4.4 Article

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

Journal

DISABILITY AND REHABILITATION
Volume 44, Issue 16, Pages 4474-4484

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2021.1900930

Keywords

Brain injuries; traumatic; health service needs and demand; health care surveys; military personnel; rehabilitation; surveys and questionnaires; veterans

Categories

Funding

  1. Defense and Veterans Brain Injury Center subcontract from General Dynamics Information Technology [HT0014-19-C-0004, W91YTZ-13-C-0015]

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The Rehabilitation Needs Survey (RNS) was developed through expert consensus and was administered to TBI patients in the chronic phase. The RNS identified an average of 8-9 endorsed needs and 1-2 unmet needs. Correlations were found between number of needs endorsed and functional status, neurobehavioral symptoms, and mental health symptoms, supporting the convergent validity of the RNS. Further research on the psychometrics and clinical utility of the RNS is recommended.
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.

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