Research Reports - Identifying factors associated with perceived success in the transition from hospital to home after brain injury

Nalder, Emily BOccThy (Hons); Fleming, Jennifer PhD; Foster, Michele PhD; Cornwell, Petrea PhD; Shields, Cassandra BPsych (Hons); Khan, Asad PhD

Journal of Head Trauma Rehabilitation:
March/April 2012 - Volume 27 - Issue 2 - p 143–153

Objective: To identify the factors associated with perceived success of the transition from hospital to home after traumatic brain injury (TBI).

Design: Prospective longitudinal cohort design with data collection at discharge and 1, 3, and 6 months postdischarge.

Participants: A total of 127 individuals with TBI discharged to the community and 83 significant others.

Main Measures: An analog scale (0–100) of perceived success of the transition from hospital to home rated by individuals and significant others; Sentinel Events Questionnaire; EuroQol Group Quality-of-Life measure visual analog scale; Sydney Psychosocial Reintegration Scale; Mayo-Portland Adaptability Inventory-4; short form of the Depression, Anxiety, Stress Scales; Craig Hospital Inventory of Environmental Factors; and Caregiver Strain Index.

Results: Greater perceived success of transition for individuals with a TBI was associated with higher levels of health-related quality of life, level of community integration, and more severe injury. Among survivors, sentinel events such as returning to work and independent community access and changing living situation were associated with greater perceived success; financial strain and difficulty accessing therapy services were associated with less success. Among significant others, lower ratings of transition success were associated with higher significant other stress levels as well as lower levels of community integration and changes in the living situation of the individual with TBI.

Conclusion: A combination of sentinel events and personal and environmental factors influences the perceptions of individuals and their families regarding the success of the transition from hospital to home.

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