Community integration and health-related quality-of-life following acquired brain injury for persons living at home

Abstract

Primary objective: To study predictors of community integration (CI) and health-related quality-of-life (HRQoL) in a sample of Canadian adult, urban, multi-ethnic persons with acquired brain injury (ABI) receiving publicly-funded community services. Hypothesis 1 examined the predictive utility of age, ratings of disability, functioning and cognition for CI and HRQoL. Hypothesis 2 examined the correlation between CI and HRQoL.

Research design: Cohort study.

Methods and procedures: A convenience sample of community-residing clients completed measures with their care co-ordinators: Resident Assessment Instrument-Home Care (RAI-HC), Disability Rating Scale (DRS), Community Integration Questionnaire (CIQ) and the Quality-of-Life after Brain Injury Instrument (QOLIBRI).

Results: Regression analysis showed DRS scores explained significant variance in CIQ and QOLIBRI. Correlations also showed that cognitive skill and ADL/IADL functioning are strongly related to CI and the Daily life and autonomy QOLIBRI sub-scale. The CIQ Total was not correlated with QOLIBRI Total, although there were some significant correlations between the CIQ social sub-scale and QOLIBRI.

Conclusions: Lesser degree of disability is a key predictor of greater CI and QoL. The present findings suggest that rehabilitation efforts should focus on minimizing disability and promoting social integration and involvement to avoid adverse long-term effects of ABI for community-resident persons.

Keywords: Community integration; case management; head injury; quality-of-life; social reintegration.