Traumatic brain injury rehabilitation : services, treatments and outcomes

In 1986 the Trustees of the Nuffield Provincial Hospitals Trust decided to develop a major core programme of studies concerned with the organization, development and improvement of services for physically disabled and frail elderly people. This programme developed rapidly due to the enthusiastic response of those in the field; and by 1992 the total value of the programme was in excess of £2 million and currently totals over £3. 2 million. It comprised a cohesive matrix of grants commissioned throughout the United Kingdom for work in identified areas which, taken in conjunction with existing grants, formed a comprehensive programme of much-needed studies and research in this field. The whole was to be underpinned by a major study planned and financed by the Trust but conducted by the Royal College of Physicians to survey the existing services being provided by some 180 health authorities. This study, together with concern for the handicapped schoolleaver, information about the availability of disability services and the care of mild/moderate head-injured persons, formed the prime initial thrust of the programme. In the case of head injury, the Trust was particularly concerned that there was discontinuity of care for many patients and little evidence as to which treatments were effective. Once patients had stabilized in hospital they were discharged into the community under the care of their general practitioner often without a continuing responsibility from the hospital. Front Matter....Pages i-xiii Front Matter....Pages 1-1 Head injury — the challenge: principles and practice of service organization....Pages 3-11 The epidemiology of head injury....Pages 12-24 A national service: coma to community....Pages 25-36 A regional service: developing a head injury service....Pages 37-50 A rural service: developing rehabilitation in the community....Pages 51-65 An urban community service: head injury — using occupational therapy to meet the challenge of community reintegration....Pages 66-83 A home-based service: a community rehabilitation programme....Pages 84-87 A clinically and neurophysiologically led postacute rehabilitation programme....Pages 88-98 Front Matter....Pages 99-99 Principles and practice of treatment....Pages 101-118 Evaluation of memory rehabilitation: many questions and some answers....Pages 119-140 Slow information processing and the use of compensatory strategies....Pages 141-152 Introduction to behavioural techniques for rehabilitation of brain-injured adults....Pages 153-166 He’s no longer the same person: how families adjust to personality change after head injury....Pages 167-179 Making group work work....Pages 180-192 Developing communications skills: a group therapy approach....Pages 193-204 Front Matter....Pages 205-205 The principles and practice of measuring outcome....Pages 207-212 Disability — the Functional Independence Measure....Pages 213-224 Handicap as a measure of outcome following head injury....Pages 225-233 A score of zero?....Pages 234-244 Choosing outcome measures....Pages 245-258 Reflections....Pages 259-263 Back Matter....Pages 264-273 "Traumatic Brain Injury Rehabilitation offers a wide range of new ideas for service delivery, treatment and evaluation of outcome." "Part One presents the size and nature of the problem in clinical and epidemiological terms at national, regional and local levels, in both urban and rural settings and offers suggestions for appropriate patterns of service." "Part Two has selected distinctive approaches and innovations in treatment such as the use of compensatory strategies in slow information processing, the use of behavioural techniques and a group approach to developing communication skills." "Part Three describes the rationale for choosing methods of assessing outcome and the difficulties and advantages of existing methods." "The book will be an invaluable resource for doctors, therapists, managers and other health professionals working with people with brain injury."--Jacket