Brightwater Research Centre, Brightwater Care Group, Inglewood, Australia.
J Rehabil Med. 2023 Sep 12;55:jrm5303. doi: 10.2340/jrm.v55.5303.
To identify sex/gender differences in functional, psychosocial and service use patterns in community-based post-acute care for acquired brain injury. Design: Retrospective cohort study.
SUBJECTS/PATIENTS: Adults with acquired brain injury enrolled in post-acute neurorehabilitation and disability support in Western Australia (n = 1,011).
UK Functional Independence Measure and Functional Assessment Measure (FIM + FAM), Mayo-Portland Adaptability Inventory-4, goal attainment, length of stay (LOS), number of episodes of care and deaths were evaluated using routinely collected clinical and linked administrative data.
At admission, women were older (p < 0.001) and displayed poorer functional independence (FIM + FAM; p < 0.05) compared with men. At discharge, there were no differences in goal attainment, psychosocial function or functional independence between men and women. Both groups demonstrated functional gains; however, women demonstrated clinically significant gains (+ 15.1, p < 0.001) and men did not (+ 13.7, p < 0.001). Women and men had equivalent LOS (p = 0.205). Aboriginal and/or Torres Strait Islander status predicted longer LOS for women but not for men. Being partnered predicted reduced LOS for women but not men. Women had a higher risk of multiple episodes of care (p < 0.001), but not death (p = 0.409), compared with that of men.
At admission to rehabilitation and disability support services for acquired brain injury, women have poorer functional independence and higher risk of multiple episodes of care, compared with men, suggesting greater disability in the community. By the time of discharge from these services, women and men make equivalent functional and psychosocial gains. The higher risk of multiple episodes of care for women relative to men suggest women may need additional post-discharge support, to avoid readmission.
确定基于社区的后天性脑损伤康复治疗中功能、心理社会和服务利用模式的性别差异。设计：回顾性队列研究。
受试者/患者：在澳大利亚西部接受后天性神经康复和残疾支持的成年人，共 1011 名患有脑损伤。
采用英国功能独立性量表和功能评估量表（FIM+FAM）、梅奥-波特兰适应能力量表-4、目标实现情况、住院时间（LOS）、护理次数和死亡率，使用常规收集的临床和相关行政数据进行评估。
在入院时，女性比男性年龄更大（p<0.001），且功能独立性更差（FIM+FAM；p<0.05）。在出院时，男性和女性在目标实现情况、心理社会功能或功能独立性方面没有差异。两组均表现出功能改善；然而，女性表现出显著的临床改善（+15.1，p<0.001），而男性则没有（+13.7，p<0.001）。女性和男性的 LOS 没有差异（p=0.205）。原住民或托雷斯海峡岛民身份预测女性的 LOS 较长，但对男性没有影响。有伴侣预测女性的 LOS 较短，但对男性没有影响。与男性相比，女性接受多次护理的风险更高（p<0.001），但死亡风险没有差异（p=0.409）。
在后天性脑损伤康复和残疾支持服务入院时，女性的功能独立性更差，且多次接受护理的风险更高，表明其在社区中残疾程度更高。在离开这些服务时，女性和男性在功能和心理社会方面取得了同等的进步。与男性相比，女性接受多次护理的风险更高，这表明女性可能需要额外的出院后支持，以避免再次入院。
