Development of the traumatic brain injury Rehabilitation Needs Survey: a Veterans Affairs TBI Model Systems study

Abstract

Purpose To describe the development of the Rehabilitation Needs Survey (RNS) for persons in the chronic phase of traumatic brain injury (TBI) recovery. Materials and methods RNS items were generated following a literature review (January – March 2015) on the topic of rehabilitation needs and revised via consensus from an expert panel of TBI clinicians and researchers. The RNS was added to the VA TBI Model Systems longitudinal study; data collection occurred between 2015–2019. Needs were classified as current (if endorsed) or absent; if current, needs were classified as unmet if no help was received. Need frequency and association with rehabilitation outcomes were presented. Results Eight studies examined rehabilitation needs and formed the initial item pool of 42 needs. This was reduced to form the 21-item RNS which was administered at year 1 (n = 260) and year 2 (n = 297) post-TBI. Number of needs endorsed was 8–9, and number of unmet needs was 1–2, on average. Number of needs was correlated with functional status, neurobehavioral symptoms, and mental health symptoms (p < 0.05) suggesting support for convergent validity of the RNS. Conclusion The RNS is a new measure of rehabilitation needs following TBI. Further investigation into its psychometrics and clinical utility is recommended. Implications for rehabilitation Veterans and Service Members with traumatic brain injury across the severity spectrum have ongoing rehabilitation needs during the chronic phase of recovery. The Rehabilitation Needs Survey is a standardized measure of rehabilitation needs following traumatic brain injury. Identification of unmet rehabilitation needs is important for raising awareness of service gaps and providing justification for resource allocation.