Dr. Dawson et M. Chipman, THE DISABLEMENT EXPERIENCED BY TRAUMATICALLY BRAIN-INJURED ADULTS LIVING IN THE COMMUNITY, Brain injury, 9(4), 1995, pp. 339-353
The disablement that occurs following traumatic brain injury (TBI) can
be extensive and severe and consequently has been difficult to report
on in a comprehensive and thorough manner. We were able to address th
is difficulty by analysing a sub group of data from the Canadian Healt
h and Activity Limitation Survey (HALS) using the theoretical framewor
k of disablement developed by the World Health Organization, the Inter
national Classification of Impairment, Disability and Handicap (ICIDH)
. There were 454 survey respondents (representing 12290 in the Canadia
n population) with disability resulting from a TBI and a mean time pos
t-injury of 13 years. Three handicaps identified in the ICIDH were the
focus of the study: physical independence, work, social integration.
The prevalence of long term handicap was very high with 66% of the sam
ple reporting the need for ongoing assistance with some activities of
daily living, 75% not working, and 90% reporting some limitations or d
issatisfaction with their social integration. Multivariate regression
analysis was used to investigate the determinants of the handicaps. Th
e determinants included: age, gender, level of education, living alone
, physical environment, and specific disabilities. The implications of
these findings are discussed in relation to rehabilitation issues, th
e usefulness of the ICIDH as a model to investigate outcomes, and dire
ctions for future research.