A1-Year Longitudinal Study of Severe Traumatic Brain Injury in Australia Using the Sickness Impact Profile

Abstract

Objective: To document outcome and to investigate patterns of physical and psychosocial recovery in the first year following severe traumatic brain Injury (TDI) In an Australian patient sample. Design: A longitudinal prospective study of a cohort of patients, with data collection at 3, 6,9, and 12 months post injury. Setting: A head injury rehabilitation unit in a large metropolitan public hospital. Patients: A sample of 55 patients selected from 120 consecutive admissions with severe TBI. Patients who were more than 3 months post injury on admission, who remained confused, or who had severe communication deficits or a previous neurologic disorder were excluded. Interventions: All subjects participated in a multidisciplinary inpatient rehabilitation program, followed by varied participation in outpatient rehabilitation and community-based services. Main Outcome Measures: The Sickness Impact Profile (SIP) provided physical, psychosocial, and total dysfunction scores at each follow-up. Outcome at 1 year was measured by the Disability Rating Scale. Results: Multivariate analysis of variance indicated that the linear trend of recovery over time was less for psychosocial dysfunction than for physical dysfunction (F(l, 51)=5.87, P<.02). One year post injury, 22% of subjects had returned to their previous level of employability, and 42% were able to live independently. Conclusions: Recovery from TBI in this Australian sample followed a pattern similar to that observed in other countries, with psychosocial dysfunction being more persistent. Self-report measures such as the SIP in TBI research are limited by problems of diminished self-awareness.