| Titre : | Communication and Psychosocial Outcomes 2-Years After Severe Traumatic Brain Injury: Development of a Prognostic Model (2023) |
| Auteurs : | Leanne Togher ; Elise Elbourn ; Belinda Kenny ; Cynthia Honan ; Emma Power ; Robyn Tate ; Skye McDonald ; Brian MacWhinney |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 11, 2023) |
| Article en page(s) : | p. 1840-1849 |
| Note générale : | https://doi.org/10.1016/j.apmr.2023.04.010 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Cognition ; Communication ; Évaluation de résultat (soins) ; Lésions traumatiques de l'encéphale ; Pronostic ; Réadaptation |
| Résumé : | Objective To examine predictive factors underlying communication and psychosocial outcomes at 2 years post-injury. Prognosis of communication and psychosocial outcomes after severe traumatic brain injury (TBI) is largely unknown yet is relevant for clinical service provision, resource allocation, and managing patient and family expectations for recovery. Design A prospective longitudinal inception design was employed with assessments at 3 months, 6 months, and 2 years. Participants The cohort included 57 participants with severe TBI (N=57). Setting Subacute and post-acute rehabilitation. Main Outcome Measures Preinjury/injury measures included age, sex, education years, Glasgow Coma Scale, and PTA. The 3-month and 6-month data points included speech, language, and communication measures across the ICF domains and measures of cognition. The 2-year outcome measures included conversation, perceived communication skills, and psychosocial functioning. Predictors were examined using multiple regression. Interventions Not applicable. Results The cognitive and communication measures at 6 months significantly predicted conversation measures at 2 years and psychosocial functioning as reported by others at 2 years. At 6 months, 69% of participants presented with a cognitive-communication disorder (Functional Assessment of Verbal Reasoning and Executive Strategies [FAVRES]). The unique variance accounted for by the FAVRES measure was 7% for conversation measures and 9% for psychosocial functioning. Psychosocial functioning at 2 years was also predicted by pre-injury/injury factors and 3-month communication measures. Pre-injury education level was a unique predictor, accounting for 17% of the variance, and processing speed/memory at 3 months uniquely accounted for 14% of the variance. Conclusion Cognitive-communication skills at 6 months are a potent predictor of persisting communication challenges and poor psychosocial outcomes up to 2 years after a severe TBI. Findings emphasize the importance of addressing modifiable cognitive and communication outcomes variables during the first 2 years after severe TBI to maximize functional patient outcomes. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999323002502 |
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