Patterns of community integration 2-5 years post-discharge from brain injury rehabilitation

Outcome after traumatic brain injury (TBI) is characterized by a high degre e of variability which has often been difficult to capture in traditional o utcome studies. The purpose of this study was to describe patterns of commu nity integration 2-5 years after TBI. Participants were 208 patients admitt ed to a Brain Injury Rehabilitation Unit between 1991-1995 in Brisbane, Aus tralia. The design comprised retrospective data collection and questionnair e follow-up by mail. Mean follow-up was 3.5 years. Demographic, injury seve rity and functional status variables were retrieved from hospital records. Community integration was assessed using the Community Integration Question naire (CIQ), and vocational status measured by a self administered question naire. Data was analysed using cluster analysis which divided the data into meaningful subsets. Based on the CIQ subscale scores of home, social and p roductive integration, a three cluster solution was selected, with groups l abelled as working (n = 78), balanced (n = 46) and poorly integrated (n = 8 4). Although 38% of the sample returned to a high level of productive activ ity and 22% achieved a balanced lifestyle, overall community integration wa s poor for the remainder. This poorly integrated group had more severe inju ry characterized by longer periods of acute care and post-traumatic amnesia (PTA) and greater functional disability on discharge. These findings have implications for service delivery prior to and during the process of reinte gration after brain injury.