The Dynamics of Change in Outcomes over the First Five Years Following TBI
Longitudinal studies of persons with traumatic brain injuries
have given
minimal attention to dynamic aspects of outcomes, with only the recent
reports from the TBI Model Systems examining individual
trends over time.
While persistent problems in employment, psychosocial functioning, and
cognitive functions have been common outcomes, research has
not been guided
by theoretical schema of the overall nature of outcomes. The
present study
employs a cross-sequential design to compare samples of
persons with traumatic
brain injuries, one to five years post-discharge from rehabilitation,
with a matched group of persons with traumatic spinal cord
injuries (SCI).
The nature and extent of change in outcomes over this time
period is being
examined. The study design allows testing of the uniqueness of dynamic
outcomes to persons with traumatic brain injury; and will examine the
extent to which patterns of change are individual or
developmental. Premorbid
and injury related differences which may determine later outcomes will
be identified; as well as post-injury treatment and
environmental factors
which may alter outcomes. This study uses a tripartite model
of conceptualizing
outcomes, which has at its foundation the assumption that outcome must
be judged from at least three perspectives, that of the
affected individual
receiving a service, the professional providing it, and the society to
which the individual belongs.
Data collection for this project continues for one more year.
Preliminary
analyses have been conducted for the the first and second evaluations,
comparing individuals who are one, two, and three years post-injury and
two, three and four years post-injury. The analysis of
longitudinal data
will be used to determine the meaningfulness of the
cross-sectional findings.