Article

PURPOSE: To investigate the characteristics and inpatient rehabilitation outcomes
of persons who sustained a traumatic brain injury (TBI) resulting from physical
assault - a form of intentional TBI - and compare these outcomes to those of
persons with TBI resulting from other aetiologies.
METHOD: A prospective
population-based cohort study using inpatient rehabilitation data from Canadian
population-based administrative databases for the fiscal years 2001-2006. Outcome
measures were measures of functional independence (motor and cognitive), as
measured by the FIM Instrument, and discharge destinations. RESULTS:
Characteristics associated with intentional TBI were being male, younger in age
and unemployed; living alone and having a greater likelihood of alcohol/drug
abuse prior to admission. The intentional TBI group showed poorer total
functional gains at discharge from inpatient rehabilitation. Multivariate
regression analyses showed that persons with intentional injury were less likely
to be discharged home. CONCLUSIONS: Persons with TBI from physical assault are a
distinct clinical group in Canadian inpatient rehabilitation settings. These
findings can support clinicians in determining proper assessment, management,
discharge planning and post-rehabilitation care that target specific needs of
persons with TBI resulting from physical assault. IMPLICATIONS FOR
REHABILITATION: Clinicians should have appropriate training to properly assess
the mental health status of this patient group. Inpatient rehabilitation
facilities should be prepared to provide services targeting psychosocial,
substance abuse and interpersonal relationship issues to persons with a TBI from
physical assault while patients are still within a hospital setting. Follow-up
clinical care and community support services are warranted for those with
intentional TBIs, including provision of occupational rehabilitation services,
such as vocational rehabilitation. The discharge team should be responsible for
ensuring appropriate discharge to community in the absence of family or other
advocates on behalf of the patient.

Langue : ANGLAIS