Sander Angelle M, Pappadis Monique R, Davis Lynne Cole, Clark Allison N, Evans Gina, Struchen Margaret A, Mazzei Diana M
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
NeuroRehabilitation. 2009;24(1):15-27. doi: 10.3233/NRE-2009-0450.
The purpose of the current study was to determine the contribution of race/ethnicity and income to community integration at approximately 6 months following traumatic brain injury (TBI). Participants were 151 persons with mild to severe TBI (38% Black; 38% Hispanic; 24% White) recruited from consecutive admissions to the Neurosurgery service of a county Level I trauma center. A large number of participants had low income and low education. Community integration was assessed using the Community Integration Questionnaire (CIQ), Craig Handicap Assessment and Reporting Technique - Short Form (CHART-SF), and Community Integration Measure (CIM). Results of analysis of covariance (ANCOVA) indicated that, after accounting for injury severity, age, education, and income, race/ethnicity contributed significantly to the variance in CIQ Total score, Home Integration Scale, and Productive Activity Scale scores. Blacks had lower CIQ Total scores compared to Whites. Black and Hispanic participants had lower scores than Whites on the Home Integration Scale, and Blacks had lower scores than Whites and Hispanics on the CIQ Productive Activity Scale. Low income ( < or = $20,000) was related to lower scores on the CIQ and CHART-SF Social Integration Scales, and scores on the CIM Total, Belonging, and Independent Participation scales. These results indicate that racial/ethnic differences in community integration exist, even after accounting for income. However, income was more predictive than race/ethnicity for certain aspects of community integration, indicating that it should be accounted for in all studies investigating racial/ethnic differences in outcomes.
本研究的目的是确定种族/族裔和收入对创伤性脑损伤(TBI)后约6个月社区融入情况的影响。研究对象为151名轻至重度TBI患者(38%为黑人;38%为西班牙裔;24%为白人),他们是从某县一级创伤中心神经外科连续收治的患者中招募而来。大量参与者收入低且受教育程度低。使用社区融入问卷(CIQ)、克雷格残疾评估与报告技术简表(CHART-SF)和社区融入度量表(CIM)对社区融入情况进行评估。协方差分析(ANCOVA)结果表明,在考虑损伤严重程度、年龄、教育程度和收入因素后,种族/族裔对CIQ总分、家庭融入量表得分和生产活动量表得分的方差有显著贡献。与白人相比,黑人的CIQ总分较低。在家庭融入量表上,黑人和西班牙裔参与者的得分低于白人;在CIQ生产活动量表上,黑人的得分低于白人和西班牙裔。低收入(≤20,000美元)与CIQ和CHART-SF社会融入量表得分较低以及CIM总分、归属感和独立参与量表得分较低有关。这些结果表明,即使考虑了收入因素,社区融入方面的种族/族裔差异仍然存在。然而,在社区融入的某些方面,收入比种族/族裔更具预测性,这表明在所有调查结果中种族/族裔差异的研究中都应考虑收入因素。