Environmental Barriers are Associated With Rehabilitation Needs 10 to 15 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study

Journal of Head Trauma Rehabilitation, Год журнала: 2025, Номер 40(2), С. 125 - 136

Опубликована: Март 1, 2025

To examine the association between environmental barriers and unmet rehabilitation needs during chronic recovery from traumatic brain injury (TBI) in persons discharged inpatient rehabilitation. Five Veterans Affairs Polytrauma Rehabilitation Centers. Cohort study of TBI Model Systems participants who completed a 10 or 15 year follow up (N = 474). Craig Hospital Inventory Environmental Factors, Short Form (CHIEF-SF); Needs Survey (RNS). RNS scores ranged 0 to 42 with an average score 6.9 (SD 7.7). The most frequent endorsed included need improve memory, solve problems, control physical symptoms. In adjusted model, (RNS total) was associated overall (CHIEF-SF Total Score) three five CHIEF-SF subscales: Policy barriers, Attitudes/Support Services/Assistance barriers. Results this suggest that persist for at least decade after occur areas may be modifiable intervention. Health care providers shoulder consider periodic screening potential treatments address them as medically indicated Also, results support growing recognition dynamic lifelong condition necessitating disease management model. Despite significant investment healthcare infrastructure Service Members, knowledge gaps remain regarding understanding addressing their long-term needs, well how impact ability those needs. Unmet among women minority groups; evaluation systems interventions ameliorate they face are important foci future research.

Язык: Английский

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Factors Associated With Life Satisfaction Among Veterans Enrolled in the Healthy Aging Project-Brain (HAP-B) Psychoeducational Class

Journal of Applied Gerontology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 11, 2025

Healthy Aging Project-Brain (HAP-B) is a novel clinical psychoeducation offering developed to encourage engagement in activities associated with successful aging. HAP-B targets sleep, socialization, physical, and cognitive activity through myth-busting, developing SMART goals, tracking behavioral change. Study aims: (1) assess feasibility/acceptability Veteran population; (2) analyze pre- post-intervention ratings examine health well-being; (3) explore associations between factors life satisfaction. The 50 participants (mean age = 70.6 years) were predominantly male-identity (88%) White (76%). Findings, based on independent t tests, revealed improvements satisfaction, emotional well-being, energy levels post-intervention. Linear regression results found higher satisfaction was lower depressive symptoms, self-efficacy. This easily implementable education intervention can result more positive self-appraisal encouraging downstream effects. Healthcare providers are well-positioned utilize classes such as promote patient-centric approaches brain health.

Язык: Английский

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Developing Brain Injury Resource Facilitation for Acquired Brain Injury: Indications and Unmet Needs

Journal of Head Trauma Rehabilitation, Год журнала: 2025, Номер unknown

Опубликована: Фев. 12, 2025

Owing to major progress in the survivorship following acquired brain injury (ABI), there exists a pressing need for development of systems care and rehabilitation tailored ABI. One supportive is resource facilitation (brain RF), which focuses on having therapeutic, social, financial resources readily available easily accessible persons with Brain RF comprises identification person’s strengths challenges, goal setting, identification, coordination, access, utilization, monitoring, evaluation, advocacy. critically important bridging community services ABI eliminating disjointed approaches that fail address full range individual’s needs long-term success. Over recent years, multiple stakeholders field have worked develop implement strategies timely RF. This white paper aims provide an overview current status analysis challenges opportunities Practical policy recommendations its implementation are proposed potential funders programs at national, state, levels. We call attention this society advocate novel, pragmatic, culturally informed approach communities where people reside.

Язык: Английский

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Neuroethics across the Disorders of Consciousness Care Continuum

Seminars in Neurology, Год журнала: 2022, Номер 42(03), С. 375 - 392

Опубликована: Июнь 1, 2022

Abstract This review provides an ethical analysis of disorders consciousness (DoC) along the care continuum, from preinjury to injury, acute subacute and early rehabilitation, finally transitioning chronic rehabilitation societal reintegration. We provide actionable, chronological assessment issues related DoC care. expands upon established ethics literature, which focuses almost exclusively on clinical encounter for DoC. Our goal is broaden aperture address how social environmental conditions predispose some persons brain such might also pose barriers meaningful reintegration after recovery.

Язык: Английский

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The Military Injuries: Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life

Journal of Neurotrauma, Год журнала: 2021, Номер 38(20), С. 2841 - 2850

Опубликована: Авг. 6, 2021

Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial effective intervention and prevention. However, mTBI frequently undocumented or poorly documented in health records. Further, records are non-continuous, such as when move through systems (e.g., from Department of Defense to Veterans Affairs [VA] between jobs the civilian sector), making population-based assessments this relationship challenging. Here, we introduce MINUTE (Military INjuries—Understanding post-Traumatic Epilepsy) study, which integrates data Health Administration with self-report survey post-9/11 veterans (n = 2603) histories TBI, controls without history TBI epilepsy. This article describes study design, implementation, hypotheses, initial results across four groups interest neurotrauma: 1) control; 2) epilepsy; 3) TBI; 4) post-traumatic (PTE). Using combined record data, test hypotheses examining lifetime differential impacts epilepsy, PTE on quality life. The revealed high rates TBIs had no evidence VA medical worse physical functioning health-related life were found + compared those either alone. effect was not fully explained by severity. These insights provide valuable opportunities optimize resilience, delivery services, community reintegration complex comorbidity.

Язык: Английский

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Barriers and Facilitators to Accessing Rehabilitation Health Care: A Veterans Affairs Traumatic Brain Injury Model Systems Qualitative Study

Archives of Physical Medicine and Rehabilitation, Год журнала: 2022, Номер 104(3), С. 380 - 389

Опубликована: Окт. 18, 2022

Язык: Английский

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Alternative Structure Models of the Traumatic Brain Injury Rehabilitation Needs Survey: A Veterans Affairs TBI Model Systems Study

Archives of Physical Medicine and Rehabilitation, Год журнала: 2023, Номер 104(7), С. 1062 - 1071

Опубликована: Фев. 2, 2023

Язык: Английский

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Factors Associated With High and Low Life Satisfaction 10 Years After Traumatic Brain Injury

Archives of Physical Medicine and Rehabilitation, Год журнала: 2022, Номер 103(11), С. 2164 - 2173

Опубликована: Фев. 22, 2022

Язык: Английский

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Exploring racial/ethnic disparities in rehabilitation outcomes after TBI: A Veterans Affairs Model Systems study

Neurorehabilitation, Год журнала: 2023, Номер 52(3), С. 451 - 462

Опубликована: Фев. 17, 2023

Almost one-third of the U.S. military population is comprised service members and veterans (SMVs) color. Research suggests poorer functional psychosocial outcomes among Black Hispanic/Latine vs. White civilians following traumatic brain injury (TBI).This study examined racial/ethnic differences in 5-year independence life satisfaction trajectories SMVs who had undergone acute rehabilitation at one five Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs).Differences demographic injury-related factors were assessed during (n = 663), 89), 124) groups. Functional Independence Measure (FIM) Motor, FIM Cognitive, Satisfaction with Life Scale (SWLS) scores collected 1, 2, 5 years after injury. Racial/ethnic comparisons these outcome made using hierarchical linear modeling.Black less likely than to have been deployed a combat zone; there no other any or variable assessed. In terms outcomes, emerged cognitive, SWLS trajectories.The absence observable from VA TBIMS PRCs contrasts sharply previous research identifying disparities same throughout larger health care system. Individuals enrolled are homogenized on key social determinants that would otherwise contribute trajectories.

Язык: Английский

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

Disability and Rehabilitation, Год журнала: 2021, Номер 44(16), С. 4474 - 4484

Опубликована: Март 23, 2021

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

Язык: Английский

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