CONCORDANCE OF PATIENTS AND FAMILY MEMBERS RATINGS OF NEUROBEHAVIORALFUNCTIONING AFTER TRAUMATIC BRAIN INJURY

Objective: To examine differences in family and patient evaluation of neurobehavioral functioning in adults with traumatic brain injury (TBI ). Design: Differences were examined by conducting 70 paired sample t tests on scale items and 6 paired sample t tests on scale scores from a neurobehavioral inventory. Setting: Medical center outpatient clinic . Participants: Three hundred one consecutive adult patients with TBI and 301 informants, primarily family members, completed the neurobehav ioral inventory. Main Outcome Measure: Neurobehavioral Functioning Inv entory (NFI) comprised of six scales with items describing symptoms an d daily living problems. Results: Paired t test analyses of the six sc ales indicated that patients reported a significantly greater level of communication problems than did their matched family members. No diff erences were found for the other five scales. Paired t test analyses o f the 70 scale items revealed significant differences in patient and f amily ratings for only 13 items. In all 13 instances, patients reporte d greater levels of dysfunction than were reported by their family mem bers. Analysis of variance (ANOVA) indicated a main effect of injury s everity for only the Communication and Memory/Attention scales. Conclu sions: Findings indicate general agreement between family members and patients regarding patients' everyday problems. Results do not support contentions that patients tend to underestimate difficulties. Agreeme nt levels appear related to injury severity, item specificity, and ite m content. More research is needed to identify other variables relatin g to agreement levels, including age, injury severity, and amount of c ontact between patients and family members. (C) 1997 by the American C ongress of Rehabilitation Medicine and the American Academy of Physica l Medicine and Rehabilitation.