We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Self-Perceived Health Care Needs and Delivery of Health Care Services 5 Years After Moderate-to-Severe Traumatic Brain Injury.
- Authors
Andelic, Nada; Soberg, Helene L.; Berntsen, Svein; Sigurdardottir, Solrun; Roe, Cecilie
- Abstract
Objective To describe the self-perceived health care needs of patients with moderate-to-severe traumatic brain injury (TBI) and to assess the impact of the functional level at 1 year after injury on patients' unmet needs at the 5-year follow-up. Design A prospective follow-up study. Setting Clinical research. Participants A total of 93 patients participated in the 5-year follow-up. Methods We registered demographic and injury-related data at the time of admission and the scores for the Disability Rating Scale, Glasgow Outcome Scale-Extended, and Short Form 36 subscales for physical functioning and mental health at 1 and 5 years. The patients' self-perceived health care needs and use of health care services at 5 years were the main outcome measurements. Results At the 5-year follow-up, 70% of patients reported at least 1 perceived need. The self-perceived health care needs were met for 39% of the patients. The patients with unmet needs (n = 29 [31%]) reported frequent needs in emotional (65%), vocational (62%), and cognitive (58%) domains. These patients were significantly more likely to present a less severe disability on the Disability Rating Scale at the 1-year follow-up (odds ratio [OR] 0.11 [95% confidence interval {CI}, 0.02-0.7]; P = .02). Worse mental health at the 1-year follow-up and a younger age (16-29 years) largely predicted unmet needs at the 5-year follow-up (OR 3.28 [95% CI, 1.1-10.04], P = .04; and OR 4.93 [95% CI, 0.16-15.2], P = .005, respectively). Conclusion Gaps between self-perceived health care needs and health care services received at the 5-year follow-up were found. An important message to clinicians who provide health care services in the late TBI phase is that they should be aware of patients' long-term needs regarding cognitive and emotional difficulties. Of equal importance is an emphasis on long-term vocational rehabilitation services. To ensure the appropriateness of health care service delivery, health care services after TBI should be better targeted at less-severe TBI population as well.
- Publication
PM & R: Journal of Injury, Function & Rehabilitation, 2014, Vol 6, Issue 11, p1013
- ISSN
1934-1482
- Publication type
Article
- DOI
10.1016/j.pmrj.2014.05.005