Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study

Chesnel, C.; Jourdan, C.; Bayen, É.; Ghout, Idir; Darnoux, E.; Azerad, S.; Charanton, James; Aegerter, Philippe; Pradat‐Diehl, Pascale; Ruet, A.; Azouvi, Philippe; Vallat‐Azouvi, Claire

doi:10.1177/0269215517734294

Cited by 30 publications

(17 citation statements)

References 66 publications

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“…Previous studies have shown that long-term outcome in term of global functioning of participation in a paid productive activity was determined by multiple factors, some of which were socio-demographic, such as age and sex, others were related to the severity of TBI (4, 6). The aim of the present study was to give a comprehensive picture of long-term (8-year) outcome in an homogeneous sample of patients with severe TBI and to assess its determinants or related factors, in line with the previous reports on this cohort (11, 14–19).…”

Section: Introductionmentioning

confidence: 85%

“…For the study, we created a questionnaire to assess the neurological and somatic impairments. Patients were asked the following question “What are the physical difficulties you have because of head trauma?.” Eleven of the most frequent deficiencies reported in previous studies were proposed with the possibility of classifying them as “none,” “moderate,” “severe.” Cognitive and behavioral complaints were investigated with the Brain Injury Complaint Questionnaire (BICoQ), after the following explanation “We will ask you questions about the problems you face in your everyday life since the TBI.” Twenty-five closed questions were given addressing frequently reported cognitive and behavioral complaints (19, 24). The same questions were asked to their relatives.…”

Section: Methodsmentioning

confidence: 99%

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A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury

et al. 2019

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Background and aims: Severe traumatic brain injury is a leading cause of acquired persistent disabilities, and represents an important health and economic burden. However, the determinants of long-term outcome have rarely been systematically studied in a prospective longitudinal study of a homogeneous group of patients suffering exclusively from severe TBI Methods: Prospective observational study of an inception cohort of adult patients with severe traumatic brain injury in the Parisian area (PariS-TBI). Outcome was assessed with face-to-face interview 8 years after Traumatic Brain Injury, focusing on impairments, activity limitations, and participation restriction. Results: Five hundred and four patients were included between 2005 and 2007. At 8-year follow-up, 261 patients were deceased, 128 were lost to follow-up, 22 refused to participate, and 86 were finally evaluated. Age, gender, initial injury severity did not significantly differ between evaluated patients and lost to follow-up, but the latter were more frequently students or unemployed. Mean age was 41.9 ( SD 13.6), 79% were male, median initial Glasgow Coma Scale Score was 6. The most frequent somatic complaints concerned balance (47.5%), motricity (31%), and headaches (36%), but these were less frequent than cognitive complaints (Memory 71%, Slowness 68%, Concentration 67%). According to the Hospital Anxiety and Depression Scale (HADS), 25 % had a score >8 for anxiety and 23.7% for depression. According to the Extended Glasgow Outcome Scale, 19.8% remained severely disabled, 46.5% moderately disabled, 33.7% had a good recovery. Older age, longer education duration, lower functional status upon intensive care discharge, and more severe 8-year dysexecutive problems were significantly associated with a lower Extended Glasgow Outcome Scale score in multivariable analysis. At 8 years, 48.7% of patients were employed in a productive job. Of those, 38% declared a salary loss since traumatic brain injury. Unemployment was significantly associated with lower 1-year GOSE score and more severe 8-year dysexecutive problems. Conclusions: These results from an inception cohort study highlight the fact that long-term outcome after severe TBI is determined by a complex combination of injury-related, demographic and neuropsychological factors. Long after the injury, persisting impairments still interfere with social integration, and participation.

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Section: Introductionmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury

et al. 2019

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“…However, in a study conducted four years after TBI, with 90 patient-family pairs, the lack of self-awareness only significantly influenced the burden perceived by the family member, and was not related to the severity of the initial trauma, the sociodemographic data, the severity of impairments (neurocognitive and mood), limitations of activity or participation or quality of life of the patient (Chesnel et al, 2018).…”

Section: Self-awareness From Cognitive Neurosciencementioning

confidence: 90%

“…In Impairment Self-Awareness deficits (ISA) that can arise after TBI, patients experience difficulties in understanding the disabilities resulting from their injury and the impact these deficiencies have on their functional capacity, these characteristics make these patients very difficult to treat in rehabilitation plans (Noé et al, 2005;Prigatano, 2005;Prigatano & Sherer, 2020;Vales, 2020). They fail to assess their neurobehavioral competencies, particularly with regard to cognitive and social functioning, they have a reduced ability to adopt the perspective of another person (Bivona et al, 2014;Chesnel et al, 2018).…”

Section: Lisandro Heber Vales Mottamentioning

confidence: 99%

Complete Journal

Martínez¹

2021

JACN

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“…9 To help persons with injuries return to a good life rather than social isolation, rehabilitation needs to use strategies to combat stigma and target motor, cognitive and social skills that enhance personal and work relationships. 46,47 Rehabilitation needs to include a social perspective that also understands the consequences of the disease or injury, and uses effective strategies to deal with them. As an example, one strategy is to help establish links with groups with similar interests to the injured person.…”

Section: (Continued)mentioning

confidence: 99%

Is independence enough? Rehabilitation should include autonomy and social engagement to achieve quality of life

McClure

Leah

2020

Clin Rehabil

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Purpose: This discussion paper argues that holding independence as the central goal for rehabilitation has limitations that hinder successful outcomes. It shows why autonomy and social engagement should also serve as goals of rehabilitation, in order to achieve quality of life and effective functioning. Methods: The paper reviews problems arising from the over-emphasis on independence in rehabilitation. Although independence is a valuable goal on some tasks, it is sometimes not possible or desirable and is best complimented by autonomy and social engagement. Autonomy recognises that enacting some goals requires the support of other people. Autonomy is thus linked to social engagement (connectivity) in the workplace and personal relationships. The paper applies this framework to motor and cognitive disabilities. Results: The inclusion of autonomy and social engagement as goals for rehabilitation addresses the limitations of independence and can serve the unifying aim of enhancing the person’s quality of life. These goals apply equally to motor disabilities and the cognitive and behavioural effects of injuries which affect personal and work relationships. Conclusions: Rehabilitation is likely to be more effective if it aims at a combination of independence, autonomy and social engagement, in service of the goal of a good quality of life.

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Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study

Cited by 30 publications

References 66 publications

A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury

A Detailed Overview of Long-Term Outcomes in Severe Traumatic Brain Injury Eight Years Post-injury

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Is independence enough? Rehabilitation should include autonomy and social engagement to achieve quality of life

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