Occupational performance priorities and outcomes in long-term transitional rehabilitation for young adults with acquired brain injury.

Abstract

In a new long-term transitional rehabilitation service following acquired brain injury, occupational performance problems are analysed. The objective was to describe these problems and the participants' prioritization, and also to describe the changes between admission and discharge. Another objective was to describe changes in assessed independence-related disability. Observational clinical study. Young adults (18-25 years), (n = 46), who had earlier undergone traditional medical rehabilitation following acquired brain injury. The Canadian Occupational Performance Measure (COPM) was used on both admission and discharge. Independence-related general disability was assessed using the Glasgow Outcome Scale-Extended (GOSE). Patients identified 122 occupational performance problems as important. Most problems were in socialization (3/7), community activities (1/3), and finding paid or unpaid work (1/4). Self-rated levels of performance and satisfaction in COPM were significantly higher on discharge compared with admission. The range of GOSE scores increased from 4-6 to 4-8 between admission and discharge. Young adults with acquired brain injury tend to prioritize rehabilitation goals to reduce difficulties in establishing relationships and/or in professional life. On discharge, ratings of implementation and satisfaction of performance were distinctly elevated, while assessed global disability was decreased. The results highlight the need for transitional rehabilitation for patient-centred remediating measures.