Dawson D R, Chipman M
Department of Occupational Therapy, University of Toronto, Canada.
Brain Inj. 1995 May-Jun;9(4):339-53. doi: 10.3109/02699059509005774.
The disablement that occurs following traumatic brain injury (TBI) can be extensive and severe and consequently has been difficult to report on in a comprehensive and thorough manner. We were able to address this difficulty by analysing a sub group of data from the Canadian Health and Activity Limitation Survey (HALS) using the theoretical framework of disablement developed by the World Health Organization, the International Classification of Impairment, Disability and Handicap (ICIDH). There were 454 survey respondents (representing 12,290 in the Canadian population) with disability resulting from a TBI and a mean time post-injury of 13 years. Three handicaps identified in the ICIDH were the focus of the study: physical independence, work, social integration. The prevalence of long term handicap was very high with 66% of the sample reporting the need for ongoing assistance with some activities of daily living, 75% not working, and 90% reporting some limitations or dissatisfaction with their social integration. Multivariate regression analysis was used to investigate the determinants of the handicaps. The determinants included: age, gender, level of education, living alone, physical environment, and specific disabilities. The implications of these findings are discussed in relation to rehabilitation issues, the usefulness of the ICIDH as a model to investigate outcomes, and directions for future research.
创伤性脑损伤（TBI）后出现的残疾情况可能广泛且严重，因此很难全面、深入地进行报告。我们通过使用世界卫生组织制定的残疾理论框架——《国际损伤、残疾和障碍分类》（ICIDH），分析了加拿大健康与活动受限调查（HALS）的一个子数据集，从而解决了这一难题。有454名因创伤性脑损伤导致残疾的调查受访者（代表加拿大人口中的12290人），受伤后的平均时间为13年。ICIDH中确定的三个障碍是该研究的重点：身体独立性、工作、社会融合。长期障碍的患病率非常高，66%的样本报告在一些日常生活活动中需要持续帮助，75%没有工作，90%报告在社会融合方面存在一些限制或不满意。使用多变量回归分析来研究障碍的决定因素。这些决定因素包括：年龄、性别、教育水平、独居、物理环境和特定残疾。结合康复问题、ICIDH作为研究结果模型的实用性以及未来研究方向，讨论了这些发现的意义。
