Key Points

 

  • Following ABI, individuals often struggle with independence and integration at home and in the community due to their injury-related deficits, as well as physical and social barriers.
  • Rehabilitation programs focused on social support and integration are effective in promoting independence and productivity in patients with ABI.
  • More intense and structured cognitive rehabilitation in both group and individual settings, improves participants’ satisfaction with community integration and cognitive functioning outcomes, compared with standard, less structured multidisciplinary rehabilitation.
  • Primary caregivers of individuals with ABI experience significant levels of burden, stress, anxiety, and depression.
  • The presence of cognitive, behavioral, and emotional changes in individuals with ABI are strong predictors of anxiety and depression in their caregivers and relatives.
  • Caregivers who are socially isolated feel more burdened, isolated, and dissatisfied.
  • Families that are cohesive, flexible, and communicative adjust better to the consequences of ABI and experience less caregiver strain.
  • Depression rates among caregivers for individuals with ABI range from 22% to 51%.
  • Caregiver depression is strongly associated with their degree of burden, life satisfaction, and coping strategies.
  • Caregivers often feel unprepared for the caregiving role prior to discharge of the individual with ABI.
  • Caregivers supported through programs that combined education with training or therapy experience less burden and better support than those receiving education alone.
  • Caregivers supported through home-based interventions experience less distress than those participating in on-site groups.
  • Following ABI, individuals often experience a decline in their QoL.
  • Health-related QoL is influenced by an individual’s perception of their trauma.
  • Lower psychosocial functioning and increased anxiety and depression are more common among individuals who use non-productive coping strategies.
  • Life satisfaction is influenced by an individual’s disability and recovery; however, the relationship between life satisfaction and patient disability does not appear to be a linear one.
  • Social support groups, coping skills training, and comprehensive case management give patients a better sense of control.
  • Following ABI, those who resume productive activities typically return to lower levels of employment or education, and only a small number are able to return to activities that are comparable to pre-injury levels.
  • Return to work is influenced by age, injury severity, relationship status, functional and cognitive abilities, and as well as pre-injury employment and education.
  • Vocational rehabilitation and resource facilitation programs increase the number of individuals that return to vocational activity.
  • Vocational rehabilitation is most effective when implemented earlier following injury.
  • Supported employment interventions improve job placement and retention post ABI.
  • Pre-injury driving accidents, violations, and behaviours are predictors of post-injury driving fitness.
  • Accidents are more common among individuals with ABI who return to driving, which may be related to patients prematurely returning to driving.
  • Participation in a multidisciplinary rehabilitation program increases the number of patients who return to driving post ABI.
  • Return to driving is more likely for individuals with less severe injuries