About this Research Topic
A large proportion of patients with traumatic brain injuries (TBI) sustain long-term physical, cognitive and emotional impairments that have a profound impact on their everyday level of functioning and community participation and reintegration. Participation in daily life activities and work is identified as one of the most important outcomes of rehabilitation following TBI both by patients/ their families and health care professionals. The medical complexity of TBI and the strong role of psychological and environmental factors in affecting prognosis and outcome require individualized and often long-term rehabilitative care. It is a clinical challenge to provide and evaluate the long-term services needed to target aspects of participation that patients with TBI experience as particularly challenging. It is not easy to identify single predictors for long-term participation, as there seems to be a close interaction between several factors. For example, motor and cognitive deficits appear to have significant impact on participation in the early stages, whereas personal, emotional and social factors may play a major role in later stages of TBI. There is thus reason to believe that injury-specific factors play the greatest prognostic role early on in recovery, while general factors such as resilience, access to social support, degree of pre- and co-morbid psychological problems, and substance dependency play a greater role in long-term adjustment.
Despite knowledge that cognitive, emotional and vocational problems are experienced as the most troubling long-term symptoms, the most commonly provided service in all stages of TBI is physiotherapy. A multidimensional assessment of needs related to different domains of participation including patients' subjective experiences may help care providers to define common service goals, and to coordinate and individualize service delivery. There are a limited number of well-designed TBI studies regarding determinants of participation as experienced by the patients, effective rehabilitation and community re-entry programs, and long-term follow-up studies.
As many individuals worldwide are living with a TBI-related disability, it is our goal that the articles published in this Research Topic will contribute to an increased recognition of the impact of TBI on participation in daily life activities and work. Such knowledge will be helpful for improving care, rehabilitation, and long-term service delivery after TBI. Authors are welcome to submit original research papers related to topics of interest. We are particularly interested in papers that explore the impact of TBI along with relevant pre- and co-morbid variables (intracranial damage, somatic complains, cognitive deficits, behavioral and emotional difficulties and co-morbidities) on participation in daily activities and return to work including trajectories of social integration, family related functioning and productivity as well as patients’ needs and the provision of healthcare services and social support, using any approach for research (e.g. case-control studies, empirical research, rehabilitation program evaluations, literature review) and methods (qualitative and/or quantitative).
Keywords: TBI, community integration, return to work, long-term rehabilitation, health care services
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