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Outcomes of intensive neuropsychological rehabilitation: The relationship between the Dysexecutive Questionnaire (DEX) and European Brain Injury Questionnaire and SMART Goals Attainment
Bateman, A., Brentnall, S., Evans, J., Gartland, D., Gracey, F., Keohane, C., Megoran, R., Psaila, K., WILSON, B.A. & Yeates, G.
Brain Impairment, 6(2), 132-133, 2005
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Objectives: Questionnaire and goal attainment data have been collected at entry and discharge (week 24) from rehabilitation at The Oliver Zangwill Centre. Self- and independent-ratings of brain-injury-symptom frequencies were assessed using the European Brain Injury Questionnaire (EBIQ) and dysexecutive symptoms (DEX) checklist. Change in scores over the course of rehabilitation, and relationships between baseline questionnaire responses and goal attainment at discharge were examined. Methods: Goal attainment is rated at discharge by the interdisciplinary team as 'fully', 'partially', or 'not achieved' against criteria specified within the client-centred goals. Questionnaires are provided to the client for self-rating and to a carer-relative to provide an independent rater perspective. Results: Of 95 clients seen to date, 73% are male and 76% have sustained a traumatic brain injury. Of 676 goals set for the clients, 50 (7%) of these were not achieved. The remainder were fully (47%) or partially (45%) achieved. Changes in questionnaire scores were found to be significant. Self-rating EBIQ data at baseline was partitioned by quartiles, and frequency of goal attainment ratings was examined by Chi-square tests and visual inspection. High scores (i.e. high symptom ratings >140) on the EBIQ were not associated with higher rates of non-achievement of goals. In contrast, low scores (<100, indicating fewer problems) appear to be associated with a higher frequency of fully achieving goals. Conclusions: The data demonstrate that the rehabilitation programme is effective in terms of goal attainment and changes in questionnaire scores. Goals were attained by clients across the range of scores on standardised questionnaires. This may indicate that goals are set with the client that are achievable, appropriate, and realistic. Measurement of efficacy of rehabilitation is difficult because of uncertainty around selection of outcome measures, and lack of a control group for comparison. Nonetheless, these data provide a foundation for further analysis. Abstract only published - Paper given at the Conference on Neuropsychological Rehabilitation, July 11-12, 2005, Galway Ireland.