Menzies Health Institute Queensland, The Hopkins Centre, Griffith University, Brisbane, Australia.
Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, Australia.
Disabil Rehabil. 2022 Oct;44(20):5919-5929. doi: 10.1080/09638288.2021.1952321. Epub 2021 Jul 16.
Little is known about obstacles to health and rehabilitation services experienced by people with acquired brain injury (ABI) over time and what impact these have on recovery. This study utilised the International Classification of Functioning, Disability, and Health model to better understand the impact of service obstacles. The aims were: (1) describe and compare service obstacles reported in the 12-months post-discharge from inpatient rehabilitation; (2) examine service obstacles as a moderator of the relationship between functional impairment and activities and participation.
Prospective survey of 41 people who received ABI inpatient rehabilitation in Queensland, Australia. Validated self-report measures of service obstacles, functional impairment, and activities and participation were administered at 6- and 12-months post-discharge.
Transportation was the highest-rated obstacle at 6-months post-discharge, and this decreased at 12-months. Dissatisfaction with treatment resources and financial obstacles were, on average, low-to-moderate and remained constant. Specifically, the moderation analyses showed that financial obstacles may exacerbate the negative impact of functional impairment on independent living skills.
Our findings suggest that people living in Queensland, Australia, who experience financial obstacles to services after brain injury may be at risk of poorer recovery outcomes. Rehabilitation policy should consider prioritising individuals who experience financial obstacles to accessing services.IMPLICATIONS FOR REHABILITATIONIn Queensland, Australia, financial obstacles to accessing health services after brain injury may exacerbate the negative impact of functional impairment on independent living skills, in the first 12-months after hospital discharge.There may be a need to prioritize rehabilitation policy that targets individuals who experience financial obstacles to accessing health and rehabilitation services, after brain injury, irrespective of a health system's potential to enable access.
人们对获得性脑损伤（ABI）患者随着时间的推移而经历的健康和康复服务障碍知之甚少，也不知道这些障碍对康复有何影响。本研究利用国际功能、残疾和健康分类模型来更好地了解服务障碍的影响。目的是：（1）描述和比较从住院康复出院后 12 个月内报告的服务障碍；（2）研究服务障碍作为功能障碍与活动和参与之间关系的调节因素。
对澳大利亚昆士兰州接受 ABI 住院康复的 41 人进行前瞻性调查。在出院后 6 个月和 12 个月时，对经过验证的服务障碍、功能障碍和活动与参与的自我报告测量进行了评估。
在出院后 6 个月时，交通是评分最高的障碍，而在 12 个月时则有所下降。对治疗资源和财务障碍的不满程度为低到中度，且保持不变。具体来说，调节分析表明，财务障碍可能会加剧功能障碍对独立生活技能的负面影响。
我们的研究结果表明，在澳大利亚昆士兰州，经历脑损伤后服务财务障碍的患者可能面临康复效果较差的风险。康复政策应考虑优先考虑那些难以获得服务的人。
在澳大利亚昆士兰州，脑损伤后获得健康服务的财务障碍可能会加剧功能障碍对独立生活技能的负面影响，在出院后 12 个月内。可能需要优先制定康复政策，针对那些经历财务障碍而难以获得健康和康复服务的人，无论其所在的医疗系统是否有能力提供服务。
