THE DISABLEMENT EXPERIENCED BY TRAUMATICALLY BRAIN-INJURED ADULTS LIVING IN THE COMMUNITY

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.