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Table 9 Interventions for Life Satisfaction Post ABI

Author Year Country Study Design Sample Size Methods Outcome
  Backhaus et al. (2010) USA RCT PEDro=4 N=40   Population: ABI=20, Caregivers=20; Gender: Male=14, Female=26.  Intervention: Each group had 10 caregivers and 10 individuals with ABI. Those in the treatment group received Brain Injury Coping Skills (BICS) training. The control group was waitlisted. BICS training involved psychotherapy, stress management training, problem solving skills, and group discussion (12-2 hr sessions). Outcome Measures: Brief Symptoms Inventory-18 (BSI-18), Brain Injury Coping Skills Questionnaire. 1.       There was no difference found between the two groups in relation to psychological distress (p>0.10). 2.       The control group showed more emotional distress at 3mo by elevations on the BSI-18 subscales (p<0.05). 3.       Greater perceived self-efficacy was associated with less emotional distress (p=0.007).
Cicerone et al. (2008) USA RCT PEDro=6 N=68 Population: TBI; Gender: Male=46, Female=22; Severity: Severe=40, Moderate=16, Mild=9, Unknown=3. Treatment Group (n=34): Mean Age=38.7yr; Mean Time Post Injury=49.6mo. Control Group (n=34): Mean Age=34.5yr; Mean Time Post Injury=37 mo. Intervention: Patients were randomly assigned to an Intensive Cognitive Rehabilitation Program (ICRP, treatment) or a standard neurorehabilitation program (control). ICRP received holistic neuropsychological rehabilitation in cognitive, emotional, interpersonal, and functional interventions, and controls received discipline-specific therapies. All participants received 15 hr/wk for 16 wk. Outcome Measures: Community Integration Question (CIQ), Perceived Quality of Life Scale (PQOL), Self-efficacy Scale (SES), Employment. 1.       The treatment group had significant increases on CIQ total (p=0.004), PQOL (p=0.004) and SES (p=0.024) compared to controls post treatment. 2.       Employment post treatment was acquired by 47% of the treatment group compared to 21% of controls. 3.       Controls were more likely to receive continued comprehensive treatment after the study than the treatment group (p=0.001).
Heinemann et al. (2004) USA PCT N=319 Population: TBI; Mean Age=36yr; Gender: Male=246, Female=73; Mean Time Post Injury=1.4 yr. Intervention: Patients with substance abuse problems received comprehensive case management treatment (treatment, n=217) or standard care (control, n=102). Outcome Measures: Community Integration Questionnaire (CIQ), Satisfaction With Life Scale (SWLS). 1.       The treatment group received more total hours of case management than the control group (p<0.01). 2.       Both groups experienced equivalent gains on CIQ (p=0.001). 3.       The treatment group experienced greater gains on SWLS than the control group at 9mo.
Cusick et al. (2003) USA Case Control N=132 Population: TBI; Gender: Male=84, Female=48; Time Post Injury=1-3yr; Severity: Moderate=14, Severe=119. Intervention: Patients received post-injury care through the Colorado Medicaid Program (CMP; n=66) and were compared to a matched sample who did not receive this service (control group, n=66). Patients were interviewed after treatment. Outcome Measures: Craig Handicap Evaluation and Reporting Technique-Short Form (CHART-SF), Sickness Impact Profile-Alertness Behaviour, Satisfaction with Life Scale (SWLS), Short-Form Health Survey – Short Form (SF-12). 1.       The CMP group showed significantly fewer problems in terms of SF-12 mental health (p=0.006), alcohol use (p=0.003), and risk of using alcohol (p<0.001) compared to controls. 2.       The CMP group used significantly more case management (p=0.005), physical therapy (p=0.038), second rehabilitation admission (p=0.013), and group home stay (p=0.008) compared with the controls. 3.       The CMP group had poorer outcomes on the total CHART-SF (p<0.01) and on the physical independence, cognitive independence, mobility, and occupational subscales. 4.       No significant differences were found on SWLS (p=0.771).
Vandiver & Christofero-Snider (2000 ) USA Case Series Ninitial=49, Nfinal=15 Population: TBI; Gender: Male=34, Female=15. Intervention: Patients attended a community psychosocial support program (2x/mo). Outcome Measures: Self-Efficacy Scale, Quality of Life interview. 1.       At follow-up, self-efficacy scores increased from 3.36 to 3.61 (p<0.05). 2.       Participants perceived social relations, leisure and finances as important variables contributing to quality of life.
Armengol (1999) USA Pre-Post N=6 Population: TBI, Mean Age=30.33yr; Gender: Male=3, Female=3; Mean Time Post Injury=22.16 mo. Intervention: Patients attended a support group focused on education, coping skills, and goal setting (2.5 hr/wk for 10 wk). Outcomes were assessed before and after treatment and at 1yr follow-up. Outcome Measures: Beck Hopelessness Scale (BHS), Purpose In Life test (PIL), Perceived Self-Regulatory Ability Inventory (PSRA). 1.       Significant reduction in hopelessness and improvement in feelings of control and destiny were found post-intervention on BHS, PIL and PSRA (p<0.05). 2.       At 1yr follow-up, all patients had maintained a positive attitude and 5 patients had returned to work or education.
Carbonneau et al. (2011) Canada Pre-Post NInitial=5, NFinal=5 Population: TBI=3; Mean age= 39.33yr; Gender: Male=3; Mean Time Post Injury=>1yr; Severity: Moderate-to-Severe=3. Caregivers=2: Mean age=not reported; Gender: not reported. Intervention: Participants took part in a Leisure Education Program (LEP) which involved ten one-on-one sessions held over 7-10wks. The program focused on: ·         Fostering awareness/participation in new and/or alternative ways to pursue leisure activities ·         Build skills in individually selected leisure pursuits ·         Foster increased leisure satisfaction Outcome measures were assessed at baseline, at the end of the program and 1mo follow-up. Outcome Measures: Katz Adjustment Scale (KAS), Leisure Satisfaction Scale (LSS), Leisure self-efficacy scale, General Well-Being Schedule, Sickness Impact Profile (SIP), Mayo Portland Adaptability Inventory (MPAI-4), the facilitator (RA) log in which the RAs documented their experiences with the program, audio-recorded program sessions, interviews with participants 1.        No statistical analyses were conducted. 2.        All three participants with TBI reported improved leisure satisfaction and self-efficacy following the completion of the LEP. 3.        This extended to improvements in general wellbeing and health-related quality of life for two of the three participants.
Geurtsen, Van Heugten, Martina, & Geurts (2012) Netherlands Pre-Post NInitial=70, NFinal=67 Population: TBI=47, stroke=7, brain tumor=10, encephalitis=4, hypoxia=2; Mean Age: 25.1±7.9yr; Gender: Male=46, Female=24; Mean Time Post Injury=5.2y; Severity: Mean GCS=7.5 Intervention: Participants attended a structured residential treatment program consisting of three modules: the independent living module (100h per person), the social-emotional module (110h per person), and the vocational module (44h per person). Outcome measures were assessed at inclusion (T0), the start of the treatment 3mo later (T1), the end of the treatment (T2) and 1yr follow-up after the end of treatment (T3) Outcome Measures: Community Integration Questionnaire (CIQ), Employability Rating Scale (ERS), living situation, school, work situation, work hours, Center for Epidemiological Studies Depression Scale (CES-D), EuroQOL quality of life scale (EQ-5D), World Health Organization Quality of Life Scale Abbreviated (WHOQOL-BREF; 5 scales), Global Assessment of Functioning (GAF) scale 1.        Participants’ levels of depression decreased significantly immediately after treatment (CES-D; p<.001), 2.        Participants’ quality of life improved significantly immediately after treatment (EQ-5D; p=.008; EuroQOL Health Status visual analog scale; p<.001; GAF p<.001; WHOQOL-BREF; overall; p=.008)
Geurtsen, Van Heugten, Martina, Rietveld, et al. (2012) Netherlands Post-Test NInitial=67, NFinal=63   *Follow-up study of Geurtsen, Van Heugten, Martina, & Geurts (2012)         Population: TBI=42, stroke=6, brain tumor=9, encephalitis=4, hypoxia=2, Mean Age= 24.7±7.2yr, Gender: Male=42, Female=21, Mean Time Post Injury=5.1±5.3yr, Severity: Mean GCS=7.8 Intervention: Participants attended a structured residential treatment program consisting of three modules: the independent living module (100h per person), the social-emotional module (110h per person), and the vocational module (44h per person). Outcome measures were assessed 1 and 3yr post treatment. Outcome Measures: Community Integration Questionnaire (CIQ), Employability Rating Scale (ERS), living situation, school, work situation, work hours, Center for Epidemiological Studies Depression Scale (CES-D), World Health Organization Quality of Life Scale Abbreviated (WHOQOL-BREF; 5 scales) 1.        There were no significant differences for any of the outcome measures between the 1yr and 3yr follow-up assessment (p>.05), indicating that the post-intervention gains at 1yr were maintained at 3yr follow-up.
Mitchell et al. (2014) Australia Pre-Post NInitial=13, NFinal=12 Population: TBI=10, Non-Traumatic ABI=2; Mean Age=36yr; Gender: Male=8, Female=4; Mean Time Post Injury: <12mo=1, 12-24mo=4, 24-48mo=7; Severity: Mild=0, Moderate-to-Severe=12 Intervention: Participants took part in Pushing the Boundaries, a 1wk residential leisure education program (LEP) conducted in group format. The LEP provided participants with the opportunity to engage in various sporting and recreational activities and involved sessions on social communication skills. Outcome measures, except the semi-structured interview, were assessed prior to, immediately following and at 3mo post program. Brief semi-structured interviews were conducted with participants at 3-mo follow-up Outcome Measures: Leisure Satisfaction Scale (LSS), World Health Organisation Quality of Life – BREF (WHOQOL-BREF) and Rosenberg Self Esteem Scale (RSES), brief semi-structured interviews 1.        Participants showed significant improvements in leisure satisfaction 3mo post program (LSS; p=0.002) 2.        Participants showed significant improvements in self-esteem 3mo post program (RSES; p=0.03) 3.        Participants showed significant improvements in QoL (p=0.02 to 0.008 for four domains of the WHOQOL-BREF) 3mo post program.