contribution with an additional 13% of the explained variance. On the third step, all three of the neuropsychological tests were entered simultaneously, resulting in a significant increase in R2 with a further 12% of the explained variance. Our results are in accordance with a number of studies using early neuropsychological tests as predictors of the return to work after TBI. The full model R2 was also significant for the ESN score, F(7, 96) = 15, 08, p< .001, R2 = .52, Social Integration score, F(7, 96) = 4.28, p< .001, R2 = .24, and Home Integration score F(7, 96) = 4.83, p< .001, R2 = .26, with no significant partial effect for any of the cognitive tests. The total FIM score at the discharge from hospital rehabilitation showed the unique effect on the Home Integration subscale results, which is in accordance with the investigation of the latent structure of the original CIQ.

Traumatic brain injury, post-traumatic amnesia, Community Integration Questionnaire-Revised, neuropsychological assessment.

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