@article{ref1,
title="Self-perceived health care needs and delivery of health care services 5 years after moderate-to-severe traumatic brain injury",
journal="PM & R : the journal of injury, function, and rehabilitation",
year="2014",
author="Andelic, Nada and Soberg, Helene and Berntsen, Svein and Sigurdardottir, Solrun and Roe, Cecilie",
volume="6",
number="11",
pages="1013-21; quiz 1021",
abstract="OBJECTIVE: To describe the self-perceived health care needs in patients with moderate-to-severe traumatic brain injury (TBI) and to assess the impact of functional level at 1-year post injury on patients' unmet needs at the 5-year follow-up. <br><br>DESIGN: Prospective follow-up study. SETTING: Clinical research. PARTICIPANTS: A total of 93 patients participated in the 5-year follow-up. <br><br>METHODS: We registered demographic and injury-related data at the time of admission and scores for the Disability Rating Scale (DRS), Glasgow Outcome Scale-Extended (GOSE) and SF-36 subscales for physical functioning (PF) and mental health (MH) at 1 and 5 years. The patients' self-perceived health care needs and use of health care services at 5 years was main outcome measurement. <br><br>RESULTS: At the 5-year follow-up, 70% of patients reported at least one perceived need. The self-perceived health care needs were met in 39% of patients. The patients with unmet needs (n=29, 31%) reported frequent needs in emotional (65%), vocational (62%) and cognitive (58%) domains. These patients were significantly more likely to present a less severe disability on the DRS at the 1-year follow-up (OR, 0.11; 95% CI, 0.02-0.7; p=.02). Worse MH at the 1-year follow-up and a younger age (16-29 years) largely predicted unmet needs at the 5-year follow-up (OR, 3.28; 95% CI, 1.1-10.04; p=.04 and OR, 4.93; 95% CI, 0.16-15.2; p=.005 respectively). <br><br>CONCLUSION: Gaps between self-perceived health care needs and health care services received at the 5-year follow-up were found. An important message to clinicians who provide health care services in the late TBI phase is that they should be aware of patients' long-term needs regarding cognitive and emotional difficulties. Of equal importance is an emphasis on long-term vocational rehabilitation services. To ensure the appropriateness of health care service delivery, health care services after TBI should be better targeted at less severe TBI population as well.<p /> <p>Language: en</p>",
language="en",
issn="1934-1482",
doi="10.1016/j.pmrj.2014.05.005",
url="http://dx.doi.org/10.1016/j.pmrj.2014.05.005"
}