Outcome Measurement in an Inpatient and Outpatient Traumatic Brain Injury Rehabilitation Programme

TLDR

The study outlines approaches to measuring outcomes in a TBI rehabilitation programme, emphasizing the need for objective handicap measures alongside self‑report. Outcome evaluation employed a Role Checklist, Goal Attainment Scaling, a structured questionnaire, and standardized instruments such as the Sickness Impact Profile, CHART, and Leeds Anxiety/Depression scales. Over five years, patients maintained gains across life domains, with good inter‑rater reliability, most agreeing with close others on cognitive and behavioural changes, though emotional adjustment significantly affected self‑reported problems.

Abstract

Abstract This paper outlines approaches taken to the measurement of outcome from a rehabilitation programme for individuals with traumatic brain injury (TBI). It describes methods used to evaluate progress made by individuals towards the attainment of goals within the programme, including the use of a Role Checklist and Goal Attainment Scaling. Maintenance of gains and long-term outcome in a range of life domains over 5 years after injury has been documented using a structured questionnaire, on which we obtained good inter-rater reliability. By 5 years after injury, the majority of individuals with TBI were in reasonable agreement with their close others regarding the presence of cognitive and behavioural changes. Standardised measures used in addition to the structured questionnaire have included the Sickness Impact Profile, the Craig Handicap Assessment and Reporting Technique (CHART), and the Leeds Scales for the Self-assessment of Anxiety and Depression. Findings and inter-correlations of all these measures are discussed. Emotional adjustment appears to have a significant influence upon self-reporting of problems and changes on measures such as the Sickness Impact Profile. It is therefore important to use more objective measures of handicap in a range of domains, such as the CHART, in addition to self-report measures.