Functional assessment scales. A study of persons after traumatic brain injury.

The purpose of this study was to investigate disability in persons after traumatic brain injury (TBI) by using combinations of functional assessment item, subscale, domain, and full-scale scores to predict (1) the need for assistance in performance of specific physical care tasks measured in minutes of help per day provided by another person in the home and (2) the subject's level of satisfaction with life in general. This study also sought to account for the amount of supervision that persons with TBI may require beyond that needed for physical care tasks. The Functional Independence Measure (FIM) contributed to prediction of subjects' physical care needs. A single-point change in total FIM score was equivalent to an average of about 5 min of help from another person per day. Satisfaction with life in general was predicted mainly by the depression subscale of the Brief Symptom Inventory. However, this latter prediction was only true when subjects who required constant supervision were removed from analysis. Thus, the amount of supervision required by persons with TBI is an important variable to study in this population. Three categories of supervision were identified: constant (all of the time), periodic (daily or weekly), or not at all. The need for supervision and physical assistance from another person and a subject's satisfaction with life in general are important standards by which functional assessment instruments may be compared to reflect, in pragmatic terms, the impact of disability on the lives of individuals and on human and economic resources of the community.