Silva Marc A, Finn Jacob A, Dillahunt-Aspillaga Christina, Cotner Bridget A, Stevens Lillian F, Nakase-Richardson Risa
Mental Health and Behavioral Sciences Section (MHBSS), James A. Haley Veterans' Hospital, Tampa, FL, USA.
Department of Internal Medicine, University of South Florida, Tampa, FL, USA.
Disabil Rehabil. 2022 Aug;44(16):4474-4484. doi: 10.1080/09638288.2021.1900930. Epub 2021 Mar 23.
To describe the development of the Rehabilitation Needs Survey (RNS) for persons in the chronic phase of traumatic brain injury (TBI) recovery.
RNS items were generated following a literature review (January - March 2015) on the topic of rehabilitation needs and revised consensus from an expert panel of TBI clinicians and researchers. The RNS was added to the VA TBI Model Systems longitudinal study; data collection occurred between 2015-2019. Needs were classified as current (if endorsed) or absent; if current, needs were classified as unmet if no help was received. Need frequency and association with rehabilitation outcomes were presented.
Eight studies examined rehabilitation needs and formed the initial item pool of 42 needs. This was reduced to form the 21-item RNS which was administered at year 1 ( = 260) and year 2 ( = 297) post-TBI. Number of needs endorsed was 8-9, and number of unmet needs was 1-2, on average. Number of needs was correlated with functional status, neurobehavioral symptoms, and mental health symptoms ( < 0.05) suggesting support for convergent validity of the RNS.
The RNS is a new measure of rehabilitation needs following TBI. Further investigation into its psychometrics and clinical utility is recommended.Implications for rehabilitationVeterans and Service Members with traumatic brain injury across the severity spectrum have ongoing rehabilitation needs during the chronic phase of recovery.The Rehabilitation Needs Survey is a standardized measure of rehabilitation needs following traumatic brain injury.Identification of unmet rehabilitation needs is important for raising awareness of service gaps and providing justification for resource allocation.
描述创伤性脑损伤(TBI)恢复慢性期患者康复需求调查(RNS)的开发过程。
RNS项目是在对康复需求主题进行文献综述(2015年1月 - 3月)后生成的,并根据TBI临床医生和研究人员专家小组的修订共识进行了修改。RNS被添加到退伍军人事务部TBI模型系统纵向研究中;数据收集于2015 - 2019年期间进行。需求被分类为当前存在(如果被认可)或不存在;如果是当前存在的需求,若未得到帮助则被分类为未满足。呈现了需求频率以及与康复结果的关联。
八项研究考察了康复需求,形成了42项需求的初始项目池。在此基础上进行缩减,形成了21项的RNS,并在TBI后的第1年(n = 260)和第2年(n = 297)进行施测。平均而言,被认可的需求数量为8 - 9项,未满足的需求数量为1 - 2项。需求数量与功能状态、神经行为症状和心理健康症状相关(P < 0.05),这表明支持RNS的聚合效度。
RNS是一种用于评估TBI后康复需求的新指标。建议对其心理测量学和临床效用进行进一步研究。
对康复的启示
不同严重程度的创伤性脑损伤退伍军人和现役军人在恢复的慢性期都有持续的康复需求。
康复需求调查是创伤性脑损伤后康复需求的标准化测量方法。
识别未满足的康复需求对于提高对服务差距的认识以及为资源分配提供依据很重要。