Family Involvement in Traumatic Brain Injury Inpatient Rehabilitation: A Propensity Score Analysis of Effects on Outcomes During the First Year After Discharge |
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Affiliation: | 1. The Ohio State University College of Medicine, Columbus, OH;2. Brooks Rehabilitation Hospital, Jacksonville, FL;3. University of Utah School of Medicine, Salt Lake City, UT;4. Indiana University School of Medicine, Indianapolis, IN;5. Icahn School of Medicine at Mount Sinai, New York, NY;6. Wayne State University, Detroit, MI;7. Intermountain Medical Center, Murray, UT;8. Rush University Medical Center, Chicago, IL;9. Cleveland VA Medical Center, Cleveland, OH;10. Rocky Mountain University of Health Professions, Provo, UT;1. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;2. Department of Occupational Therapy, College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, PA;3. Shriners Hospitals for Children, Philadelphia, PA;4. Shriners Hospitals for Children, Chicago, IL;5. Rush Medical College, Chicago, IL;6. Kennedy Krieger Rehabilitation Institute, Baltimore, MD;7. Shriners Hospitals for Children, Sacramento, CA;8. MGH Institute of Health Professions, Boston, MA;1. Center for Rehabilitation Outcomes Research, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Evanston, Illinois;1. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil;2. Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, Sydney, Australia;1. Department of Urology, Stanford University Medical Center, Stanford, California;2. Division of Urology, Santa Clara Valley Medical Center, San Jose, California;3. Department of Urology, University of Michigan, Ann Arbor, Michigan;4. Division of Urology, University of Utah, Salt Lake City, Utah;5. Division of Urology, Western University, London, Ontario, Canada;6. Department of Urology, University of Minnesota, Minneapolis, Minnesota;7. Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, Fruitdale, California |
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Abstract: | ObjectiveTo evaluate the effect of family attendance at inpatient rehabilitation therapy sessions on traumatic brain injury (TBI) patient outcomes at discharge and up to 9 months postdischarge.DesignPropensity score methods are applied to the TBI Practice-Based Evidence database, a database consisting of multisite, prospective, longitudinal, and observational data.SettingNine inpatient rehabilitation centers in the United States.ParticipantsPatients (N=1835) admitted for first inpatient rehabilitation after an index TBI.InterventionFamily attendance during therapy sessions.Main Outcome MeasuresParticipation Assessment for Recombined Tools-Objective-17 (Total scores and subdomain scores of Productivity, Out and About, and Social Relations), Functional Independence Measure, Satisfaction with Life Scale, and Patient Health Questionnaire-9.ResultsParticipants whose families were in attendance for at least 10% of the treatment time were more out and about in their communities at 3 and 9 months postdischarge than participants whose families attended treatment less than 10% of the time. Although findings varied by propensity score method, improved functional independence in the cognitive area at 9 months was also associated with increased family attendance.ConclusionsFamily involvement during inpatient rehabilitation may improve community participation and cognitive functioning up to 9 months after discharge. Rehabilitation teams should engage patients’ families in the rehabilitation process to maximize outcomes. |
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Keywords: | Brain injuries, traumatic Occupational therapy Physical therapists Propensity score Recreation therapy Rehabilitation Speech therapy 95% CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" 95% confidence interval ASD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" absolute standardized difference CSI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" Comprehensive Severity Index FI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" family involvement PART-O" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" Participation Assessment with Recombined Tools-Objective PHQ-9" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" Patient Health Questionnaire-9 POC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0110" }," $$" :[{" #name" :" text" ," _" :" point of care TBI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0120" }," $$" :[{" #name" :" text" ," _" :" traumatic brain injury TBI-PBE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0130" }," $$" :[{" #name" :" text" ," _" :" Traumatic Brain Injury Practice-Based Evidence study |
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