Outcome Measurement in a Community Head Injury Service

A Preliminary Exploration of Goal-setting in Community-based Rehabilitation for People with Brain Impairment

Community-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.

Long-term employment outcomes in a rural area following traumatic brain injury

One of the major sequelae following traumatic brain injury is a change in employment status. This poses significant challenges for rehabilitation services. Several studies have investigated the longer-term outcome after traumatic brain injury. Longer-term outcome in an economically disadvantaged rural environment with limited rehabilitation services has not been studied extensively. A group of individuals (n = 65) who sustained a traumatic brain injury were compared regarding pre- and post-employment status. The moderate and severely injured sub-groups showed a significant change in employment status. Ideally rehabilitation programs should target re-employment as an outcome. Limited employment opportunities in rural areas may make this more difficult to achieve.