Methods of Evaluation in a Cognitive-behavioural Rehabilitation Programme for Brain Injury: The Experience of Ticehurst House and Unsted Park Hospitals

Abstract

This article summarises experience of evaluation gained over 9 years of providing cognitive-behavioural rehabilitation . Measures of impairment are not particularly useful as indicators of outcome but do contribute to rehabilitatio n planning. Measurement of disability is central to rehabilitatio n but current measures have a limited ability to assess cognitive disability despite their relative strength in assessing physical problems. Goal setting is an integral part of the rehabilitatio n process but has limited utility in the evaluation of outcome. Although handicap is important as an index of outcome, this is difficult to measure whilst the person is resident in a rehabilitation centre. The use of modified measures and methods of assessment have helped to compensate for some of the limitations . However, new or revised measures are needed to allow repeated measurement and to enable satisfactory assessment of change in cognitive disabilities.There are several aspects of a service that influence the selection of methods for assessment. These include historical factors, the design and aims of the programme, the constitution of the rehabilitation team, and of course, the nature of the patients' difficulties and goals.Our Brain Injury Rehabilitation Service was initially set up at Ticehurst in 1989 as an inpatient and day patient unit for those with cognitive and Requests for reprints should be sent to Michael Oddy, Ticehurst House Hospital, Ticehurst, Wadhurst, East Sussex TN5 7HU, UK.

Assessing executive performance during cognitive rehabilitation

“…In fact, there are few measures that tap the cognitive aspects of everyday behaviours. Oddy, Alcott, Francis, Jenkins, and Fowlie (1999) stated that the absence of cognitive measures of everyday behaviour was conspicuous, a situation that has not altered in the subsequent years.…”

Acupuncture for Central Pain Affecting the Ribcage following Traumatic Brain Injury and Rib Fractures – a Case Report

“…20 It avoids the use of physical items in the scale and is useful for assessing psychological distress in patients with any kind of physical disability. 21 It is used within the TBI population in clinical practice and research, [22][23][24] but has never been validated for these patients. This patient reported reduced anxiety and improved mood, whilst the HADS score remained unchanged.…”