Psychosocial Outcome 5 Years after Assessment of Disability in Patients with Traumatic Brain Injury

Park, Joon Soon; Rho, Seung Ho

Abstract

OBJECTIVES
This study was designed to investigate the long-term psychosocial outcome of the patients with traumatic brain injury (TBI) about five years after initial assessment of disability. The psychosocial outcome was evaluated in the areas of cognitive function, neurobehavioral symptoms, socio-occupational function, purpose of life, and quality of life.
METHODS
Twenty seven patients with TBI (TBI-S) were selected, who had admitted to the department of Neuropsychiatry of the Wonkwang University Hospital with a primary diagnosis of TBI for the initial assessment of disability during the period 1994-1998. At first, the author assessed their functions with the Neurobehavioral Rating Scale, Social Occupational Functioning Assessment Scale, and Quality of Life Index. And the patients completed the Korean Wechsler Adult Intelligence Scale, Rey-Kim Memory Test and Kims Executive Function Test, the Head Injury Symptom Checklist, Korean version of SmithKline Beecham Quality of Life Scale and Purpose-in-Life Test. The data from the TBI-S were compared between those from the TBI patients (TBI-C) who had received brain injury at the similar time and the TBI-S and admitted for the assessment of disability.
RESULTS
Although there was no significant difference between the two TBI groups in the areas of cognitive function, such as general intelligence, verbal comprehension, visuo-spatial function, attention, memory, and executive function, the TBI-S showed significantly lower neurobehavioral symptoms, higher socio-occupational functioning, and higher purpose in life and quality of life levels than the TBI-C. Though 5 years had passed since injury the TBI-S still had various emotional and somatic symptoms and remained at the relatively lower levels in psychosocial functioning.
CONCLUSION
The overall long-term psychosocial outcome of the TBI patients depends significantly on the status at the initial assessment of disability about 5 years ago. The improvement was seen in the areas of neurobehavioral symptoms and socio-occupational functioning but not in cognitive function. In spite of the improvement in some areas they still remained at relatively low levels in purpose-in-life and quality of life. This findings suggest that the specialized medical and social support is needed for their rehabilitation.