Authors

  1. Niemeier, Janet P. PhD, ABPP
  2. Taylor, Laura A. PhD
  3. Kreutzer, Jeffrey S. PhD, ABPP

Article Content

Objectives: To determine whether (1) a comprehensive, manualized, neuropsychological intervention could be successfully implemented in an acute traumatic brain injury (TBI) rehabilitation setting and (2) at least 50% of study participants could complete a 10-lesson protocol, retain at least 50% of the intervention materials presented, and demonstrate persistence of learning of the materials at 3-month follow-up. Design: Prospective single-factor repeated measures study. Setting: Acute inpatient brain injury rehabilitation unit in trauma level 1 hospital. Participants: Patients (N = 52) with TBI, mean time since injury 30.20 days; injury severity: 16% mild, 22% moderate, 62% severe; gender: 54% men, 46% women; ethnicity: 40% minority, 60% Caucasian. Intervention: Ten manualized intervention sessions addressing primary domains of post-TBI challenge in daily, 1/2-hour individual sessions. Main outcome measures: Pre-, post- and 3-month follow-up assessment with the Intervention Learning Assessment (LA), Neurobehavioral Rating Scale (NBRS), Satisfaction with Life Scale (SWLS), FIM(TM) scores, and Disability Rating Scale (DRS) scores. Pretreatment to posttreatment comparisons of LA, NBRS, SWLA, and FIM(TM) scores. Consumer Treatment evaluation form Post-treatment. Results: Participants were able to retain an average of 89.90% (SD = 9.30) of intervention materials at posttreatment. Overall participants had significant gains (P = .001) from pretreatment to posttreatment on the LA, the SWLS, and the NBRS self-appraisal item, the entire NBRS subscales, FIM(TM), and the DRS items. While there was some decay in learning, pre- to follow-up measures were still significantly improved (P = .001). One hundred percent of participants rated the intervention at least moderately helpful. Age, level of education, race, sex, and length of stay did not significantly affect results. Conclusions: It is feasible to complete a 10-lesson neurobehavioral intervention acutely. Persons with TBI can not only learn information critical to understanding and coping with their injury while in acute care, they can retain a significant portion of what they have learned after discharge from the hospital.