Title

Cognitive Predictors of Community Participation at 1, 2, and 5 Years After Moderate to Severe Traumatic Brain Injury

Author

Thida Han

Date of Award

7-13-2016

Document Type

Doctoral Capstone

Degree Name

Psy.D.

Department

Graduate School of Professional Psychology

First Advisor

Kim Gorgens

First Committee Member

Laura Meyer

Second Committee Member

Don Gerber

Keywords

Traumatic brain injury, functional cognition, inpatient rehabilitation

Abstract

Objective: To identify whether measures of functional cognition, as measured by the FIM during inpatient rehabilitation, predict participation at one, two, and five years after traumatic brain injury (TBI). Setting: Acute inpatient rehabilitation facilities within the Traumatic Brain Injury Model Systems of Care. Participants: 1000 individuals over the age of 16 who sustained a moderate to severe TBI.

Design: Secondary analysis of data from a multicenter longitudinal cohort study. Main Measures: FIM Cognitive and Participation Assessment with Recombined Tools – Objective (PART-O).

Results: Hierarchical linear regression analyses indicated that Total FIM Cognitive scores obtained at discharge from inpatient rehabilitation significantly predicted community participation at one, two, and five years post-injury. Four of the five individual FIM Cognitive subscales did not account for significant variance in participation over and above demographic and clinical TBI severity predictor variables in the regression models at one, two, or five years after TBI. Memory functioning was a significant predictor of community participation at two years post-injury.

Conclusions: These findings support the use of comprehensive rehabilitation programs that target overall cognition to improve community participation in the first five years after TBI. Interventions that incorporate compensatory memory training into rehabilitation may also benefit participation over time. Finally, the importance of participation as a meaningful but underutilized measure of health care outcomes is discussed.

Comments

Copyright is held by the author. Permanently suppressed.

Extent

36 pages

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