ABSTRACT
PRIMARY OBJECTIVE: To study predictors of community integration (CI) and health-related quality-of-life (HRQoL) in a sample of Canadian adult, urban, multi-ethnic persons with acquired brain injury (ABI) receiving publicly-funded community services. Hypothesis 1 examined the predictive utility of age, ratings of disability, functioning and cognition for CI and HRQoL. Hypothesis 2 examined the correlation between CI and HRQoL. RESEARCH DESIGN: Cohort study. METHODS AND PROCEDURES: A convenience sample of community-residing clients completed measures with their care co-ordinators: Resident Assessment Instrument-Home Care (RAI-HC), Disability Rating Scale (DRS), Community Integration Questionnaire (CIQ) and the Quality-of-Life after Brain Injury Instrument (QOLIBRI). RESULTS: Regression analysis showed DRS scores explained significant variance in CIQ and QOLIBRI. Correlations also showed that cognitive skill and ADL/IADL functioning are strongly related to CI and the Daily life and autonomy QOLIBRI sub-scale. The CIQ Total was not correlated with QOLIBRI Total, although there were some significant correlations between the CIQ social sub-scale and QOLIBRI. CONCLUSIONS: Lesser degree of disability is a key predictor of greater CI and QoL. The present findings suggest that rehabilitation efforts should focus on minimizing disability and promoting social integration and involvement to avoid adverse long-term effects of ABI for community-resident persons.
Subject(s)
Activities of Daily Living , Brain Injuries/nursing , Brain Injuries/psychology , Community Integration , Quality of Life/psychology , Adolescent , Adult , Aged , Canada , Cohort Studies , Disability Evaluation , Female , Home Care Services , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Psychometrics , Regression Analysis , Surveys and Questionnaires , Young AdultABSTRACT
PRIMARY OBJECTIVE: To describe and evaluate a new day programme for persons living with an acquired brain injury (ABI), including persons exhibiting challenging behaviours. Activities were designed to reduce participants' social isolation, increase participation in community activities and increase social and leisure skills. It was expected that community integration would increase and challenging behaviours and family burden would decrease for day programme participants. METHODS AND PROCEDURES: Pre-post convenience sample design. Sixty-one participants and family members completed questionnaires before starting the day programme and after 6-month participation. MEASURES: Community Integration Questionnaire, Overt Behaviour Scale, Burden Assessment Scale, Goal Attainment Scaling. RESULTS: Participants had increased community integration (p = 0.000) and decreased family burden (p = 0.006). There was a trend to decreased severity of challenging behaviour. Participants and family members were very satisfied. Results suggest that the programme was effective in reducing participants' social isolation and increasing appropriate interpersonal behaviours. CONCLUSIONS: Participation increased community integration and reduced burden on family caregivers. ABI day programmes help fill the void left after other rehabilitation services end and provide survivors with opportunities to engage in a variety of activities. Persons living with ABI have need for ongoing social, recreational and life skill coaching services after formal rehabilitation has been completed.
Subject(s)
Brain Injuries/psychology , Brain Injuries/rehabilitation , Recreation Therapy/methods , Recreation Therapy/psychology , Adult , Aged , Caregivers/psychology , Community Integration/psychology , Female , Humans , Male , Middle Aged , Quality of Life/psychology , Socioenvironmental Therapy , Surveys and QuestionnairesABSTRACT
One hundred and eighty persons with serious mental illness (SMI) in eastern Ontario, receiving services from assertive community treatment teams in Brockville and Kingston were interviewed about substance use. Data were compared to survey findings for the Ontario population. Tobacco use was higher among both men and women in the SMI sample, but use of alcohol and drugs in the past 12 months was lower than population data. The frequency of alcohol use was significantly greater than drug use among the SMI sample.
Subject(s)
Mental Disorders/complications , Substance-Related Disorders/epidemiology , Adolescent , Adult , Aged , Alcohol Drinking/epidemiology , Bipolar Disorder/complications , Female , Humans , Linear Models , Male , Middle Aged , Ontario/epidemiology , Prevalence , Schizophrenia/complications , Smoking/epidemiologyABSTRACT
Three aspects of community integration (i.e., physical, social, and psychological integration) were examined in relation to subjective well-being (SWB) in a sample of 92 persons with psychiatric disabilities receiving services from assertive community treatment (ACT) teams. Although two of the integration variables, namely physical and psychological integration, were related to SWB at the bivariate level, these relationships were not maintained following sequential multiple regression analysis. Findings support previously established relationships between SWB and psychiatric symptoms and between SWB and self-esteem. Results also emphasize the importance of client perceptions of social support that may be attributable, in part, to ACT services.