Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Norway.
Disabil Rehabil. 2010;32(13):1122-31. doi: 10.3109/09638280903410722.
The purpose of this study was to assess disability and the physical and mental health status 1 year after traumatic brain injury (TBI), using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model for understanding TBI disability.
A prospective study of 85 patients with moderate-to-severe TBI (aged 16-55 years) due to injury occurring from May 2005 to May 2007 and hospitalised at the Trauma Referral Centre in Eastern Norway were included. The severity of structural brain damage and overall trauma were used as indices of body structure impairments. Activity limitations were measured by the Functional Independence Measure, and participation restrictions were assessed via the Community Integration Questionnaire. Physical and mental health dimensions as reported on the Medical Outcome Survey Short-Form were chosen as outcome measures.
Roughly one quarter of the patients reported disability requiring personal assistance. One third [corrected] had major problems with social integration, and 42% were not working. Nearly half of the patients reported poor physical health, and 37% reported poor mental health. Regression models, including demographics, impairments, activity limitations and participation restrictions, accounted for 50% of the variance in physical health and 35% of the variance in mental health. More severe impairments, fewer activity limitations and fewer participation restrictions equated to better overall health.
The results demonstrated that a significant proportion of TBI survivors face substantial disability and impaired overall health 1 year after injury. To optimise health and well-being outcomes, clinicians need to ensure that health needs of patients with less severe TBI are identified and treated during the post-acute period.
本研究旨在评估创伤性脑损伤（TBI）后 1 年的残疾以及身心健康状况，采用国际功能、残疾和健康分类（ICF）作为理解 TBI 残疾的概念模型。
本研究纳入了 85 名因伤于 2005 年 5 月至 2007 年 5 月期间在挪威东部创伤转诊中心住院的中重度 TBI（年龄 16-55 岁）患者。结构脑损伤严重程度和总体创伤程度作为身体结构损伤的指标。活动受限通过功能独立性量表进行测量，参与受限通过社区融入问卷进行评估。选择医疗结果调查短表报告的身体和心理健康维度作为结局指标。
大约四分之一的患者报告存在需要他人帮助的残疾。三分之一的患者存在严重的社会融合问题，42%的患者没有工作。近一半的患者报告身体健康状况较差，37%的患者报告心理健康状况较差。包含人口统计学因素、损伤、活动受限和参与受限的回归模型，解释了 50%的身体健康变化和 35%的心理健康变化。更严重的损伤、较少的活动受限和较少的参与受限等同于更好的整体健康状况。
结果表明，相当一部分 TBI 幸存者在受伤后 1 年内面临严重的残疾和受损的整体健康状况。为了优化健康和幸福感结局，临床医生需要确保在急性后期识别和治疗轻度 TBI 患者的健康需求。
