Huebner Ruth A, Johnson Kerrie, Bennett Chantel Miller, Schneck Colleen
Department of Occupational Therapy, Eastern Kentucky University, Richmond, Kentucky, USA.
Am J Occup Ther. 2003 Mar-Apr;57(2):177-85. doi: 10.5014/ajot.57.2.177.
This study examined outcomes after traumatic brain injury in adults salient to occupational therapy.
Demographic data and Functional Independence Measure (FIM) scores from the inpatient rehabilitation stay were first gathered from a retrospective chart review. At follow-up, 25 adults, on average 21 months post-injury, completed measures of disability, community participation, quality of life, and satisfaction with occupational therapy during a telephone interview. Analysis of covariance was used to test the differences between pretest and posttest scores on the FIM; regression analysis and correlations were used to analyze predictions and relationships.
Statistically significant improvements in FIM scores during rehabilitation were predictive of the level of long-term disability and community participation among participants. At follow-up, participants were often unemployed, depressed and withdrawn, and experienced limitations in decision making, hand use, bladder control, and community integration. Less disability and more community participation were related to higher quality of life. Satisfaction with occupational therapy, although high, was unrelated to most outcomes.
Results support the premise that participation is associated with a high quality of life, yet persons with brain injury have significant needs for long-term occupational therapy.
本研究调查了成人创伤性脑损伤后与职业治疗相关的结果。
首先通过回顾性病历审查收集住院康复期间的人口统计学数据和功能独立性测量(FIM)评分。在随访时,25名成年人(平均受伤后21个月)在电话访谈中完成了残疾、社区参与、生活质量以及对职业治疗满意度的测量。采用协方差分析来检验FIM测试前和测试后分数之间的差异;采用回归分析和相关性分析来分析预测结果和关系。
康复期间FIM评分的显著改善可预测参与者的长期残疾水平和社区参与度。在随访时,参与者常常失业、抑郁且孤僻,在决策、手部使用、膀胱控制和社区融入方面存在困难。残疾程度较低和社区参与度较高与较高的生活质量相关。对职业治疗的满意度虽然较高,但与大多数结果无关。
结果支持这样的前提,即参与与高质量生活相关,但脑损伤患者对长期职业治疗有重大需求。