Effectiveness of Communication-specific Coping Intervention for adults with traumatic brain injury: preliminary results.

People with traumatic brain injury (TBI) describe everyday interactions as a long-term challenge frequently associated with ongoing stress. Communication-specific Coping Intervention (CommCope-I) is a new treatment developed to target coping in the context of communication breakdown. The intervention incorporates principles of cognitive behavioural therapy, self-coaching and context-sensitive social communication therapy. The purpose of this study was to examine the effectiveness of CommCope-I in a group of adults with severe TBI and ongoing functional communication difficulties. Participants were 13 adults with severe TBI (GCS = 3-8; mean age = 35.2 years; mean time post-injury = 7.6 years). The project involved three phases: (1) Control/pre-intervention wait phase (multiple assessments), (2) Treatment (6 weeks), and (3) Follow-up (12 weeks). Repeated measures ANOVA with planned pairwise comparisons were used to test the significance of change. Intervention elicited statistically significant improvements in communication-specific coping, functional communication and stress that were maintained for three months. Improved use of communication-specific coping strategies was evident in clinician blind ratings. Clients reported significant reduction in stress at the end of treatment and one and three months later. This intervention provides a promising means of improving communication-specific coping and reducing communication dysfunction and its negative consequences for people with TBI.

A Prospective Analysis of Olfactory Impairment Recovery After Severe Traumatic Brain Injury.

OBJECTIVE: To investigate the natural progression of olfactory impairment (OI) in individuals with traumatic brain injury (TBI) at 6 months postinjury. PARTICIPANTS: Forty-seven adults (mean age = 43.1 years, SD = 18.2), with predominantly severe TBI (mean posttraumatic amnesia [PTA] duration = 25.5 days, SD = 22.8). DESIGN: Consecutive admission longitudinal study. MAIN MEASURES: Participants were evaluated using the University of Pennsylvania Smell Identification Test (UPSIT) at resolution of PTA and at 6 months post-initial injury. Each participant was also interviewed to explore his or her experience of having an OI. Standard multiple regression was used to assess the ability of age, PTA duration, presence of facial fractures, and initial UPSIT score to predict olfactory performance at 6 months. RESULTS: Thirty-five participants (74%) continued to demonstrate OI at 6 months. Thirty-two participants (68%) showed some improvement, but only 12 of these individuals achieved scores within the normal range. The remaining 15 participants either produced a poorer performance (23%) or demonstrated no change (9%). Initial UPSIT score uniquely accounted for 73.5% of the variance in UPSIT performance at 6 months. CONCLUSIONS: Olfactory impairment persists in a substantial proportion of adults who experience it post-TBI and has the potential to impact a broad spectrum of everyday activities.

"I really hope it comes back" - Olfactory impairment following traumatic brain injury: A longitudinal study.

BACKGROUND: Olfactory impairment (OI) can present in up to 66% of all individuals following traumatic brain injury (TBI) and can have significant implications for everyday life. OBJECTIVE: To investigate the predictive factors, natural progression and consequences of OI following TBI in individuals 12 months post injury. METHODS: In this prospective longitudinal study, 37 adults (28 males, 9 females), mean age 42.3 years (SD 19.4), with predominately severe TBI (mean length of posttraumatic amnesia (PTA) 28.6 days, SD 22.6) were assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Each participant also participated in an open ended interview to allow exploration of their experience of having OI. RESULTS: Thirty (83.33%) of the participants demonstrated persisting OI at 12 months. Nineteen of these participants demonstrated no change in their OI severity category and 4 produced a poorer performance. Thirteen participants (36.11%) demonstrated some recovery with 6 of these performing within the 'normal' range for age andgender. CONCLUSIONS: OI is an enduring impairment for a substantial proportion of individuals who experience it following severe TBI. It impacts a range of everyday activities, regardless of its severity, and requires comprehensive management during rehabilitation.

'If I haven't got any smell I'm out of work': consequences of olfactory impairment following traumatic brain injury.

PRIMARY OBJECTIVE: Although estimates of the incidence of post-traumatic olfactory dysfunction range from 10-66.8%, there has been little research into its functional implications. The objective of this study was to describe the impact of olfactory impairment on daily activities and social participation from the perspective of adults who are living with the impairment. RESEARCH DESIGN: A qualitative research design based on a constructivist grounded theory approach. METHODS AND PROCEDURES: Purposive sampling of five participants with severe traumatic brain injury (TBI) who reported post-injury changes in their olfactory function was utilized. No participant had a pre-injury history of olfactory disturbance. The presence of olfactory disturbance was confirmed using the University of Pennsylvania Smell Identification Test (UPSIT). A semi-structured interview was employed to ascertain the participants' experiences. All interviews were transcribed verbatim and thematic analyses applied. CONCLUSIONS: The themes that emerged demonstrated olfactory dysfunction has significant impact on a range of activities and social roles.