Laraine Winter1,2, Helene J Moriarty2,3, Keith Robinson4,5, Catherine V Piersol6, Tracey Vause-Earland6, Brian Newhart4, Delores Blazer Iacovone4, Nancy Hodgson7, Laura N Gitlin7. 1. a Philadelphia Research and Education Foundation. 2. b Nursing Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA. 3. c Villanova University College of Nursing , Villanova , PA , USA. 4. d Medical Rehabilitation Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA. 5. e Perelman School of Medicine , University of Pennsylvania , PA , USA. 6. f Thomas Jefferson University , School of Health Professions , Philadelphia , PA , USA. 7. g The Center for Innovative Care in Aging, School of Nursing , Johns Hopkins University , Baltimore , MD , USA.
Abstract
OBJECTIVE: Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. SETTING: Interviews and intervention sessions were conducted in homes or by telephone. PARTICIPANTS: Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. DESIGN: This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. MAIN MEASURES: VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. RESULTS: At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. CONCLUSION: A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.
RCT Entities:
OBJECTIVE:Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. SETTING: Interviews and intervention sessions were conducted in homes or by telephone. PARTICIPANTS: Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. DESIGN: This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. MAIN MEASURES: VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. RESULTS: At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. CONCLUSION: A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.
Authors: Megan E Shepherd-Banigan; Abigail Shapiro; Jennifer R McDuffie; Mira Brancu; Nina R Sperber; Courtney H Van Houtven; Andrzej S Kosinski; Neha N Mehta; Avishek Nagi; John W Williams Journal: J Gen Intern Med Date: 2018-05-07 Impact factor: 5.128
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Authors: Ida M H Borgen; Solveig L Hauger; Marit V Forslund; Ingerid Kleffelgård; Cathrine Brunborg; Nada Andelic; Unni Sveen; Helene L Søberg; Solrun Sigurdardottir; Cecilie Røe; Marianne Løvstad Journal: J Clin Med Date: 2022-02-12 Impact factor: 4.241