Citation

Nalder E, Fleming J, Cornwell P, Foster M, Skidmore ERD, Bottari CL, Dawson DR. Arch. Phys. Med. Rehabil. 2015; 97(2 Suppl): S46-53.

Affiliation

Baycrest, Rotman Research Institute, Toronto, Canada; University of Toronto, Department of Occupational Science and Occupational Therapy and the Graduate Department of Rehabilitation Sciences, Toronto, Canada.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.07.428

PMID

25662399

Abstract

OBJECTIVE: To describe the occurrence of sentinel events and their influence on community integration of women with a traumatic brain injury (TBI) transitioning from hospital to home.

DESIGN: A longitudinal study was completed with data collected prior to, and at 1, 3 and 6-months following, hospital discharge. SETTING: Participants were recruited from a brain injury rehabilitation unit and an acute neurosciences ward. PARTICIPANTS: The sample included 25 women, aged between 17 and 50, with severe TBI (duration of post traumatic amnesia ranged from 1-123 days). Sixteen family caregivers also participated. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Community integration was measured using the Mayo-Portland Adaptability Inventory (MPAI). Depression, anxiety and stress were measured using the Depression Anxiety Stress Scale (DASS). The Sentinel Events Questionnaire (SEQ) was used to record life events that potentially influence the transition process.

RESULTS: The majority of women (over 16 at each time-point) experienced mild-moderate impairments in psychosocial integration. A third of the sample reported symptoms of depression (n=8), anxiety (n=9), and stress (n=7) that exceeded clinical cut-off levels on at least one occasion. At 6-months three women reported clinically significant depression and anxiety (12%), and two reported significant stress levels (8%). Positive sentinel events such as return to meaningful occupation were common (n=14). Negative events were also quite common. For example, reduced access to therapy, reported by 10 women, was associated with poorer participation levels.

CONCLUSION: These findings suggest that the presence of sentinel events influences the transition experiences of women with TBI in this sample. Rehabilitation should consider the occurrence and impact of sentinel events as this may facilitate successful transitions.

Language: en