Journal
JOURNAL OF HEAD TRAUMA REHABILITATION
Volume 32, Issue 4, Pages 245-254Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HTR.0000000000000317
Keywords
brain injuries; outcomes research; rehabilitation
Categories
Funding
- Department of Veterans Affairs
- Department of Education, National Institute on Disability, Independent Living, and Rehabilitation Research
- VHA Central Office VA TBI Model System Program of Research
- General Dynamics Health Solutions from the Defense and Veterans Brain Injury Center [W91YTZ-13-C-0015]
- US Army Medical Research and Material Command (USAMRMC)
- U.S. Department of Veterans Affairs [1 I50 HX001233-01, W81XWH-13-2-0095]
- U.S. Department of Defense Congressionally Directed Medical Research Programs
- National Institute on Disability, Independent Living, and Rehabilitation Research [90RT5007, 90DP0028, 90DP0060]
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Objective: To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population. Setting: Five VA Polytrauma Rehabilitation Centers. Participants: A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program. Design: Prospective, longitudinal, multisite. Main Measures: Primary residence and supervision levels measured via scores on the Supervision Rating Scale. For predictive modeling, scores were dichotomized into 2 groups: those that were fully independent/living alone or required only some supervision during the day (independent group, n = 195) and those that required overnight supervision, full-time indirect supervision, and full-time direct supervision (dependent group, n = 107). Results: Thirty-five percent were receiving supervision at 1 year post-TBI across residential settings and 28% were living in alternative settings. Multivariate modeling indicated that older age and longer posttraumatic amnesia (PTA) were predictive of having a need for supervision at 1 year postinjury. Conclusions: Supervision needs are long-term features of moderate and severe TBI. Results of this study lend support to the shift toward conceptualizing TBI as a chronic disease.
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