Repository logo
 

Selection and visualisation of outcome measures for complex post-acute acquired brain injury rehabilitation interventions.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Ford, Catherine Elaine Longworth 
Malley, Donna 
Clare, Isabel CH 
Wagner, Adam P 

Abstract

BACKGROUND: Outcome measurement challenges rehabilitation services to select tools that promote stakeholder engagement in measuring complex interventions. OBJECTIVES: To examine the suitability of outcome measures for complex post-acute acquired brain injury (ABI) rehabilitation interventions, report outcomes of a holistic, neuropsychological ABI rehabilitation program and propose a simple way of visualizing complex outcomes. METHODS: Patient/carer reported outcome measures (PROMS), experience measures (PREMS) and staff-rated measures were collected for consecutive admissions over 1 year to an 18-week holistic, neuropsychological rehabilitation programme at baseline, 18 weeks and 3- and 6-month follow-up. RESULTS: Engagement with outcome measurement was poorest for carers and at follow-up for all stakeholders. Dependence, abilities, adjustment, unmet needs, symptomatology including executive dysfunction, and self-reassurance showed improvements at 18 weeks. Adjustment, social participation, perceived health, symptomatology including dysexecutive difficulties, and anxiety were worse at baseline for those who did not complete rehabilitation, than those who did. A radar plot facilitated outcome visualization. CONCLUSIONS: Engagement with outcome measurement was best when time and support were provided. Supplementing patient- with staff-rated and attendance measures may explain missing data and help quantify healthcare needs. The MPAI4, EBIQ and DEX-R appeared suitable measures to evaluate outcomes and distinguish those completing and not completing neuropsychological rehabilitation.

Description

Keywords

Brain injuries, health services research, neuropsychology, outcome and process assessment, rehabilitation, stroke, Adolescent, Adult, Anxiety, Brain Injuries, Caregivers, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Self Report, Young Adult

Journal Title

NeuroRehabilitation

Conference Name

Journal ISSN

1053-8135
1878-6448

Volume Title

39

Publisher

IOS
Sponsorship
National Institute for Health Research